9/18/12

Primary Hypersomnia Treatment & Management

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PrimaryHypersomniaTreatment& Management
Author:AdrianPreda,MDChiefEditor:IqbalAhmed,MBBS,FRCPsych(UK)more...

Updated:May14,2012

ApproachConsiderations
Severeidiopathichypersomniaisadisablingproblemthatoftenleadstopermanent unemploymentandrespondspoorlytomedicaltreatment.[9,8]Moreover,becausethe underlyingcauseofidiopathichypersomniaisunknown,treatmentremainssymptomaticin nature. TheAmericanAcademyofSleepMedicinepracticeparametersstatethatsuccessful treatmentofhypersomniaofcentraloriginrequiresanaccuratediagnosis,individualtailoring oftherapytoproducemaximumpossiblereturnoffunction,andregularfollowuptomonitor responsetotherapy. Modafinil,sodiumoxybate,amphetamine,methamphetamine,dextroamphetamine, methylphenidate,andselegilineareeffectivetreatmentsforexcessivesleepinessassociated withnarcolepsyandprimaryhypersomnias.Schedulednapscanbebeneficialtocombat sleepinessinthesepatients.[28] Behavioralapproachesandsleephygienetechniquesarerecommended,althoughtheyhave littleoverallpositiveimpactonthisdisease.

Consultations
Thediagnosisofprimaryhypersomniaismadeafterexcludingneurologic,pulmonary,and psychiatricdisordersknowntocauseexcessivesleepiness.Therefore,ifanunderlyingcause
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Primary Hypersomnia Treatment & Management

issuggested,appropriateconsultationswithaneurologist,pulmonologist,andpsychiatrist shouldbeobtained.

Activity
Cautionisrecommendedinactivitiesinwhichhypersomnolencemaybehazardous.

ContributorInformationandDisclosures
Author AdrianPreda,MDHealthSciencesAssociateProfessorofPsychiatryandHuman Behavior,UniversityofCaliforniaIrvineSchoolofMedicine AdrianPreda,MDisamemberofthefollowingmedicalsocieties:InternationalCongressof SchizophreniaResearch,SchizophreniaInternationalResearchSociety,andSocietyof BiologicalPsychiatry Disclosure:Nothingtodisclose. ChiefEditor IqbalAhmed,MBBS,FRCPsych(UK)Faculty,DepartmentofPsychiatry,TriplerArmy MedicalCenterClinicalProfessorofPsychiatry,UniformedServicesUniversityofHealth Sciences:ClinicalProfessorofPsychiatry,ClinicalProfessorofGeriatricMedicine, UniversityofHawaii,JohnABurnsSchoolofMedicine IqbalAhmed,MBBS,FRCPsych(UK)isamemberofthefollowingmedicalsocieties: AcademyofPsychosomaticMedicine,AmericanAssociationforGeriatricPsychiatry, AmericanNeuropsychiatricAssociation,AmericanPsychiatricAssociation,American SocietyofClinicalPsychopharmacology,andRoyalCollegeofPsychiatrists Disclosure:Nothingtodisclose. AdditionalContributors JenniferSMorse,MDAssociateMedicalDirector,OptumHealth JenniferSMorse,MDisamemberofthefollowingmedicalsocieties:Academyof PsychosomaticMedicine,AerospaceMedicalAssociation,andAmericanPsychiatric Association Disclosure:Nothingtodisclose. FranciscoTalavera,PharmD,PhDAdjunctAssistantProfessor,UniversityofNebraska MedicalCenterCollegeofPharmacyEditorinChief,MedscapeDrugReference Disclosure:MedscapeSalaryEmployment

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Primary Hypersomnia Treatment & Management

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