Is It Narcolepsy or Depression Making My Patient Sleepy?

Abstract

Hypersomnia is a symptom of disturbed sleep. Depressive disorders most commonly result in insomnia with fatigue and tiredness but not excessive sleepiness. Hypersomnia with depression is considered a feature of atypical depression and is more common in patients with bipolar disorder or the adolescent/young adult. Hypersomnia becomes clinically significant when the fight against sleepiness results in social and occupational dysfunction. The classic disorder of hypersomnia is narcolepsy with or without the emotionally triggered muscular weakness of cataplexy, although insufficient sleep, circadian misalignment, medication side effect, and sleep disorders such as sleep apnea and idiopathic hypersomnia are other reasons for excessive daytime sleepiness. What follows is a case of a man whose college career was interrupted by hypersomnia, leading to treatment of a presumed depression but subsequent diagnosis of narcolepsy, type II without cataplexy.