Materiały źródłowe

• #1 Approach to the patient with excessive daytime sleepiness – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-excessive-daytime-sleepiness/print

  Patients with excessive daytime sleepiness (EDS) have impaired function due to difficulty maintaining wakefulness or alertness at appropriate times during the day. […] EDS is important to recognize because it can signal an undiagnosed sleep disorder or other treatable condition. […] This topic provides a general overview of the epidemiology, etiology, clinical features, and diagnosis of disorders that cause excessive daytime sleepiness. […] The International Classification of Sleep Disorders, Third Edition, Text Revision (ICSD-3-TR) defines EDS as the inability to maintain wakefulness and alertness during the major waking episodes of the day, with sleep occurring unintentionally or at inappropriate times almost daily for at least three months. […] In the ICSD-3-TR, hypersomnolence is used to describe symptoms including excessive sleepiness and increased sleep duration, and hypersomnia refers to specific disorders characterized by hypersomnolence.

• #1 Idiopathic hypersomnia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypersomnia/diagnosis-treatment/drc-20362338

  To diagnose idiopathic hypersomnia, your healthcare professional asks about your symptoms and reviews your medical history. You’ll also likely have a physical exam. You may have several tests to either diagnose idiopathic hypersomnia or rule out other conditions that may be causing the symptoms. […] People who are diagnosed with idiopathic hypersomnia have excess sleepiness every day for at least three months. […] These tools and tests also may help diagnose idiopathic hypersomnia: […] Polysomnogram. With this test, you stay in a sleep center overnight. A polysomnogram monitors your brain activity, eye movements, leg movements, heart rate, breathing function and oxygen levels as you sleep. […] Multiple sleep latency test. For this test, you are given multiple daytime nap opportunities. During these naps, the types and stages of sleep you go through are measured. This test usually is done the day after a polysomnogram.

• #1 Excessive daytime sleepiness (hypersomnia)

  https://www.nhs.uk/conditions/excessive-daytime-sleepiness-hypersomnia/

  Excessive daytime sleepiness (hypersomnia) is a condition where people fall asleep repeatedly during the day. […] Excessive daytime sleepiness (hypersomnia) is different from feeling tired all the time. […] If you have hypersomnia, you may: regularly nap during the day, fall asleep during the day, still sleep for long hours at night. […] To find out why you’re sleeping excessively, a GP might: ask you about possible causes of your sleepiness, such as mental or physical health problems, or any medicines you may be taking, suggest you keep a diary of when you sleep, refer you to a doctor who specialises in sleep disorders. […] Treatment for excessive sleepiness will depend on what’s causing it. It may include medicine to help keep you awake. […] Some medicines, drinking too much alcohol and taking drugs can also cause excessive daytime sleepiness.

• #1 How Is It Diagnosed?

  https://www.webmd.com/sleep-disorders/diagnosis-idiopathic-hypersomnia

  If you have idiopathic hypersomnia (IH), a chronic disorder marked by an urgent need to sleep during the day, the extreme sleepiness you often feel doesn’t ease after a full night in bed. […] A proper diagnosis of IH is the first step toward treatment. […] To determine whether it’s IH or another problem that causes your daytime sleepiness, your doctor will look at your symptoms, get a medical history (of you and your family), and do a physical exam. […] Your health care team may do several tests to rule out those other disorders before moving toward a diagnosis of IH. […] Your doctor can confirm a diagnosis of IH in several ways, including: […] A proper diagnosis of IH is critical to making sure that you receive the best treatment available.

• #1 Hypersomnia Tests and Diagnosis

  https://www.webmd.com/sleep-disorders/daytime-sleepiness

  If you consistently feel drowsy during the day, talk to your doctor. You may be suffering from a sleep disorder called hypersomnia, which causes excessive daytime sleepiness. […] To determine the cause of your sleepiness, your doctor will ask about your sleeping habits, how much sleep you get at night, if you wake up at night, and whether you fall asleep during the day. Your doctor may also suggest the following tests: Blood tests to rule out underlying conditions such as anemia (low blood count) or a sluggish thyroid, Computed tomography (CT) or MRI scans to rule out neurological issues such as multiple sclerosis, Polysomnography, a sleep test used to help determine the cause of many sleep problems, Electroencephalogram (EEG), a test which measures the electrical activity of the brain.

• #1 Diagnosis and management of central hypersomnias – PMC Lock

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3437530/

  Central hypersomnias are diseases manifested in excessive daytime sleepiness (EDS) not caused by disturbed nocturnal sleep or misaligned circadian rhythms. […] The Epworth Sleepiness Scale is a subjective tool mostly used for EDS assessment, while the Multiple Sleep Latency Test serves as an objective diagnostic method for narcolepsy and idiopathic hypersomnias. […] For the diagnosis of central hypersomnias (with the exception of recurrent hypersomnia and hypersomnia due to drug and substance intake), EDS symptoms must be present for at least 3 months. […] The basic diagnostic protocol in EDS consists of nocturnal polysomnography and the Multiple Sleep Latency Test (MSLT). […] MSLT is indicated in suspected narcolepsy and idiopathic hypersomnia and in EDS differential diagnosis. […] The Epworth Sleepiness Scale value of 10 and higher is considered abnormal.

• #1 Excessive Daytime Sleepiness, Hypersomnia, and Narcolepsy – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/sleep-disorders/daytime-sleepiness-hypersomnia-narcolepsy.html

  Excessive daytime sleepiness, or EDS, is a condition that causes a person to feel very sleepy during the day. […] Hypersomnia and narcolepsy are sleep disorders that cause excessive daytime sleepiness. […] A test called the Multiple Sleep Latency Test (MLST) can be used to know if a child has hypersomnia or narcolepsy. […] A sleep study is used to evaluate whether excessive daytime sleepiness is due to hypersomnia or narcolepsy. Narcolepsy is diagnosed if a person enters the REM stage of sleep more quickly than normal. […] A doctor will perform a medical history and physical exam. Blood tests may be used to look for changes in blood counts, hormones, and organ function. […] Tests specific to sleep and sleep patterns may include: Patient and family interview or questionnaire to assess symptoms, Sleep diary to track daytime and nighttime sleep, Sleep study to measure brain, muscle, heart rate, and breathing activity during overnight sleep (polysomnography), Multiple Sleep Latency Test (MSLT) to measure how long it takes the patient to fall asleep. […] In narcolepsy, patients fall asleep quickly and enter REM sleep, a specific part of the normal sleep cycle. People without sleep problems take longer to go into REM sleep and are less likely to enter REM sleep during daytime naps.

• #1 Hypersomnia Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/hypersomnia-overview-4582688

  Hypersomnia is excessive sleepiness when wakefulness is expected. Its also known as excessive daytime sleepiness (EDS). […] If you have symptoms of hypersomnia, your healthcare provider will work with you to identify the root cause of your symptoms. […] Your description of your own experience is by far the most important aspect of your diagnosis. […] A polysomnogram (PSG) is a non-invasive sleep test that measures the brain rhythm with an electroencephalogram (EEG), as well as measuring muscle movements with electromyography (EMG), eye movements, breathing rate, heart rate, and oxygen levels. […] If you are experiencing hypersomnia, your healthcare provider will want to rule out more common causes of excessive daytime sleepiness before diagnosing you with hypersomnolence. […] When there is no identified explanation for excessive sleepiness, it is described either as idiopathic or primary hypersomnia, or idiopathic or primary hypersomnolence. […] Talk to a healthcare provider if you think you are experiencing hypersomnia. They can run tests to rule out other conditions that can cause similar symptoms and help you get the treatment you need so you can regain energy to participate in life.

• #1 Primary Hypersomnia Workup: Approach Considerations, Polysomnography and Multiple Sleep Latency Test, Electroencephalography (EEG)

  https://emedicine.medscape.com/article/291699-workup

  Complete in-laboratory polysomnography (PSG) studies are essential to exclude other sleep disorders, particularly sleep breathing disorder, periodic limb movement disorder (PLMD), and narcolepsy. […] A PSG study is required prior to the Multiple Sleep Latency Test (MSLT) to objectively characterize preceding sleep and uncover potential causes of sleep fragmentation. […] The PSG must have confirmed at least 6 hours of sleep for the MSLT results to be considered in diagnosing hypersomnolence. […] The following PSG features are required for the diagnosis of hypersomnolence: A sleep period that is normal or prolonged in duration, Normal REM sleep latency, A mean sleep latency score of less than 8 on the MSLT, Fewer than 2 sleep-onset REM periods. […] The MSLT evaluates the presence of pathologic sleepiness. The MSLT involves studying the patient during 5 daytime naps taken 2 hours apart. […] The mean MSLT score in hypersomnolence is slightly higher than the score in narcolepsy. The mean MSLT score was found to be 6.5 3.2 minutes for IH versus 3.3 3.3 minutes for narcolepsy. Further, narcolepsy is excluded by the absence of SOREMPs on the 5-nap MSLT.

• #1 Patient Evaluation for Excessive Daytime Sleepiness

  https://www.neurologylive.com/view/patient-evaluation-for-excessive-daytime-sleepiness

  After ruling out inadequate sleep, medications and substance use, and medical conditions that cause EDS, it is necessary to perform polysomnography to rule out other sleep disorders before making a diagnosis of a primary hypersomnia. […] Polysomnography will determine the patients apnea-hypopnea index (normal, 5/hour). It will also evaluate for periodic limb movements of sleep (normal, 15/hour). […] If the sleep history does not suggest sleep apnea or excessive limb movements as the cause of the sleepiness, the polysomnogram should be ordered in conjunction with a multiple sleep latency test (MSLT). […] The polysomnogram will be performed first, followed by the MSLT if the polysomnogram reveals no significant abnormalities. […] MSLT includes 5 nap opportunities wherein the patient attempts to fall asleep within 20 minutes.

• #1 Idiopathic Hypersomnia (Hypersomnolence Disorder) – PsychDB

  https://www.psychdb.com/sleep/3-hypersomnolence-disorder

  The hypersomnolence is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). […] Individuals often report constant sleepiness and prolonged naps. The naps are not refreshing. […] Sleep efficiency is mostly greater than 90%. Some individuals with hypersomnolence disorder have increased amounts of slow-wave sleep. The multiple sleep latency test documents sleep tendency, typically indicated by mean sleep latency values of less than 8 minutes. […] In hypersomnolence disorder, the mean sleep latency is typically less than 10 minutes and frequently 8 minutes or less.

• #1 Excessive Daytime Sleepiness | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0301/p391.html

  A targeted medical history, physical examination, and laboratory assessment should be used to evaluate patients at risk of medical or psychological causes of secondary excessive daytime sleepiness. […] In most cases, overnight polysomnography is required to confirm the diagnosis of OSA and to determine the appropriate pressure levels for treatment using continuous positive airway pressure (CPAP) or a similar system. […] If OSA is not confirmed by polysomnography in a patient who has significant excessive daytime sleepiness, or if sleepiness persists in a patient with OSA despite appropriate therapy, further investigation is required to quantify the level of daytime sleepiness and evaluate for the potential diagnosis of narcolepsy. […] The most common tests for assessing psychological variations in daytime sleepiness are the Multiple Sleep Latency Test (MSLT) and the Maintenance of Wakefulness Test (MWT).

• #1 Idiopathic Hypersomnia: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/sleep-disorders/idiopathic-hypersomnia

  Idiopathic hypersomnia (IH) is a type of sleep disorder. The main symptom is excessive daytime sleepiness or prolonged nighttime sleeping. […] Treatment involves medications and lifestyle changes to manage symptoms. […] This article discusses IH, including the symptoms, causes, diagnosis, and treatment. […] To diagnose hypersomnia, your doctor will take a medical history, perform an exam, and possibly order testing. […] Tests may include: actigraphy, which can measure sleep-wake cycles and circadian rhythms with a device like a wristwatch; blood tests, which can help find or rule out medical causes of hypersomnia; multiple sleep latency testing, which is a nap test the day after a sleep study; overnight oximetry, to rule out nighttime breathing disorders, such as sleep apnea; sleep studies, such as polysomnography.

• #1

  https://www.xywavhcp.com/idiopathic-hypersomnia/diagnosis/

  Idiopathic Hypersomnia (IH) is a unique, 24hour sleep disorder with multiple symptoms. It’s a debilitating, rare, and distinct chronic neurological sleep disorder with multiple key symptoms. People with IH still experience excessive daytime sleepiness (EDS) during the day despite sleeping a normal or longer than normal amount of time each night. […] EDS (or unremitting hypersomnolence) is a symptom of IH and is experienced daily for 3 months. […] IH is different from other sleep disorders that also cause EDS, such as narcolepsy and sleep apnea. […] The ICSD-III-TR has distinct diagnostic criteria for IH that includes both daytime and nighttime diagnostic components. For a diagnosis of IH, the following must be met: EDS daily for 3 months, Cataplexy is NOT present, PSG and MSLT findings are not consistent with a diagnosis of narcolepsy type I or 2, Insufficient sleep syndrome is ruled out, Symptoms and signs are not better explained by a circadian rhythm sleep-wake disorder or other current sleep disorder, medical disorder, mental disorder, or medication/substance use or withdrawal.

• #1 Hypersomnia: What It Is and How to Treat It – PCSI

  https://pcsifl.com/hypersomnia-what-it-is-and-how-to-treat-it/

  Hypersomnia is a neurological disorder characterized by excessive daytime sleepiness, brain fog, inability to sleep well, and excessive sleep period during the day, explains Dr. Pea-Hernndez. […] If you think you may be experiencing hypersomnia, you should speak with your doctor to discuss your symptoms, says Dr. Pea-Hernndez. They will likely refer you to a sleep specialist or recommend that you undergo a sleep study. […] If your PCP determines that you do suffer from a sleep disorder, you’ll be referred to a sleep specialist for further evaluation. […] For those who meet certain criteria, a sleep study might be scheduled. […] Additionally, if an underlying condition is suspected to be the cause of your hypersomnia, further tests may be ordered to identify and help treat the condition. […] If you feel excessively sleepy no matter how long you sleep at night, you might be suffering from idiopathic hypersomnia. While obtaining a diagnosis for a sleep disorder might seem daunting, it’s the first step towards feeling like yourself again.

• #1 Primary Hypersomnia Differential Diagnoses

  https://emedicine.medscape.com/article/291699-differential

  Before making a diagnosis of hypersomnolence, consider the following: […] In addition, carefully consider factors such as age of onset, typical versus atypical features, and course. Such determinations should help in differentiating among the following diagnoses. […] The nocturnal sleep duration should be qualified as adequate before a diagnosis of IH is made. An average sleep duration of less than 7 hours can result in excessive daytime sleepiness similar in presentation to hypersomnolence. […] Hypersomnia can result from the use or abuse of prescription medications, over-the-counter drugs, or illicit drugs. […] This syndrome is associated with excessive daytime sleepiness and heavy snoring causing frequent arousals during nocturnal sleep. […] Excessive daytime hypersomnia may also occur from repeated awakenings due to chronic pain or other underlying medical disorders.

• #1

  https://www.sleepcountshcp.com/idiopathic-hypersomnia-other-conditions/

  IH is a unique medical disorder that is different from other disorders, such as narcolepsy, sleep apnea, or depression. […] Confidence in an IH diagnosis remains challenging for several reasons: Excessive daytime sleepiness (EDS) is a common symptom of many disorders. […] There is currently no validated biomarker for IH. […] The key symptoms of IH are often present in other sleep and/or mental disorders. […] Patients may go undiagnosed or misdiagnosed for as long as 10 to 15 years after the onset of initial symptoms.

• #1 Primary Hypersomnia Differential Diagnoses

  https://emedicine.medscape.com/article/291699-differential

  Hypersomnia may be the presenting feature of primary depression. […] Excessive daytime sleepiness, a history of cataplexy, and the presence of sleep-onset REM periods differentiate narcolepsy from IH. […] By contrast, patients with primary hypersomnia usually present with longer and less interrupted nocturnal sleep, have more difficulties waking up, and have more sleepiness during the daytime. […] Delayed sleep phase syndrome is a diagnostic consideration in some patients whose main complaints are extreme difficulty awakening at a desired time and excessive morning sleepiness. […] Hypersomnia is frequently associated with dysthymia and related mood disorders.

• #1 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  Excessive sleepiness commonly is seen in patients with psychiatric disorders, particularly affective disorders (e.g., depression, atypical depression, seasonal affective disorder) and psychosis (e.g., schizophrenia), and in patients taking certain psychiatric medications (e.g., benzodiazepines, tricyclic antidepressants). […] Among patients with major depressive disorder (MDD), the prevalence of hypersomnia may be as high as 10 to 20 percent. […] Many clinicians may be unaware of the connection between sleep disturbances and psychiatric conditions and as a result may fail to determine the cause of abnormal excessive sleepiness. […] Excessive sleepiness is recognized as an important comorbid condition in patients with primary psychiatric disorders. […] Despite these diagnostic challenges, it is essential to determine whether excessive sleepiness is the consequence of an underlying sleep disturbance or a medical or psychiatric condition so that the cause can be found and treated properly.

• #1 Differential Diagnosis of Idiopathic Hypersomnia | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/hypersomnias/idiopathic-hypersomnia/differential-diagnosis-idiopathic-hypersomnia/

  The differential diagnosis of idiopathic hypersomnia is challenging for several reasons. Its hallmark symptom, excessive daytime sleepiness, is a common symptom of many disorders, and its ancillary symptoms also overlap with other disorders. A lack of validated biomarkers adds to the challenge. […] Assessing for key symptoms and medical history is a first step to help identify patients presenting with excessive daytime sleepiness who may have idiopathic hypersomnia. […] Idiopathic hypersomnia can be particularly challenging to diagnose because of its lack of specific biomarkers, as well as its symptoms resembling those of other disorders. How do you differentiate idiopathic hypersomnia from hypersomnias of a specific cause, such as narcolepsy type 1 and type 2, insufficient sleep syndrome, or hypersomnia due to a neurodegenerative disease?

• #1 Spotlight on Sleep: Updates in Diagnosis and Treatment of Narcolepsy and Idiopathic Hypersomnia

  https://practicalneurology.com/diseases-diagnoses/sleep/spotlight-on-sleep-updates-in-diagnosis-and-treatment-of-narcolepsy-and-idiopathic-hypersomnia/32063/

  New treatment options highlight the importance of efficient and accurate diagnosis of central disorders of hypersomnolence. […] The recent availability of a number of new medications for the management of excessive daytime sleepiness highlights the importance of efficient and accurate diagnosis of central disorders of hypersomnolence, such as narcolepsy and idiopathic hypersomnia. […] Delayed diagnosis is a known problem for narcolepsy and idiopathic hypersomnia, often with years elapsing from symptom onset to diagnosis. […] Underrecognition of these disorders, symptom overlap with more common disorders, and limitations in diagnostic testing can make timely diagnosis challenging. […] Even with a high degree of clinical suspicion, current diagnostic tests have limitations for idiopathic hypersomnia that may lead to delays in care for people with this condition.

• #1 Spotlight on Sleep: Updates in Diagnosis and Treatment of Narcolepsy and Idiopathic Hypersomnia

  https://practicalneurology.com/diseases-diagnoses/sleep/spotlight-on-sleep-updates-in-diagnosis-and-treatment-of-narcolepsy-and-idiopathic-hypersomnia/32063/

  Thus, information about habitual sleep duration is critical in the evaluation of a central disorder of hypersomnolence. […] Careful evaluation for adequate sleep duration is essential, as the most common diagnostic test for narcolepsy and idiopathic hypersomnia (the Multiple Sleep Latency Test [MSLT]) does not differentiate these conditions from insufficient sleep. […] Even when following best practices, overnight polysomnography with MSLT is not a perfect test. […] Whereas this test has relatively good sensitivity and reliability for narcolepsy type 1, the sensitivity and reliability are limited for idiopathic hypersomnia, with up to half of people with idiopathic hypersomnia having normal PSG test results. […] A careful clinical and sleep history that includes evaluation of sleep time and duration and thoughtful application of available diagnostic testing contributes to improved diagnosis of central disorders of hypersomnolence. […] The goal of treatment for people with excessive daytime sleepiness is to support full participation in their academic, professional, and social lives.

• #1 Spotlight on Sleep: Updates in Diagnosis and Treatment of Narcolepsy and Idiopathic Hypersomnia

  https://practicalneurology.com/diseases-diagnoses/sleep/spotlight-on-sleep-updates-in-diagnosis-and-treatment-of-narcolepsy-and-idiopathic-hypersomnia/32063/

  However, efficient and accurate diagnosis of these conditions is important, as there is increasing availability of medications that improve quality of life and substantially alleviate symptoms of these disorders. […] Contemporary management of narcolepsy and idiopathic hypersomnia should account for the individuals preferences and priorities to support optimal functioning in school, at work, and within social and family realms. […] Narcolepsy and idiopathic hypersomnia are central disorders of hypersomnolence, with diagnosis based on clinical history and supportive neurophysiologic testing. […] Excessive daytime sleepiness is the central feature of narcolepsy; additional symptoms can include sleep paralysis, sleep-related hallucinations, and cataplexy (episodes of muscle weakness associated with strong emotion, which is present in narcolepsy type 1).

• #1 Idiopathic Hypersomnia, Understanding the Often Overlooked Sleep Disorder | Jazz Pharmaceuticals

  https://www.jazzpharma.com/science_stories/idiopathic-hypersomnia-understanding-often-overlooked-sleep-disorder

  Idiopathic hypersomnia (IH) is a debilitating neurologic sleep disorder characterized by chronic excessive daytime sleepiness. Patients with IH are often unable to stay awake and alert during the day, which results in an irrepressible need to sleep or unplanned lapses into sleep or drowsiness. Its not a problem that can be solved with naps or a good nights sleeppeople with IH may sleep a normal or longer than normal amount of time each night but still experience excessive sleepiness during the day. […] Low levels of awareness may contribute to patients experiencing long delays in receiving an accurate diagnosisup to 10 to 15 years in some cases. […] Despite the disruptive effects IH can have on nearly every aspect of a patients life, there are currently no U.S. FDA-approved treatments for the condition in the U.S.

• #1 Excessive daytime sleepiness (hypersomnia)

  https://www.nhs.uk/conditions/excessive-daytime-sleepiness-hypersomnia/

  Idiopathic hypersomnia is when someone sleeps for long periods and wakes up feeling confused or irritable (known as sleep inertia) and not refreshed. […] There’s no known cause for idiopathic hypersomnia. […] If you’re diagnosed with hypersomnia you’ll need to tell the Driver and Vehicle Licensing Agency (DVLA) and you may not be able to drive.

• #1 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  An accurate diagnosis starts with a detailed interview with the patient about possible factors that may contribute to the abnormal sleepiness. […] The evaluation process may require a sleep study. […] Nonpharmacologic approaches to treat should be introduced initially, with an emphasis on proper sleep hygiene and, in some cases, the use of short prophylactic naps. […] If these techniques do not resolve the problem, a wake-promoting agent or stimulant medications may be indicated. […] A variety of classes and formulations of drugs are available. […] These medications have been shown to enhance alertness, increase wakefulness, improve cognition and performance, and decrease the subjective sense of fatigue and should become part of a comprehensive treatment program.

• #1 Patient Evaluation for Excessive Daytime Sleepiness

  https://www.neurologylive.com/view/patient-evaluation-for-excessive-daytime-sleepiness

  It is also possible to diagnose narcolepsy by testing orexin levels in the cerebrospinal fluid (CSF). […] A low CSF orexin A level, defined as less than 110 pg/mL, replaces the MSLT as a diagnostic criterion for narcolepsy. […] However, it is typically unnecessary to perform CSF testing, as the presence of cataplexy and a positive MSLT are sufficient for the diagnosis. […] Patients presenting with EDS can be conceptualized as having either a primary or secondary hypersomnia. […] Secondary causes, such as insufficient sleep, medical or psychiatric disorders, and medications and substances, should be evaluated and treated first. […] If EDS persists following optimization of each of these, a primary hypersomnia should be considered. […] Polysomnography with MSLT is the test of choice for evaluating primary hypersomnias, although MSLT is notoriously unreliable.

• #1 Hypersomnia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21591-hypersomnia

  Hypersomnia makes it hard or impossible for you to stay awake during the day. […] Talk to a healthcare provider if you feel tired all the time or feel like you cant control when you fall asleep. […] A healthcare provider will diagnose hypersomnia based on the symptoms youre experiencing and how theyre affecting your health. […] Your provider can use a few tests to diagnose hypersomnia, including: A sleep study, Multiple sleep latency test (MLST), Sleep questionaries (like the Epworth Sleepiness Scale). […] Your provider will suggest a combination of medications and tweaks to your sleep habits to help manage hypersomnia. […] If you have secondary hypersomnia, your provider will suggest treatments that manage its cause. […] There isnt currently a cure for hypersomnia. […] Youll need follow-up visits with your provider after starting hypersomnia treatments. […] See a healthcare provider if youre falling asleep without meaning to. Theyll diagnose it, no matter which type of hypersomnia you have.

• #2 Approach to the patient with excessive daytime sleepiness – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-excessive-daytime-sleepiness

  Approach to the patient with excessive daytime sleepiness […] Patients with excessive daytime sleepiness (EDS) have impaired function due to difficulty maintaining wakefulness or alertness at appropriate times during the day. […] EDS is important to recognize because it can signal an undiagnosed sleep disorder or other treatable condition. […] This topic provides a general overview of the epidemiology, etiology, clinical features, and diagnosis of disorders that cause excessive daytime sleepiness. […] Excessive daytime sleepiness — Daytime sleepiness is defined as excessive when it causes a subjective complaint or interferes with function. […] The International Classification of Sleep Disorders, Third Edition, Text Revision (ICSD-3-TR) defines EDS as the inability to maintain wakefulness and alertness during the major waking episodes of the day, with sleep occurring unintentionally or at inappropriate times almost daily for at least three months. […] In the ICSD-3-TR, hypersomnolence is used to describe symptoms including excessive sleepiness and increased sleep duration, and hypersomnia refers to specific disorders characterized by hypersomnolence.

• #2 Hypersomnia Tests and Diagnosis

  https://www.webmd.com/sleep-disorders/daytime-sleepiness

  If you consistently feel drowsy during the day, talk to your doctor. You may be suffering from a sleep disorder called hypersomnia, which causes excessive daytime sleepiness. […] To determine the cause of your sleepiness, your doctor will ask about your sleeping habits, how much sleep you get at night, if you wake up at night, and whether you fall asleep during the day. Your doctor may also suggest the following tests: Blood tests to rule out underlying conditions such as anemia (low blood count) or a sluggish thyroid, Computed tomography (CT) or MRI scans to rule out neurological issues such as multiple sclerosis, Polysomnography, a sleep test used to help determine the cause of many sleep problems, Electroencephalogram (EEG), a test which measures the electrical activity of the brain.

• #2 Idiopathic hypersomnia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypersomnia/diagnosis-treatment/drc-20362338

  To diagnose idiopathic hypersomnia, your healthcare professional asks about your symptoms and reviews your medical history. You’ll also likely have a physical exam. You may have several tests to either diagnose idiopathic hypersomnia or rule out other conditions that may be causing the symptoms. […] People who are diagnosed with idiopathic hypersomnia have excess sleepiness every day for at least three months. […] These tools and tests also may help diagnose idiopathic hypersomnia: […] Polysomnogram. With this test, you stay in a sleep center overnight. A polysomnogram monitors your brain activity, eye movements, leg movements, heart rate, breathing function and oxygen levels as you sleep. […] Multiple sleep latency test. For this test, you are given multiple daytime nap opportunities. During these naps, the types and stages of sleep you go through are measured. This test usually is done the day after a polysomnogram.

• #2 Excessive Daytime Sleepiness – Diagnosis & Treatment | Conditions, Treatments & Specialty | Geisinger

  https://www.geisinger.org/patient-care/conditions-treatments-specialty/daytime-sleepiness

  Excessive daytime sleepiness (EDS) is not a sleep disorder itself, but it may be a symptom of an underlying sleep disorder — often narcolepsy — a medical condition or poor sleep habits. […] Our team of sleep medicine specialists are experienced in diagnosing EDS and related sleep disorders. Diagnostic tests may include: Sleep study – A sleep study may be performed to diagnose sleep disorders or rule out non-sleep disorders. Sleep studies are done at specialized sleep centers where body functions can be monitored while you sleep. A home sleep test may also be able to help determine whether you have a sleep disorder. […] If you suspect you may have EDS, our sleep specialists help identify the cause of your daytime sleepiness and develop a personalized treatment plan that gets you back to well-rested nights.

• #2 Hypersomnia: Causes, Symptoms, Treatment, and Management

  https://www.everydayhealth.com/sleep/excessive-daytime-sleepiness-facts/

  A sleep specialist will review your symptoms, history, and the medications you take. […] He or she may ask you to keep a sleep diary to log and characterize your sleep. Then, we’ll typically do a polysomnography, which looks at other things that are disturbing your sleep and making it ineffective, Bazil says. […] If you are getting enough sleep and are still experiencing daytime sleepiness, its possible you have idiopathic hypersomnia, sometimes referred to as hypersomnolence disorder, according to the NIHs National Center for Advancing Translational Sciences. […] Idiopathic hypersomnia is really a diagnosis of exclusion, Bazil says. If you are still sleepy and there’s no other diagnosis, that’s idiopathic hypersomnia, though its pretty unusual. […] Along with polysomnography, there are additional tests to diagnose idiopathic insomnia, such as the multiple sleep latency test (MSLT), according to Stanford Medicine.

• #2 Primary Hypersomnia Workup: Approach Considerations, Polysomnography and Multiple Sleep Latency Test, Electroencephalography (EEG)

  https://emedicine.medscape.com/article/291699-workup

  Hypersomnolence is a diagnosis of exclusion. Other causes of excessive daytime somnolence should be ruled out before a diagnosis of hypersomnolence is made. […] A complete blood count (CBC), screening biochemistry tests, and thyroid-stimulating hormone tests are recommended to exclude common physical disorders that may present with excessive tiredness, often expressed as excessive sleepiness. A drug screen is indicated if substance-induced sleep disorder needs to be ruled out. […] Commonly used scales for a quantitative, systematic assessment of excessive sleepiness are the Epworth Sleepiness Scale and the Stanford Sleepiness Scale. While helpful, these are essentially subjective scales, which raises questions about the characteristics of sleepiness when assessed by subjective methods (eg, the Epworth and Stanford sleepiness scales) versus objective ones (eg, polysomnography and the Multiple Sleep Latency Test).

• #2 Excessive Daytime Sleepiness I Hypersomnia | IU Health

  https://iuhealth.org/find-medical-services/excessive-daytime-sleepiness

  Hypersomnia or excessive daytime sleepiness (EDS) can be a sign of many sleep disorders, including sleep apnea, narcolepsy or restless leg syndrome. Being sleepy during the day puts you at greater risk for accidents and increases your risk for health conditions such as diabetes, heart disease and obesity. […] IU Health Sleep Disorders physicians use a variety of diagnostic tools to help identify sleep disorders such as insomnia, narcolepsy and sleep apnea. […] Questions assess your likelihood to fall asleep in normal situations such as driving, watching TV or sitting and chatting with someone. This tool gives insight into the severity of your sleepiness. […] If you rate high on the sleepiness scale, you may undergo an overnight sleep study so your doctors can observe how your body handles sleep.

• #2 Diagnosis and management of central hypersomnias – PMC Lock

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3437530/

  Central hypersomnias are diseases manifested in excessive daytime sleepiness (EDS) not caused by disturbed nocturnal sleep or misaligned circadian rhythms. […] The Epworth Sleepiness Scale is a subjective tool mostly used for EDS assessment, while the Multiple Sleep Latency Test serves as an objective diagnostic method for narcolepsy and idiopathic hypersomnias. […] For the diagnosis of central hypersomnias (with the exception of recurrent hypersomnia and hypersomnia due to drug and substance intake), EDS symptoms must be present for at least 3 months. […] The basic diagnostic protocol in EDS consists of nocturnal polysomnography and the Multiple Sleep Latency Test (MSLT). […] MSLT is indicated in suspected narcolepsy and idiopathic hypersomnia and in EDS differential diagnosis. […] The Epworth Sleepiness Scale value of 10 and higher is considered abnormal.

• #2 Primary Hypersomnia Workup: Approach Considerations, Polysomnography and Multiple Sleep Latency Test, Electroencephalography (EEG)

  https://emedicine.medscape.com/article/291699-workup

  Complete in-laboratory polysomnography (PSG) studies are essential to exclude other sleep disorders, particularly sleep breathing disorder, periodic limb movement disorder (PLMD), and narcolepsy. […] A PSG study is required prior to the Multiple Sleep Latency Test (MSLT) to objectively characterize preceding sleep and uncover potential causes of sleep fragmentation. […] The PSG must have confirmed at least 6 hours of sleep for the MSLT results to be considered in diagnosing hypersomnolence. […] The following PSG features are required for the diagnosis of hypersomnolence: A sleep period that is normal or prolonged in duration, Normal REM sleep latency, A mean sleep latency score of less than 8 on the MSLT, Fewer than 2 sleep-onset REM periods. […] The MSLT evaluates the presence of pathologic sleepiness. The MSLT involves studying the patient during 5 daytime naps taken 2 hours apart. […] The mean MSLT score in hypersomnolence is slightly higher than the score in narcolepsy. The mean MSLT score was found to be 6.5 3.2 minutes for IH versus 3.3 3.3 minutes for narcolepsy. Further, narcolepsy is excluded by the absence of SOREMPs on the 5-nap MSLT.

• #2 Idiopathic Hypersomnia – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/idiopathic-hypersomnia

  Idiopathic hypersomnia is excessive daytime sleepiness with or without a long sleep time; it is differentiated from narcolepsy by lack of cataplexy, hypnagogic hallucinations, and sleep paralysis. […] Excessive daytime sleepiness is the main symptom, with difficulty waking up in the morning; sleep time may or may not be prolonged. […] In idiopathic hypersomnia with a long sleep time, the history or sleep logs indicate 10 hours of nocturnal sleep; in idiopathic hypersomnia without a long sleep time, it is 6 hours but 10 hours. In both cases, polysomnography shows no evidence of other sleep abnormalities. Multiple sleep latency testing shows short sleep latencies ( 8 minutes) with fewer than 2 REM periods. Typically, patients with idiopathic hypersomnia have difficulty waking up, and when they awaken, they experience a period of sleep inertia characterized by drowsiness, decreased cognition, and motor impairment.

• #2 Idiopathic Hypersomnia (Hypersomnolence Disorder) – PsychDB

  https://www.psychdb.com/sleep/3-hypersomnolence-disorder

  The hypersomnolence is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). […] Individuals often report constant sleepiness and prolonged naps. The naps are not refreshing. […] Sleep efficiency is mostly greater than 90%. Some individuals with hypersomnolence disorder have increased amounts of slow-wave sleep. The multiple sleep latency test documents sleep tendency, typically indicated by mean sleep latency values of less than 8 minutes. […] In hypersomnolence disorder, the mean sleep latency is typically less than 10 minutes and frequently 8 minutes or less.

• #2 Patient Evaluation for Excessive Daytime Sleepiness

  https://www.neurologylive.com/view/patient-evaluation-for-excessive-daytime-sleepiness

  If sleep occurs, it can continue for 15 minutes before being interrupted by the technologist. […] The 2 principal measurements are sleep latency (eg, how long it took to fall asleep) in each nap, which is averaged to determine the mean sleep latency, and the presence of stage REM sleep, referred to as a sleep-onset REM period (SOREMP). […] Pathological sleepiness is identified by mean sleep latencies less than 8 minutes (8- to 10-minute sleep latencies are borderline abnormal and should be interpreted in the clinical context). […] In cases of pathological sleepiness, the presence of 2 or more SOREMPs is consistent with narcolepsy, whereas 0 to 1 SOREMP is labeled IH. […] Studies have shown that the presence of 2 or more SOREMPs with a mean latency of less than 5 minutes had a 97% specificity for the diagnosis of narcolepsy.

• #2 Diagnosis of Idiopathic Hypersomnia | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/hypersomnias/idiopathic-hypersomnia/diagnosis-idiopathic-hypersomnia/

  The International Classification of Sleep Disorders, 3rd ed, lists the criteria needed for a diagnosis idiopathic hypersomnia. For a diagnosis of idiopathic hypersomnia, the following must be met: excessive daytime sleepiness daily for at least 3 months […] Hypersomnolence and/or MSLT findings are not better explained by another sleep disorder, other medical or psychiatric disorders, or use of drugs or medication. Objective sleep testing is needed to diagnose idiopathic hypersomnia. What polysomnography and multiple sleep latency test findings support a diagnosis of idiopathic hypersomnia? Idiopathic hypersomnia is typically diagnosed using an in-lab polysomnogram followed by a multiple sleep latency test (or a nap test) the next day. On the multiple sleep latency test, we’re looking for evidence of excessive daytime sleepiness, which is defined as a sleep latency, or time to fall asleep, of less than eight minutes, but no excessive propensity towards REM sleep.

• #2 Hypersomnia: Causes, Symptoms, Treatment, and Management

  https://www.everydayhealth.com/sleep/excessive-daytime-sleepiness-facts/

  A Maintenance of Wakefulness Test, which assesses daytime alertness, may also be used, per the Hypersomnia Foundation, though participants may experience side effects from sleep deprivation, such as headaches. […] The criteria to be diagnosed with idiopathic hypersomnia include: You experience excessive sleepiness with prolonged sleep or daily daytime sleep episodes for at least one month (or you experience excessive sleepiness that lasts at least three days several times a year for at least two years). […] Youre unable to function properly and see the effects mentally, socially, and professionally. […] Your excessive sleepiness isnt due to another known cause.

• #2 Hypersomnia: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/sleep-disorders/hypersomnia

  Testing may include: actigraphy, which measures sleep-wake cycles and circadian rhythms on a wristwatch-like device; blood tests, which can help identify or rule out underlying medical causes; multiple sleep latency testing, which is a nap test the day after a sleep study; overnight oximetry, which can find nighttime breathing disorders, such as sleep apnea; sleep studies, including polysomnography. […] Diagnosing hypersomnia involves ruling out other problems and conducting sleep studies.

• #2 Examining Clinical Considerations for Diagnosis, Management of Idiopathic Hypersomnia

  https://www.ajmc.com/view/examining-clinical-considerations-for-diagnosis-management-of-idiopathic-hypersomnia

  A review explored clinical considerations related to the pathogenesis, diagnosis, and management of idiopathic hypersomnia. […] EDS is a core diagnostic feature of IH, but its prevalence in other more commonly known sleep disorders, such as narcolepsy, has contributed to misdiagnosis and years of inadequate management for patients with IH. […] Diagnosis of IH is based on objective sleep testing and the presence of associated clinical features. However, due to its low prevalence, clinical heterogeneity, and symptoms, which are similar to those of other sleep disorders, IH may be difficult for clinicians to recognize and correctly diagnose, noted researchers. […] Current International Classification of Sleep Disorders, 3rd Edition (ICSD-3) diagnostic criteria require the presence of EDS for 3 months, absence of cataplexy, and confirmatory objective sleep testing, including mean sleep latency (MSL) of 8 minutes on the multiple sleep latency test (MSLT) and/or 24-hour total sleep time (TST) of 660 min on polysomnography (PSG) or wrist actigraphy.

• #2 Idiopathic Hypersomnia: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/sleep-disorders/idiopathic-hypersomnia

  The criteria for diagnosing IH include: excessive daytime sleepiness for 3 months or longer; no underlying medications or medical conditions that could cause excessive daytime sleepiness; no other sleep disorder, such as circadian rhythm disturbances or insufficient sleep. […] Doctors rule out medical conditions, medications, and other sleep disorders to diagnose IH.

• #2 Patient Evaluation for Excessive Daytime Sleepiness

  https://www.neurologylive.com/view/patient-evaluation-for-excessive-daytime-sleepiness

  Excessive daytime sleepiness is a hallmark of a number of sleep disorders, and ensuring the proper diagnosis and management of those presenting with it is crucial to care. […] Clinicians in all fields, and frequently neurologists, will encounter patients with EDS. The differential diagnosis for EDS can be organized into primary and secondary causes. […] The International Classification of Sleep Disorders-Third Edition includes primary and secondary causes of EDS, referred to as hypersomnias, under the Central Disorders of Hypersomnolence category. […] Secondary causes are more varied and more common than primary causes and must be excluded before a diagnosis of a primary hypersomnia can be made. […] This article will review the secondary causes of EDS to help providers determine when an evaluation for primary causes of EDS is warranted. This is followed by a discussion of the primary hypersomnias, addressing both diagnostic and treatment paradigms for the central disorders of hypersomnolence.

• #2 Primary Hypersomnia Differential Diagnoses

  https://emedicine.medscape.com/article/291699-differential

  Hypersomnia may be the presenting feature of primary depression. […] Excessive daytime sleepiness, a history of cataplexy, and the presence of sleep-onset REM periods differentiate narcolepsy from IH. […] By contrast, patients with primary hypersomnia usually present with longer and less interrupted nocturnal sleep, have more difficulties waking up, and have more sleepiness during the daytime. […] Delayed sleep phase syndrome is a diagnostic consideration in some patients whose main complaints are extreme difficulty awakening at a desired time and excessive morning sleepiness. […] Hypersomnia is frequently associated with dysthymia and related mood disorders.

• #2 Idiopathic Hypersomnia vs Narcolepsy: Which One Do You Have?

  https://goodhealthpsych.com/blog/idiopathic-hypersomnia-vs-narcolepsy-which-one-do-you-have/

  Around 34% of Americans say they have bad sleep quality, with an average of 60 million Americans struggling with sleep disorders. Understanding sleep disorders and their impact on daily life is essential, especially if you are struggling with symptoms of a sleep disorder. This article will review idiopathic hypersomnia (IH) and narcolepsy as common but distinct sleep disorders. […] Hypersomnia applies to any individual who sleeps excessively. Someone with hypersomnia will get at least 6 hours each night but it doesn’t matter how many hours they get because they’ll feel tired throughout the day and have issues waking in the morning because the sleep itself may have been poor quality or disrupted. […] Hypersomnia is a unique category among sleep conditions, and idiopathic hypersomnia refers to hypersomnia that does not have a clear cause.

• #2 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  Excessive sleepiness commonly is seen in patients with psychiatric disorders, particularly affective disorders (e.g., depression, atypical depression, seasonal affective disorder) and psychosis (e.g., schizophrenia), and in patients taking certain psychiatric medications (e.g., benzodiazepines, tricyclic antidepressants). […] Among patients with major depressive disorder (MDD), the prevalence of hypersomnia may be as high as 10 to 20 percent. […] Many clinicians may be unaware of the connection between sleep disturbances and psychiatric conditions and as a result may fail to determine the cause of abnormal excessive sleepiness. […] Excessive sleepiness is recognized as an important comorbid condition in patients with primary psychiatric disorders. […] Despite these diagnostic challenges, it is essential to determine whether excessive sleepiness is the consequence of an underlying sleep disturbance or a medical or psychiatric condition so that the cause can be found and treated properly.

• #2 Idiopathic Hypersomnia Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sleep/idiopathic-hypersomnia/diagnosis.html

  In order to diagnose idiopathic hypersomnia, a person must display symptoms of hypersomnia for at least 3 months and the disorder should have a significant impact on the person’s life. […] Making a diagnosis of idiopathic hypersomnia requires carefullly excluding other causes of daytime sleepiness such as insufficient sleep (sleep deprivation), disturbed nocturnal sleep, insomnia, circadian rhythm disorders, sleep-related breathing (sleep apnea) disorders or medical issues. […] A general medical check up excluding anemia, hypothyroidism, heart or other general medical issues is essential. […] Excluding a psychiatric condition such as depression or generalized anxiety disorder may be difficult and is needed, requiring therapeutic trials. […] Other required tests to diagnose idiopathic hypersomnia may include a polysomnogram, multiple sleep latency test (MSLT) and, in rare cases, biochemical or medical tests.

• #2 Excessive daytime sleepiness (hypersomnia)

  https://www.nhs.uk/conditions/excessive-daytime-sleepiness-hypersomnia/

  Excessive daytime sleepiness (hypersomnia) is a condition where people fall asleep repeatedly during the day. […] Excessive daytime sleepiness (hypersomnia) is different from feeling tired all the time. […] If you have hypersomnia, you may: regularly nap during the day, fall asleep during the day, still sleep for long hours at night. […] To find out why you’re sleeping excessively, a GP might: ask you about possible causes of your sleepiness, such as mental or physical health problems, or any medicines you may be taking, suggest you keep a diary of when you sleep, refer you to a doctor who specialises in sleep disorders. […] Treatment for excessive sleepiness will depend on what’s causing it. It may include medicine to help keep you awake. […] Some medicines, drinking too much alcohol and taking drugs can also cause excessive daytime sleepiness.

• #2 Spotlight on Sleep: Updates in Diagnosis and Treatment of Narcolepsy and Idiopathic Hypersomnia

  https://practicalneurology.com/diseases-diagnoses/sleep/spotlight-on-sleep-updates-in-diagnosis-and-treatment-of-narcolepsy-and-idiopathic-hypersomnia/32063/

  New treatment options highlight the importance of efficient and accurate diagnosis of central disorders of hypersomnolence. […] The recent availability of a number of new medications for the management of excessive daytime sleepiness highlights the importance of efficient and accurate diagnosis of central disorders of hypersomnolence, such as narcolepsy and idiopathic hypersomnia. […] Delayed diagnosis is a known problem for narcolepsy and idiopathic hypersomnia, often with years elapsing from symptom onset to diagnosis. […] Underrecognition of these disorders, symptom overlap with more common disorders, and limitations in diagnostic testing can make timely diagnosis challenging. […] Even with a high degree of clinical suspicion, current diagnostic tests have limitations for idiopathic hypersomnia that may lead to delays in care for people with this condition.

• #2

  https://www.sleepcountshcp.com/idiopathic-hypersomnia-other-conditions/

  IH is a unique medical disorder that is different from other disorders, such as narcolepsy, sleep apnea, or depression. […] Confidence in an IH diagnosis remains challenging for several reasons: Excessive daytime sleepiness (EDS) is a common symptom of many disorders. […] There is currently no validated biomarker for IH. […] The key symptoms of IH are often present in other sleep and/or mental disorders. […] Patients may go undiagnosed or misdiagnosed for as long as 10 to 15 years after the onset of initial symptoms.

• #2 Central Disorders of Hypersomnolence (Narcolepsy and Idiopathic Hypersomnia) | BIDMC of Boston

  https://www.bidmc.org/conditions-and-treatments/brain-spine-and-nervous-system/central-disorders-of-hypersomnolence

  Central disorders of hypersomnolence, including narcolepsy and idiopathic hypersomnia, are characterized by excessive daytime sleepiness in the absence of other sleep disorders but with the setting of adequate and regular sleep habits. […] Evaluation of central disorders of hypersomnolence includes sleep testing in the sleep lab (polysomnography, PSG) followed by a multiple sleep latency test (MSLT). […] The MSLT is a very good test for narcolepsy, but it is less sensitive for idiopathic hypersomnia. […] As a result, patients with clinical symptoms of idiopathic hypersomnia who report regularly prolonged sleep duration (average sleep duration more than 11 hours/night) may instead be referred for an extended or unrestricted sleep study.

• #2 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  Excessive sleepiness occurs frequently in the general population and is a common feature of many psychiatric conditions. […] Excessive sleepiness may be the result of a number of extrinsic and intrinsic causes. […] Underdiagnosis and undertreatment of sleep disorders are common in community psychiatric practices because clinicians may not be aware of the different causes and consequences of excessive sleepiness. […] In cases where sleep disorders are suspected, a comprehensive treatment program might include nonpharmacologic approaches, pharmacologic approaches, or both may need to be initiated to encompass the complexity of sleep disorder treatments. […] Careful monitoring and follow-up of patients with excessive daytime sleepiness, including counseling and long-term support, are essential to ensure treatment compliance and to maintain improvements over time.

• #2 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  An accurate diagnosis starts with a detailed interview with the patient about possible factors that may contribute to the abnormal sleepiness. […] The evaluation process may require a sleep study. […] Nonpharmacologic approaches to treat should be introduced initially, with an emphasis on proper sleep hygiene and, in some cases, the use of short prophylactic naps. […] If these techniques do not resolve the problem, a wake-promoting agent or stimulant medications may be indicated. […] A variety of classes and formulations of drugs are available. […] These medications have been shown to enhance alertness, increase wakefulness, improve cognition and performance, and decrease the subjective sense of fatigue and should become part of a comprehensive treatment program.

• #2 Excessive Daytime Sleepiness | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0301/p391.html

  To diagnose narcolepsy without cataplexy, the MSLT must demonstrate hypersomnolence and early onset of rapid eye movement sleep. […] Addressing the underlying cause is the mainstay of treatment of excessive daytime sleepiness. […] Treatment with positive pressure devices (e.g., CPAP) during sleep improves symptoms of daytime sleepiness for most patients. […] Modafinil (Provigil) is considered to be the first-line activating agent for the treatment of excessive daytime sleepiness.

• #2 Spotlight on Sleep: Updates in Diagnosis and Treatment of Narcolepsy and Idiopathic Hypersomnia

  https://practicalneurology.com/diseases-diagnoses/sleep/spotlight-on-sleep-updates-in-diagnosis-and-treatment-of-narcolepsy-and-idiopathic-hypersomnia/32063/

  Thus, information about habitual sleep duration is critical in the evaluation of a central disorder of hypersomnolence. […] Careful evaluation for adequate sleep duration is essential, as the most common diagnostic test for narcolepsy and idiopathic hypersomnia (the Multiple Sleep Latency Test [MSLT]) does not differentiate these conditions from insufficient sleep. […] Even when following best practices, overnight polysomnography with MSLT is not a perfect test. […] Whereas this test has relatively good sensitivity and reliability for narcolepsy type 1, the sensitivity and reliability are limited for idiopathic hypersomnia, with up to half of people with idiopathic hypersomnia having normal PSG test results. […] A careful clinical and sleep history that includes evaluation of sleep time and duration and thoughtful application of available diagnostic testing contributes to improved diagnosis of central disorders of hypersomnolence. […] The goal of treatment for people with excessive daytime sleepiness is to support full participation in their academic, professional, and social lives.

• #2 What are hypersomnia sleep disorders, such as idiopathic hypersomnia, narcolepsy types 1 and 2, and Kleine-Levin syndrome? – Hypersomnia Foundation

  https://www.hypersomniafoundation.org/

  Whether you’re already diagnosed with a hypersomnia sleep disorder or not, you’ll want to find a sleep doctor and get treatment. […] If you’re a healthcare professional or researcher working with people who have idiopathic hypersomnia or related sleep disorders, you’ll find resources for: Diagnosis and treatment of hypersomnias, including adjustments for birth control, pregnancy, and anesthesia.

• #3 The Assessment, Diagnosis, and Treatment of Excessive Sleepiness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2880940/

  Excessive sleepiness occurs frequently in the general population and is a common feature of many psychiatric conditions. […] Excessive sleepiness may be the result of a number of extrinsic and intrinsic causes. […] Underdiagnosis and undertreatment of sleep disorders are common in community psychiatric practices because clinicians may not be aware of the different causes and consequences of excessive sleepiness. […] In cases where sleep disorders are suspected, a comprehensive treatment program might include nonpharmacologic approaches, pharmacologic approaches, or both may need to be initiated to encompass the complexity of sleep disorder treatments. […] Careful monitoring and follow-up of patients with excessive daytime sleepiness, including counseling and long-term support, are essential to ensure treatment compliance and to maintain improvements over time.

• #3 Idiopathic Hypersomnia, Understanding the Often Overlooked Sleep Disorder | Jazz Pharmaceuticals

  https://www.jazzpharma.com/science_stories/idiopathic-hypersomnia-understanding-often-overlooked-sleep-disorder

  Idiopathic hypersomnia (IH) is a debilitating neurologic sleep disorder characterized by chronic excessive daytime sleepiness. Patients with IH are often unable to stay awake and alert during the day, which results in an irrepressible need to sleep or unplanned lapses into sleep or drowsiness. Its not a problem that can be solved with naps or a good nights sleeppeople with IH may sleep a normal or longer than normal amount of time each night but still experience excessive sleepiness during the day. […] Low levels of awareness may contribute to patients experiencing long delays in receiving an accurate diagnosisup to 10 to 15 years in some cases. […] Despite the disruptive effects IH can have on nearly every aspect of a patients life, there are currently no U.S. FDA-approved treatments for the condition in the U.S.

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