management
Last edited 04/2020 and last reviewed 01/2022
General advice includes:
- adopt a regular sleep routine
- avoid excess caffeine and alcohol
If daytime sleepiness continues to be a problem then some patients may prefer to take regular naps.
If naps are not possible then most patients will require drug treatment.
- in general, in patients with narcolepsy, treatment is initiated by a specialist
- treatments used to increase alertness include dexamfetamine and modafinil,
and methylphenidate
- concomitant treatment with an antidepressant drug (usually clomipramine) may be given to prevent cataplectic attacks
- in practice, management for idiopathic hypersomnia is similar to that for narcolepsy
- pitolisant (a wake promoting histamine H3-receptor inverse agonist) may provide a further treatment option (2)
Reference:
- Drug and Therapeutics Bulletin 2004; 42(7):52-6.
- Brown J, Makker KM. An approach to excessive daytime sleepiness in adults. BMJ 2020;368:m1047
solriamfetol for treating excessive daytime sleepiness caused by narcolepsy