Many people with idiopathic hypersomnia (IH) experience depressive symptoms. The cause of IH is unknown, so it’s hard to say whether one condition causes the other.

When you’re living with idiopathic hypersomnia (IH), completing daily activities can be challenging. Excessive drowsiness can make it difficult to maintain relationships and keep on top of tasks at home, school, or work.

Many people with IH experience problems with their mental health in addition to the condition’s physical effects. An older 2013 study estimated that up to one-quarter of people with IH experience depressive symptoms.

This figure may underestimate the actual frequency of depression in people with IH, as a more recent survey showed that more than 90% of respondents with a hypersomnia disorder reported experiencing at least one symptom of depression or anxiety.

The relationship between IH and depression is complex. This article breaks down some of your frequently asked questions about depressive symptoms with IH, including the role of treatment on either condition.

Hypersomnia, or an inability to stay awake and alert during the day despite adequate sleep, is common in depression. Decreased energy and fatigue are often considered key signs that someone may be experiencing depression.

But the defining nature of idiopathic hypersomnia is that it’s idiopathic in nature. That is, there’s no clear, identifiable cause of the excessive drowsiness and sleep disturbances that people with IH experience.

So while hypersomnia is often a symptom of depression, IH is a distinct sleep disorder.

Compared with people who experience hypersomnia due to a mood disorder such as depression, people with IH have been found to have:

  • faster sleep onset
  • better quality sleep
  • greater time asleep
  • more difficulty waking up from sleep

Because the cause of IH is unknown, it’s hard to say whether one condition causes the other.

Some experts have suggested that depressive symptoms could be the result of difficulties adapting to life with IH. The symptoms of IH can affect many aspects of general well-being, including relationships and social health, work or academic performance, and the ability to complete daily activities.

But treatments that reduce drowsiness and other IH symptoms don’t always improve depressive symptoms, so the relationship between the two likely isn’t so simple.

It’s also possible that the underlying physical or environmental factors that lead to depressive symptoms also trigger IH. This would mean that the two conditions are linked but not necessarily caused by one another.

Until more is uncovered about what causes IH, it may be difficult to know exactly how these two conditions are related.

A variety of depressive symptoms are common with IH. According to an online survey completed by 129 adults with IH, the most common mental health symptoms were:

  • difficulty concentrating
  • loss of interest in regular activities
  • irritability
  • sad mood
  • social isolation

Anxiety, guilt, and feelings of worthlessness were also commonly reported.

In general, research suggests that depression in IH can typically be managed with medication.

However, the effects of antidepressant use on IH are complicated. Some antidepressants can cause sleep disturbances, and others increase sleepiness.

A recent 2022 study also found that in people with IH and narcolepsy, additional problems related to deep rapid eye movement (REM) sleep were more common in people who were taking antidepressants.

If you need an antidepressant to help manage your depressive symptoms with IH, your healthcare team will work with you to find the right medication and dosage to minimize the impact on your sleep.

Talking with your doctor about your mental health can be overwhelming for some people, and it may be hard to know where to begin. You may find it easier to first discuss the physical symptoms you’re experiencing, such as poor sleep, and then move on to the mental and emotional symptoms.

To help keep the conversation on track and ensure all of your concerns are addressed, the American Academy of Family Physicians recommends that you:

  • set a goal for the appointment
  • write down your symptoms and potential stressors ahead of the appointment
  • state your concerns clearly
  • be open and honest

Once you have a treatment plan established, be sure to follow up with your healthcare team after a few weeks to let them know if your treatment is working or if you have any additional concerns. Your doctor may also be able to refer you to a therapist or other mental health specialist.

Living with IH can affect many aspects of your well-being, including your mental health. Depression is common in people with IH, and the compounding effects of these two conditions can make it increasingly difficult to cope with daily activities and manage relationships.

Depression in IH is manageable, but choosing a treatment method takes some careful consideration, as some antidepressants can lead to or worsen existing sleep problems.

If you believe you’re experiencing symptoms of depression, your healthcare team can help you understand your options and establish a treatment plan that works best for you and your IH symptoms.