Idiopathic hypersomnia (IH) is a sleep disorder that leaves you feeling as though you need to sleep all the time. Exercise may help you manage IH symptoms.

Idiopathic hypersomnia (IH) is a sleep disorder that makes you feel like you need to sleep all the time. With IH, you never feel rested, even though you might sleep more than an average person without the condition. IH also makes it very difficult to wake up. This is known as sleep inertia and can leave you feeling groggy and disoriented for hours after waking up.

Excessive daytime sleepiness has other possible causes, and healthcare professionals typically diagnose IH after ruling out other sleep disorders. IH affects about 1 in 10,000 people. Although people with IH always feel the need to sleep, sleeping doesn’t make them feel better. When you live with IH, you never feel refreshed.

In addition to excessive daytime sleepiness, you may experience difficulties with memory and concentration. IH affects your quality of life, making it almost impossible to work, be present with your family, and socialize.

Some medications are used to treat IH, but the results are mixed. If you have IH, you might be looking for other ways to manage your deep fatigue.

There is some evidence that exercise might play a part in managing this condition.

Here’s what we know about the connection between daytime sleepiness and exercise.

A healthcare professional might prescribe certain medications to help you manage your IH. Many medications are used off-label. This is when a medication does not have official approval for a specific condition but may still be helpful.

Research suggests that 39–64% of people with IH feel that off-label medications are not enough to manage their symptoms.

The types of medications used as part of IH treatment include:

  • stimulant medications to increase alertness
  • non-stimulant medications that modify brain chemicals to promote wakefulness
  • oxybates (sodium and lower sodium) to promote a deeper night’s sleep to help reduce daytime fatigue

In 2021, the Food and Drug Administration (FDA) approved the first medication to treat IH. It is calcium, magnesium, potassium, and sodium oxybates (Xywav).

This medication was already being used off-label for IH and had previously been approved to treat some other sleep disorders. It improves overnight sleep to decrease daytime drowsiness.

Another type of oxybate medication, sodium oxybate (Xyrem, Lumryz), has been used off-label for IH. It’s high in sodium, which can be a problem since IH can increase the risk of heart disease. Xywav has a lower sodium content but the same active ingredient.

Getting enough sleep doesn’t improve IH, but health experts still recommend keeping a consistent sleep schedule.

Along with medication, many people with IH try other approaches to manage their symptoms. A survey of 129 people with IH showed that 96% of them were trying strategies beyond medication. Of those, 58% were using exercise as part of managing their condition.

If you’re dealing with IH, exercise might feel like the last thing you want to do. But there is some research to suggest that activity might help with excessive daytime sleepiness.

A 2018 study of older adults with sleep disorders found that those who started a daily exercise routine had less daytime sleepiness than those who did not exercise.

Similarly, a small 2019 study found that people who got more steps throughout the day had less daytime sleepiness.

Nick Pellizzari is a registered kinesiologist in Ontario, Canada. He works in a clinic that provides team-based care to people with diabetes and other chronic diseases. He believes that exercise can play a part in managing excessive daytime sleepiness.

“Regular physical activity can lead to improvements in muscle strength and endurance as well as cardiovascular health,” Pellizzari explains. “This helps your body use oxygen and nutrients more efficiently. Your heart and lungs won’t have to work as hard to pump blood and oxygen throughout the body, resulting in more energy for your daily routine.”

Exercise also promotes better sleep due to its effects on hormone levels. “Exercise can improve sleep by increasing melatonin levels in the body,” says Pellizzari. Melatonin is a hormone involved in regulating sleep-wake cycles.

“Exercise may also lead to decreased ghrelin levels in the body. This is known to be elevated in individuals experiencing excessive daytime sleepiness,” explains Pellizzari.

You might want to try different types of exercise to help manage your IH, such as:

  • Aerobic exercise: activities that raise your heart rate, such as walking, jogging, swimming, and dancing
  • Strength training: exercise that builds and maintains muscle, such as lifting weights and using resistance bands
  • Stretching: movements that stretch your muscles to keep you more flexible
  • Balance: exercises that help you maintain balance to prevent falls

Doing a variety of types of exercise can support your overall well-being.

Pellizzari believes it’s important to consider the whole person.

“The best type of exercise may depend on the individual’s age and overall health status,” he explains. “Generally speaking, I would say that people who are struggling with fatigue should aim to increase their physical activity to 150 minutes of moderate to vigorous aerobic physical activity per week, plus strength training 2–3 times per week.”

For many people, that can feel daunting. If you’re barely able to get through your day, it may feel impossible to find energy for exercise.

Pellizzari reminds people that it doesn’t have to happen all at once. “If this seems unattainable, remember that something is better than nothing. Try starting with a 5- to 10-minute walk and building this up over time to longer durations.”

Managing IH is important. Untreated IH can affect your quality of life and make driving dangerous.

IH can be a tough condition to manage, and there’s still a lot we don’t understand about it. Along with medications, exercise can be another strategy to help reduce excessive daytime sleepiness.

Idiopathic hypersomnia is a sleep disorder that causes excessive daytime sleepiness. People with IH also experience sleep inertia, which makes it very hard to wake up after sleeping.

Some medications can help with IH, including Xywav, the first FDA-approved medication for the condition.

Exercise may also play a role in managing daytime sleepiness. Physical activity can increase feelings of wakefulness due to shifts in hormones and may improve sleep quality to reduce daytime sleepiness.