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hypersomnia pharmacotherapy

Vivien C Abad, Christian Guilleminault
Obstructive sleep apnea (OSA) is highly prevalent and constitutes a major health hazard. Current pharmacotherapy is ineffective in correcting sleep-disordered breathing and is used adjunctively to address residual sleepiness. A new drug, solriamfetol, a selective norepinephrine-dopamine reuptake inhibitor, is the first drug of its class that is being considered by the US Food and Drug Administration (FDA) to treat excessive sleepiness in OSA and narcolepsy patients. Areas covered: This review covers drug chemistry, pharmacodynamics, pharmacokinetics, and metabolism of solriamfetol...
November 2, 2018: Expert Review of Respiratory Medicine
Chiraag Thakrar, Kishankumar Patel, Grainne D'ancona, Brian D Kent, Alexander Nesbitt, Hugh Selsick, Joerg Steier, Ivana Rosenzweig, Adrian J Williams, Guy D Leschziner, Panagis Drakatos
Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively...
August 2018: Journal of Sleep Research
Suresh Kotagal
The comprehensive management of chronic disorders such as hypersomnias of childhood requires combining life-style changes with rational pharmacotherapy that is based on treating the symptoms that are most bothersome, the age, comorbidities, and metabolic and endocrine status of the patient. The excessive sleepiness of narcolepsy and idiopathic hypersomnia is best treated with dextroamphetamine or methylphenidate preparations or modafinil/armodafinil. Cataplexy treatment requires sodium oxybate, tricyclic agents, selective norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors...
January 2018: Paediatric Respiratory Reviews
Jenny McCleery, Daniel A Cohen, Ann L Sharpley
BACKGROUND: Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering, and daytime sleepiness are common clinical problems in dementia, and are associated with significant caregiver distress, increased healthcare costs, and institutionalisation. Drug treatment is often sought to alleviate these problems, but there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this vulnerable population. OBJECTIVES: To assess the effects, including common adverse effects, of any drug treatment versus placebo for sleep disorders in people with dementia, through identification and analysis of all relevant randomised controlled trials (RCTs)...
November 16, 2016: Cochrane Database of Systematic Reviews
William G Mantyh, R Robert Auger, Timothy I Morgenthaler, Michael H Silber, Wendy R Moore
STUDY OBJECTIVES: Narcolepsy and idiopathic hypersomnia are commonly treated by sleep specialists and encountered by other medical providers. Although pharmacotherapy with modafinil and traditional stimulants is considered the mainstay of treatment, physicians are often uncomfortable with their prescription because of concerns regarding misuse. The goal of this study was to assess the frequency of stimulant misuse in this population. METHODS: A retrospective cohort study was performed evaluating patients 18 years and older diagnosed with narcolepsy with and without cataplexy and idiopathic hypersomnia with and without long sleep between 2003-2008...
May 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
J Schlitzer, S Heubaum, H Frohnhofen
Sleep disorders need to be treated if they affect the quality of life, lead to functional problems in daily life or unfavorably affect self-sufficiency. The large number of sleep disorders is reflected in the number of different and varied available therapeutic procedures. The basic therapeutic procedure for any sleep disorder is the use of sleep hygiene. Sleeplessness (insomnia) is most effectively treated through behavioral therapy, with stimulus control and sleep restriction as the most effective measures, whereas pharmacotherapy is considerably less effective and has side effects...
November 2014: Zeitschrift Für Gerontologie und Geriatrie
Jenny McCleery, Daniel A Cohen, Ann L Sharpley
BACKGROUND: Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering and daytime sleepiness are common clinical problems in dementia due to Alzheimer's disease (AD), and are associated with significant caregiver distress, increased healthcare costs and institutionalisation. Drug treatment is often sought to alleviate these problems, but there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this vulnerable population...
March 21, 2014: Cochrane Database of Systematic Reviews
Shigeru Chiba
Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain (EEG), sleep-wake system, rapid eye movement (REM) sleep, and circadian rhythm system. Additionally, the advent of video-polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease (e...
2013: Seishin Shinkeigaku Zasshi, Psychiatria et Neurologia Japonica
Lukas Frase, Barbara Sixt, Christoph Nissen
We report the case of a 19-year-old male student with a Kleine-Levin syndrome who was referred to our sleep laboratory during an episode of hypersomnia, hypersexuality, cognitive impairment and bizarre behaviour. Owing to similar clinical symptoms, he had been misdiagnosed with schizophrenia. This had led to a placement in a facility for persons with chronic schizophrenia, antipsychotic pharmacotherapy for 4 years and side effects, including substantial weight gain and hypertension. After cessation of the antipsychotic medication, the weight and blood pressure normalised...
July 8, 2013: BMJ Case Reports
Emmanuel J M Mignot
Narcolepsy and other syndromes associated with excessive daytime sleepiness can be challenging to treat. New classifications now distinguish narcolepsy/hypocretin deficiency (also called type 1 narcolepsy), a lifelong disorder with well-established diagnostic procedures and etiology, from other syndromes with hypersomnolence of unknown causes. Klein-Levin Syndrome, a periodic hypersomnia associated with cognitive and behavioral abnormalities, is also considered a separate entity with separate therapeutic protocols...
October 2012: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Robin Lloyd, Maja Tippmann-Peikert, Nancy Slocumb, Suresh Kotagal
STUDY OBJECTIVE: To describe our experience regarding the clinical and polysomnographic features of REM sleep behavior disorder (RBD) in childhood. METHODS: This was a retrospective chart review of children and adolescents with RBD and REM sleep without atonia. Demographics, and clinical and polysomnographic information were tabulated. Our findings were compared with those in the existing literature. RESULTS: The 15 subjects identified (13 RBD and 2 having REM sleep without atonia) had a mean age at diagnosis of 9...
April 15, 2012: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Jasna Šaponjić
Many complex behavioral phenomena such as sleep can not be explained without multidisciplinary experimental approach, and complementay approaches in the animal models "in vivo" and human studies. Electrophysiological, pharmacological, anatomical and immunohistochemical techniques, and particularly stereotaxically guided local nanovolume microinjection technique, enable us to selectively stimulate and lesion the brain nuclei or their specific neuronal subpopulation, and to reslove the mechanisms of certain brain structure regulatory role, and its afferent-efferent connectivity within the brain...
2011: Glas
Mohsin Ali, R Robert Auger, Nancy L Slocumb, Timothy I Morgenthaler
OBJECTIVE: A recent American Academy of Sleep Medicine publication identified a need for research regarding idiopathic hypersomnia. We describe various clinical and polysomnographic features of patients with idiopathic hypersomnia, with an emphasis on response to pharmacotherapy. METHODS: A retrospective review of our database initially identified 997 patients, utilizing "idiopathic hypersomnia", "hypersomnia NOS", and "primary hypersomnia" as keywords...
December 15, 2009: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
R B Jarrett, D Kraft, M Schaffer, A Witt-Browder, R Risser, D H Atkins, J Doyle
BACKGROUND: Patients with major depressive disorder (MDD) and atypical features have reactive mood plus at least two symptoms: hypersomnia, hyperphagia, leaden paralysis or a lifetime sensitivity to rejection. These patients respond to cognitive therapy (CT) or phenelzine (PHZ) significantly more than pill placebo (PBO). The purpose of this report is to motivate research on tolerable continuation phase treatment designed to reduce the significant risk of relapse and recurrence which depressed patients with atypical features face...
September 2000: Psychotherapy and Psychosomatics
S M Sotsky, S J Simmens
BACKGROUND: The validity of diagnostic criteria and the efficacy of tricyclic antidepressant pharmacotherapy for atypical depression were studied in the NIMH Treatment of Depression Collaborative Research Program. METHODS: Outpatients with major depressive disorder (N = 239) entered a 16-week clinical trial and were randomly assigned to interpersonal psychotherapy, cognitive behavior therapy, and imipramine or placebo with clinical management. Features of atypical depression were rated on the SADS and ISI and clinical outcome was measured on the HRSD and GAS...
August 1999: Journal of Affective Disorders
H Suzuki
The recurrent hypersomnia is a rare disorder and diagnosed by recurrent episodes of hypersomnia more than 18 hours a day lasting from several days to several weeks. The Kleine-Levin syndrome is a subtype of the recurrent hypersomnia and characterized by excessive eating or hypersexuality. I review the clinical features of recurrent hypersomnia comparing with our own two cases. The slight consciousness disturbance is seemed to cause the hypersomnic state. Several neurophysiological findings also support this hypothesis...
February 1998: Nihon Rinsho. Japanese Journal of Clinical Medicine
T Roth, T A Roehrs
Excessive daytime sleepiness (EDS), the primary complaint of patients seen in sleep clinics, affects up to 12% of the general population. The effects of EDS can be debilitating and even life threatening. Patients with EDS may exhibit psychosocial distress, decreased work or school performance, and increased risk for accidents. The differential diagnosis of EDS requires objective assessments, such as polysomnography and the Multiple Sleep Latency Test. There are four major causes of EDS: (1) central nervous system (CNS) pathologic abnormalities, such as narcolepsy and idiopathic CNS hypersomnia; (2) qualitative or quantitative sleep deficiencies, such as sleep apnea and insufficient nocturnal sleep; (3) misalignments of the body's circadian pacemaker with the environment (eg...
July 1996: Clinical Therapeutics
J R Cornelius, P H Soloff, J M Perel, R F Ulrich
OBJECTIVE: The aim of this study was to assess the effectiveness of low-dose neuroleptic medication and monoamine oxidase inhibitor (MAOI) antidepressant medication in continuation pharmacotherapy of patients with borderline personality disorder. METHOD: The authors conducted a double-blind, placebo-controlled study comparing continuation therapy with a neuroleptic (up to 6 mg/day of haloperidol), an MAOI antidepressant (up to 90 mg/day of phenelzine), and placebo in 14 men and 40 women with borderline personality disorder...
December 1993: American Journal of Psychiatry
C H Schenck, M W Mahowald
There are currently three recognized menstrual-related sleep disorders: premenstrual insomnia, menopausal insomnia and premenstrual hypersomnia. Another category, premenstrual parasomnia (sleep behavior disorder), is now suggested. Case 1, a 17-year-old female, presented with a 6-year history of exclusively premenstrual sleep terrors and injurious sleep-walking that began 1 year after menarche. During the four nights preceding each menses, she would scream and run from her bed. There was no history of premenstrual syndrome...
June 1995: Journal of Psychosomatic Obstetrics and Gynaecology
M H Stone
Most patients with borderline personality disorder (BPD), especially early in their treatment, will need pharmacotherapy along with supportive or exploratory psychotherapy. A benzodiazepine anxiolytic will suffice for some. Many require more definitive treatment with an antidepressant or a neuroleptic in low dosage. Those with bipolar II comorbidity may benefit from lithium or, if the irritability component is pronounced, from carbamazepine. In practice, a variety of personality factors and comorbid conditions, over-represented in populations of BPD patients, often complicate the clinical picture...
1989: Psychopharmacology Bulletin
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