The Latest Trends in Sleep Medicine

Management of Non-Narcolepsy Hypersomnia and Excessive Daytime Sleepiness

Author(s): Imran H. Iftikhar * .

Pp: 1-19 (19)

DOI: 10.2174/9789815051032122010004

* (Excluding Mailing and Handling)

Abstract

The International Classification for Sleep Disorders- third edition (ICSD-3) has classified central disorders of hypersomnolence as, Narcolepsy type 1 and type 2, idiopathic hypersomnia (IH), Kleine–Levin syndrome (KLS), hypersomnia due to a medical or neurologic disorder, hypersomnia due to medication or substance, hypersomnia associated with psychiatric disorders, and insufficient sleep syndrome. A number of pharmacological treatment options are now available for Narcolepsy type 1 and type 2. However, for conditions like IH and KLS, much work is still being done to understand the underlying pathophysiologic mechanisms and consequently, these conditions have the least amount of high-grade evidence on pharmacologic options, and most medicines are used ‘off-label’. This chapter focuses on treating non narcoleptic hypersomnia syndromes- those commonly encountered in Sleep disorders clinics such as residual hypersomnia despite having a patient adherent to therapeutic positive airway pressure settings, to some uncommon conditions like IH and an exceedingly rare condition like KLS. New medications like solriamfetol and pitolisant and their possible use in some of these conditions is also discussed in this chapter


Keywords: Hypersomnia, Idiopathic Hypersomnia, Kliene-Levin syndrome.

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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873368187 and j.to_ip >=873368187 )) and ((j.from_date <= 1740676448 and j.to_date >= 1740676448 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16745) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873368187 and j.to_ip >=873368187 )) and ((j.from_date <= 1740676448 and j.to_date >= 1740676448 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16745) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873368187 and j.to_ip >=873368187 )) and ((j.from_date <= 1740676448 and j.to_date >= 1740676448 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16745)
      1.33msalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3326 and `b`.`banner_from_date` <= 1740676448 and `b`.`banner_to_date` >= 1740676448 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.25msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3326
      • 3: 1740676448
      • 4: 1740676448
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='16f06c3c01da495b804438a2d104717d'
      310μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    3Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        LBw2fNLeOZuhnJTVifpCgU3Iup4qSfuE4ywA5Zxs
        uc_cart_id
        16f06c3c01da495b804438a2d104717d
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/16745" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/16745
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Thu, 27 Feb 2025 17:14:08 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlNaZ3hySnlQUytZeUhUUnVjRXhxR1E9PSIsInZhbHVlIjoiZlM5M0t4VVkyZXpRZ0wwTVBMWXJqNnZTVGZ0Q0VLczVrTjNkdm5YeUJDQTRQNXBDTjN2bUlMcHcvTDJvK3pOcjRxZFNVK0NmSmY4MmhPbWU4OE5DcSsxdDNBZmgya1E1RGVtTUtuWHU0VmFTeFZlSU5BRThrVmRiRjAyZXN3ZzAiLCJtYWMiOiI4YjlkYjMwNDI5OGFkNWZjZjFhOGZhZjE4Yzg2ZWRhM2QyY2FhNjM4NDA4YmE4NTJmYzFkZDYxMGM3NzE3MjNjIiwidGFnIjoiIn0%3D; expires=Sun, 02 Mar 2025 05:14:08 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlNaZ3hySnlQUytZeUhUUnVjRXhxR1E9PSIsInZhbHVlIjoiZlM5M0t4VVkyZXpRZ0wwTVBMWXJqNnZTVGZ0Q0VLczVrTjNkdm5YeUJDQTRQNXBDTjN2bUlMcHcvTDJvK3pOcjRxZFNVK" 1 => "alphaeurekaselectnet_session=eyJpdiI6IkNDRlA1T1lFOERTNlNIcWNZR1FBdkE9PSIsInZhbHVlIjoiMFJTdStkbkdGTHpnb2VNVU0vcnYwaEJEUUVCSkw0Y1JTYk9EdTd5Ky94N2RGeXdOdXhkMXJsd1JtU2JGalZ3QVlBMEtzb3RnMlI5Zzk4amVQSFZyak9Yckt2bUp2MU5LK2FZckxjWVZSUUpHcGo4aUFvaElvV2t3WWh3eGNuNngiLCJtYWMiOiJhNjFiYzNmOWIzYmViYjliOGIwMjkyZTBlMjg1ZDJhNDU0ZTRmYWIyM2QyNjVhOWE3OGExZjFlMWVkNzJjZGQyIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IkNDRlA1T1lFOERTNlNIcWNZR1FBdkE9PSIsInZhbHVlIjoiMFJTdStkbkdGTHpnb2VNVU0vcnYwaEJEUUVCSkw0Y1JTYk9EdTd5Ky94N2RGeXdOdXhkMXJsd1J" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlNaZ3hySnlQUytZeUhUUnVjRXhxR1E9PSIsInZhbHVlIjoiZlM5M0t4VVkyZXpRZ0wwTVBMWXJqNnZTVGZ0Q0VLczVrTjNkdm5YeUJDQTRQNXBDTjN2bUlMcHcvTDJvK3pOcjRxZFNVK0NmSmY4MmhPbWU4OE5DcSsxdDNBZmgya1E1RGVtTUtuWHU0VmFTeFZlSU5BRThrVmRiRjAyZXN3ZzAiLCJtYWMiOiI4YjlkYjMwNDI5OGFkNWZjZjFhOGZhZjE4Yzg2ZWRhM2QyY2FhNjM4NDA4YmE4NTJmYzFkZDYxMGM3NzE3MjNjIiwidGFnIjoiIn0%3D; expires=Sun, 02-Mar-2025 05:14:08 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlNaZ3hySnlQUytZeUhUUnVjRXhxR1E9PSIsInZhbHVlIjoiZlM5M0t4VVkyZXpRZ0wwTVBMWXJqNnZTVGZ0Q0VLczVrTjNkdm5YeUJDQTRQNXBDTjN2bUlMcHcvTDJvK3pOcjRxZFNVK" 1 => "alphaeurekaselectnet_session=eyJpdiI6IkNDRlA1T1lFOERTNlNIcWNZR1FBdkE9PSIsInZhbHVlIjoiMFJTdStkbkdGTHpnb2VNVU0vcnYwaEJEUUVCSkw0Y1JTYk9EdTd5Ky94N2RGeXdOdXhkMXJsd1JtU2JGalZ3QVlBMEtzb3RnMlI5Zzk4amVQSFZyak9Yckt2bUp2MU5LK2FZckxjWVZSUUpHcGo4aUFvaElvV2t3WWh3eGNuNngiLCJtYWMiOiJhNjFiYzNmOWIzYmViYjliOGIwMjkyZTBlMjg1ZDJhNDU0ZTRmYWIyM2QyNjVhOWE3OGExZjFlMWVkNzJjZGQyIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IkNDRlA1T1lFOERTNlNIcWNZR1FBdkE9PSIsInZhbHVlIjoiMFJTdStkbkdGTHpnb2VNVU0vcnYwaEJEUUVCSkw0Y1JTYk9EdTd5Ky94N2RGeXdOdXhkMXJsd1J" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "LBw2fNLeOZuhnJTVifpCgU3Iup4qSfuE4ywA5Zxs" "uc_cart_id" => "16f06c3c01da495b804438a2d104717d" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/16745" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-27 17:14:08GET/chapter/16745112195