Hypersomnia & Narcolepsy

The treatment for excessive day time sleepiness might first start with a simple behavioral approach in assessing whether sufficient sleep time and proper sleep hygiene has been followed. In rare circumstances, we resort to pharmacologic approaches when treating hypersomnia due to neurologic conditions like narcolepsy or idiopathic hypersomnia. Treatment for all sleep disorders starts with patient education, good sleep hygiene and good treatment compliance. When a patient presents with hypersomnia, we evaluate for other possible causes such as: sleep apnea, shift work / circadian disorder,

medications or medical condition that might impair sleep leading to excessive day time sleepiness.

Central causes are neurologic in origin. If the brain develops an impairment in regulating sleep / wake control, narcolepsy is a possible cause. Patients with narcolepsy may have low levels or become completely deficient of a wake promoting neurotransmitter called hypocretin (orexin). When testing for narcolepsy we perform an overnight polysomnography followed by a MSLT, or multiple sleep latency test to support this diagnosis.