Hypersomnolence Disorder DSM-5 780.54 (ICD-10-CM Multiple Codes)


DSM-5 Category: Sleep-Wake Disorders


According to the new DSM 5 Hypersomnolence Disorder is one of ten sleep-wake disorders that also include breathing-related sleep disorders, nightmare disorder, restless legs syndrome, or substance/medication-induced sleep disorder ( in this case characterized by a need for excessive daytime sleep (EDS). Sufferers have a tendency to fall asleep unexpectedly (American Psychiatric Association, 2013). The DSM 5 criteria for sleep disorders are now designed to be used by generalists in medicine and mental health to ensure it is user friendly for those who lack expertise in the field. Sleep-wake disorders (Reynolds & O’Hara, 2013).  

Symptoms of Hypersomnolence Disorder

Symptoms of hypersomnolence manifest as extreme daytime sleepiness or excessive nighttime sleep (hypersomnia) that is frequently unrefreshing.  Dozing off during the day may happen frequently providing little to no relief.  There may also be signs of depression and underlying metabolic or physical factors.  Other symptoms may include headaches, loss of appetite, irritability, memory loss, cognitive impairment, depression, or low grade fevers, some of which may point to the presence of an underlying physical cause (secondary Hypersomnolence).  Classic symptoms are a difficulty in initiating and maintaining sleep, experiencing a type of sleep later described as unsatisfactory, and snoring (Decker, Lin, Tabassum, & Reeves, 2008).  Because physical conditions such as chronic kidney disease, brain tumor, anemia, cancer, spinal chord disease, several neurological disorders, and fibromyalgia (among others) can be associated with severe disruptions in sleep, the presence of hypersomnolence itself warrants additional medical screening for potential underlying physical causes.


Generally symptoms must be present for at least 3 months.  Determining factors are whether or not the condition is primary (within the brain) or secondary to another underlying cause.  Since there are so many secondary causes, advanced screening may be required in order to narrow down the primary cause and rule out potential ones.  Primary hypersomnias include narcolepsy, primary CNS hypersomnolence and recurrent such as Klein-Levin syndrome.

Specific forms of hypersomnolence disorder also include post-infectious hypersomnia and rarer types such as periodic or post traumatic hypersomnolence. Another variation is Kleine–Levin syndrome (KLS). This sleep disorder is primarily confined to teenage boys, although it can also affect other age groups including women.  KLS is extremely rare, affecting less than one in a million people. Symptoms include intermittent hypersomnolence as well as a variety of behavioral and cognitive disturbances (Ramdurg, 2010) . Idiopathic hypersomnolence, or that of an unknown cause, finds sufferers tend to have greater control over their ability to sleep unlike those with the more severe complications of narcolepsy. Surprisingly, perhaps a quarter of patients may experience spontaneous improvement in their condition; but overall it is considered to be a life-long disorder with treatments that have varying degrees of success.

DSM-5 calls for clinicians to specify comorbid conditions, medical and psychiatric, that are present. The aim is simply to acknowledge the bidirectional and interactive effects between sleep disorders and coexisting medical and psychiatric illnesses.

Finally, DSM 5 requires psychiatric practitioners to consider if a patient’s insomnia disorder – or hypersombolence – is related to a mood disorder and whether the psychological treatment may be a contributor to the sleep problems. One common example of this is the presence of depression. The patient may complain of insomnia as well; and it is incumbent upon the psychiatrist to concurrently specify two coexisting conditions (hypersombolence and depression) (Lamberg, 2013).

Psychologist Based Treatments for Hypersomnolence Disorder

In general, hypersomnolence Disorder is rooted in physical abnormalities that are best treated through pharmaceuticals. However, there may be an underlying presence of depression or comorbid psychological problems stemming from and exacerbated by the inability to deal with the disorder and these may be better handled with the support of psychotherapy in several forms. For example, regular psychotherapy sessions may help the individual create the framework for their life that will incorporate healthy lifestyle choices necessary to combat hypersombolence Disorder that is the least intrusive to one’s personal and professional life.

Pharmacological Treatment for Hypersomnolence Disorder

In the case of hypersomnolence Disorder the aim is to treat the symptoms as there may or may not be identifiable causes. Simply put, treatment relies heavily on the use of medication to counter daytime sleepiness. The most effective treatment for hypersomnolence Disorder is the use of the pharmaceutical Ritalin. However, there are a variety of conventional drugs that have been employed to combat and control sleepiness during the daytime hours. Additionally, excessive daytime tiredness may also be treated with medicines designed to stimulate the central nervous system. These include but are not limited to such drugs as methamphetamines and amphetamines.


As noted, Hypersombolence Disorder is one that may be a lifelong condition; although there have been instances of spontaneous recovery. In light of this sufferers must learn to accept the condition and its symptoms and adjust their lifestyle accordingly. Overall, with the proper treatment and adherence to medical advice patients with the disorder can still enjoy a full and satisfying life.


Unfortunately, hypersomnolence disorder is generally believed to be a lifelong condition that will require some lifestyle changes to maximize one’s ability to function with the symptoms. No single set of changes are effective for all sufferers; therefore behaviors should be individualized according to recommendations by a licensed practitioner. However, some of the more common behaviors one may expect to be advised include informing family, friends and employer of the condition and its manifestations; maintaining a regular sleep schedule and avoiding sleep deprivation that exacerbates the problem; napping for short periods during the day to help prevent an unexpected sleep attack; and never driving when drowsy.

Sufferers should remember that even short naps may result in difficulty awakening; and others should be made aware of the times and places for these short respites. This is particularly true if they are to occur during the workday. Medical professionals may also advise against the use of heavy machinery by those who have a definitive diagnosis of hypersomnolence Disorder. Also, those with hypersomnolence Disorder are also advised to avoid stimulants and barbituates that wreak havoc with the system such as caffeine, alcohol and nicotine. Finally, exercise and a well-balanced diet also help the person with this sleep issue.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Decker, M.; Lin, J.; Tabassum, H. & Reeves, W. (2008). Hypersomnolence and Sleep-related Complaints in Metropolitan, Urban, and Rural Georgia. American Journal of Epidemiology. Vol. 169, Iss. 4.

Lamberg, L. (2013). DSM-5 Sleep-Wake Disorders Section Targets Comorbidity. Clinical and Research News; DOI: 10.

Ramdurg, S. (2010). Kleine–Levin syndrome: Etiology, diagnosis, and treatment. Annals of Indian Academy of Neurology; 13 (4).

Reynolds, C.; O’Hara, R. (2013). DSM-5 Sleep-Wake Disorders Classification: Overview for Use in Clinical Practice. The American Journal of Psychiatry, Vol. 170, No. 10.

Help Us Improve This Article

Did you find an inaccuracy? We work hard to provide accurate and scientifically reliable information. If you have found an error of any kind, please let us know by sending an email to contact@theravive.com, please reference the article title and the issue you found.

Share Therapedia With Others