621 results match your criteria Primary Hypersomnia

Excessive Daytime Sleepiness: A Clinical Review.

Mayo Clin Proc 2021 05 9;96(5):1288-1301. Epub 2021 Apr 9.

Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; Center for Sleep Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Excessive daytime sleepiness (EDS) is a highly prevalent condition that is associated with significant morbidity. The causes of EDS are varied, and include inadequate sleep, sleep disordered breathing, circadian rhythm sleep-wake disorders, and central disorders of hypersomnolence (narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome). Additionally, EDS could represent a symptom of an underlying medical or psychiatric disorder. Read More

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The Swiss Primary Hypersomnolence and Narcolepsy Cohort study (SPHYNCS): Study protocol for a prospective, multicentre cohort observational study.

J Sleep Res 2021 Apr 4:e13296. Epub 2021 Apr 4.

Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Narcolepsy type 1 (NT1) is a disorder with well-established markers and a suspected autoimmune aetiology. Conversely, the narcoleptic borderland (NBL) disorders, including narcolepsy type 2, idiopathic hypersomnia, insufficient sleep syndrome and hypersomnia associated with a psychiatric disorder, lack well-defined markers and remain controversial in terms of aetiology, diagnosis and management. The Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (SPHYNCS) is a comprehensive multicentre cohort study, which will investigate the clinical picture, pathophysiology and long-term course of NT1 and the NBL. Read More

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Insomnia - A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges.

Front Psychol 2021 11;12:639198. Epub 2021 Feb 11.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Read More

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February 2021

Application of the Sleep Disturbance Scale for Children (SDSC) in infants and toddlers (6-36 months).

Sleep Med 2021 May 10;81:62-68. Epub 2021 Feb 10.

Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.

Objectives: The aim of the present study is to assess the psychometric properties of the Sleep Disturbance Scale for Children (SDSC) in an Italian population of infants and toddlers.

Methods: The SDSC was distributed to the primary caregivers of infants aged 6-36 months recruited via nurseries in the urban area of Rome. Reliability analysis for evaluating internal consistency and item-total correlation coefficients, and factor analysis were performed. Read More

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Efficacy and safety of modafinil in patients with idiopathic hypersomnia without long sleep time: a multicenter, randomized, double-blind, placebo-controlled, parallel-group comparison study.

Sleep Med 2021 Apr 20;80:315-321. Epub 2021 Jan 20.

Medical Affairs Headquarters, Alfresa Pharma Corporation, 2-2-9 Koku-machi, Chuo-ku, Osaka, 540-8575, Japan.

Background: Few treatments are available for patients with idiopathic hypersomnia (IH). Modafinil, an established treatment for narcolepsy, was tested for efficacy and safety in Japanese patients with IH without long sleep time.

Methods: This multicenter, randomized, double-blind, placebo-controlled, parallel-group comparison study was conducted at 20 institutions in Japan. Read More

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Sleep phenotype of individuals with autism spectrum disorder bearing mutations in the PER2 circadian rhythm gene.

Am J Med Genet A 2021 04 20;185(4):1120-1130. Epub 2021 Jan 20.

Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.

The Per family of genes functions as a primary circadian rhythm maintenance in the brain. Mutations in PER2 are associated with familial advanced sleep-phase syndrome 1 (FASPS1), and recently suggested in delayed sleep phase syndrome and idiopathic hypersomnia. The detection of PER2 variants in individuals with autism spectrum disorder (ASD) and without reported sleep disorders, has suggested a role of circadian-relevant genes in the pathophysiology of ASD. Read More

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Efficacy and safety of solriamfetol for excessive sleepiness in narcolepsy and obstructive sleep apnea: findings from randomized controlled trials.

Sleep Med 2021 03 2;79:40-47. Epub 2021 Jan 2.

Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.

Background: Solriamfetol is developed for the treatment of excessive sleepiness in adult patients with narcolepsy and obstructive sleep apnea (OSA). No systematic review of existing literature has been investigated before. Therefore, the meta-analysis is conducted to assess the efficacy and safety of solriamfetol for excessive sleepiness in narcolepsy and OSA. Read More

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Working nights and lower leisure-time physical activity associate with chronic pain in Southern African long-distance truck drivers: A cross-sectional study.

PLoS One 2020 3;15(12):e0243366. Epub 2020 Dec 3.

Ezintsha, A Sub-Division of Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: In South Africa, the trucking industry employs over 70,000 people and the prevalence of chronic pain in this occupational group was reported at 10%. We investigated factors associated with chronic pain in truck drivers including mental health, physical activity, and sleep, as no study has done so.

Methods: Southern African male, long-distance truck drivers were recruited at truck stops in Gauteng and Free State Provinces, South Africa (n = 614). Read More

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January 2021

Pharmacotherapies for sleep disturbances in dementia.

Cochrane Database Syst Rev 2020 11 15;11:CD009178. Epub 2020 Nov 15.

Department of Psychiatry, Oxford University, Oxford, UK.

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 carer distress, increased healthcare costs, and institutionalisation. Although non-drug interventions are recommended as the first-line approach to managing these problems, drug treatment is often sought and used. However, there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this clinically vulnerable population. Read More

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November 2020

Efficacy and safety of calcium, magnesium, potassium, and sodium oxybates (lower-sodium oxybate [LXB]; JZP-258) in a placebo-controlled, double-blind, randomized withdrawal study in adults with narcolepsy with cataplexy.

Sleep 2021 03;44(3)

Department of Neurology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.

Study Objectives: Evaluate efficacy and safety of lower-sodium oxybate (LXB), a novel oxybate medication with 92% less sodium than sodium oxybate (SXB).

Methods: Adults aged 18-70 years with narcolepsy with cataplexy were eligible. The study included a ≤30-day screening period; a 12-week, open-label, optimized treatment and titration period to transition to LXB from previous medications for the treatment of cataplexy; a 2-week stable-dose period (SDP); a 2-week, double-blind, randomized withdrawal period (DBRWP); and a 2-week safety follow-up. Read More

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Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea.

Cochrane Database Syst Rev 2020 11 3;11:CD013449. Epub 2020 Nov 3.

Bilbao, Spain.

Background: Obstructive sleep apnoea (OSA) is a syndrome characterised by episodes of apnoea (complete cessation of breathing) or hypopnoea (insufficient breathing) during sleep. Classical symptoms of the disease - such as snoring, unsatisfactory rest and daytime sleepiness - are experienced mainly by men; women report more unspecific symptoms such as low energy or fatigue, tiredness, initial insomnia and morning headaches. OSA is associated with an increased risk of occupational injuries, metabolic diseases, cardiovascular diseases, mortality, and being involved in traffic accidents. Read More

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November 2020

Efficacy and safety of solriamfetol for excessive daytime sleepiness in narcolepsy and obstructive sleep apnea: a systematic review and meta-analysis of clinical trials.

Sleep Med 2020 11 21;75:510-521. Epub 2020 Sep 21.

BP Koirala Institute of Health Sciences, Dharan, Nepal.

Introduction: Excessive daytime sleepiness (EDS) is the inability to maintain wakefulness and alertness during the major waking episodes of the day, with sleep occurring unintentionally or at inappropriate times. Solriamfetol is a selective norepinephrine-dopamine reuptake inhibitor approved for EDS. This review was done to assess the efficacy and safety of solriamfetol in patients with EDS in narcolepsy or OSA. Read More

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November 2020

The sodium in sodium oxybate: is there cause for concern?

Sleep Med 2020 11 21;75:497-501. Epub 2020 Sep 21.

Stanford University Medical Center, 450 Broadway Street, MC 5704, Pavilion C, 2nd Floor, Redwood City, CA, USA. Electronic address:

Sodium oxybate (SO), the sodium salt of γ-hydroxybutyric acid, is one of the primary pharmacologic agents used to treat excessive sleepiness, disturbed nighttime sleep, and cataplexy in narcolepsy. The sodium content of SO ranges from 550 to 1640 mg at 3-9 g, given in two equal nightly doses. Clinicians are advised to consider daily sodium intake in patients with narcolepsy who are treated with SO and have comorbid disorders associated with increased cardiovascular (CV) risk, in whom sodium intake may be a concern. Read More

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November 2020

Efficacy of a telemonitoring system in continuous positive airway pressure therapy in Asian obstructive sleep apnea.

J Clin Sleep Med 2021 01;17(1):23-29

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Study Objectives: A telemonitoring system is a promising wireless technology that possibly enhances adherence to CPAP therapy. The study aimed to determine the effect of a telemonitoring system on CPAP therapy adherence among Asian patients with moderate-to-severe OSA.

Methods: A prospective randomized controlled trial enrolled 60 Asian adults (70% male) with moderate-to-severe OSA. Read More

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January 2021

Conventional autoantibodies against brain antigens are not routinely detectable in serum and CSF of narcolepsy type 1 and 2 patients.

Sleep Med 2020 11 7;75:188-191. Epub 2020 Aug 7.

Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Neurology Department, Sechenov First Moscow State Medical University, Moscow, Russia.

Narcolepsy with cataplexy (NT1) is a chronic hypothalamic disorder with a presumed immune-mediated etiology leading to a loss of hypocretin neurons. Previous studies reported conflicting results in terms of presence of auto-antibodies involved in narcolepsy pathophysiology. A total of 86 patients with primary/idiopathic narcolepsy (74 NT1, 12 NT2) and 23 control patients with excessive daytime sleepiness due to other causes were tested for the presence of a wide range of anti-neuronal antibodies in both serum and cerebrospinal fluid (CSF). Read More

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November 2020

Prevalence of narcolepsy and other sleep disorders and frequency of diagnostic tests from 2013-2016 in insured patients actively seeking care.

J Clin Sleep Med 2020 08;16(8):1255-1263

University of Pennsylvania, Philadelphia, Pennsylvania.

Study Objectives: The primary objective was to describe trends in the 2-year limited duration prevalence of narcolepsy from 2013-2016 in a large insured population with claims activity. Secondary objectives were to assess the prevalence of other sleep disorders and the frequency of diagnostic sleep testing.

Methods: Nationwide medical/prescription claims (Symphony Health) were analyzed to estimate the annual prevalence per 100,000 persons of narcolepsy and other sleep disorders (obstructive sleep apnea, idiopathic hypersomnia, rapid eye movement sleep behavior disorder, periodic limb movement disorder) and the frequency of diagnostic sleep testing. Read More

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Polygenic risk score analysis revealed shared genetic background in attention deficit hyperactivity disorder and narcolepsy.

Transl Psychiatry 2020 08 17;10(1):284. Epub 2020 Aug 17.

Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Attention deficit hyperactive disorder (ADHD) is a highly heritable neurodevelopmental disorder, and excessive daytime sleepiness is frequently observed in ADHD patients. Excessive daytime sleepiness is also a core symptom of narcolepsy and essential hypersomnia (EHS), which are also heritable conditions. Psychostimulants are effective for the symptomatic control of ADHD (primary recommended intervention) and the two sleep disorders (frequent off-label use). Read More

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Gender differences in Epworth Sleepiness Scale revealed by paired patient-spouse scoring.

Epilepsy Behav 2021 01 8;114(Pt A):107272. Epub 2020 Jul 8.

Center for Health Equity and Quality Research (CHEQR), University of Florida College of Medicine, Jacksonville, FL, 580 W. 8th St, Tower 1, 9th floor, UF Department of Neurology, Jacksonville, FL 32209, United States of America.

Purpose: Evaluation of daytime sleepiness in the clinical sleep practice is commonly performed by administering the Epworth Sleepiness Scale (ESS). Our study investigates gender differences of ESS responses in patients (PTs) with a primary complaint of nighttime sleep disruption as they relate to ESS responses obtained from PTs' spouses (Ss).

Methods: One hundred and sixty-four patient-spouse (PT-S) pairs were recruited for the study and asked to independently complete ESS questionnaires consisting of 8 sleepiness scenarios (Q1-Q8). Read More

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January 2021

[Adult myotonic dystrophy type 1: an update].

Semergen 2020 Jul - Aug;46(5):355-362. Epub 2020 Jul 6.

Medicina Familiar y Comunitaria, Centro de Salud Periurbana Norte, Villares de la Reina, Salamanca, España; Grupo de Trabajo de Neurología SEMERGEN, España.

Myotonic dystrophy type 1 (DM1) or Steinert's disease (CIE-9-C: 359.21; CIE-10-ES: G71.11, ORPHA: 273) is a rare autosomal dominant inherited myopathy with almost complete penetrance and multisystemic consequences (neurological, cardiological, respiratory, endocrinological, and gastrointestinal). Read More

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CSF and serum ferritin levels in narcolepsy type 1 comorbid with restless legs syndrome.

Ann Clin Transl Neurol 2020 06 20;7(6):924-931. Epub 2020 May 20.

Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.

Objectives: To investigate whether cerebrospinal fluid (CSF) and serum ferritin levels differ between patients with narcolepsy type 1 (NT1) comorbid with restless legs syndrome (RLS) or periodic leg movements during sleep (PLMS), and patients with NT1 or controls without comorbid RLS or PLMS.

Methods: Sixty-six drug-free patients with NT1 (44 males, age 38.5 years [14-81]) were enrolled, including 20 with RLS, 18 with PLMS index ≥15/h (six with both RLS and PLMS). Read More

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Protocols of a diagnostic study and a randomized controlled non-inferiority trial comparing televisits vs standard in-person outpatient visits for narcolepsy diagnosis and care: TElemedicine for NARcolepsy (TENAR).

BMC Neurol 2020 May 11;20(1):176. Epub 2020 May 11.

IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy.

Background: Narcolepsy is a rare chronic sleep disorder that typically begins in youth. Excessive daytime sleepiness is the main disabling symptom, but the disease is often associated with severe endocrine-metabolic and psychosocial issues, worsened by a long diagnostic delay, requiring a multidisciplinary approach. The scarcity of reference Sleep Centres forces the patient and family to travel for seeking medical consultations, increasing the economic and psychosocial burden of the disease. Read More

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Nonpharmacologic Management of Excessive Daytime Sleepiness.

Matthew R Ebben

Sleep Med Clin 2020 Jun;15(2):195-203

Department of Neurology, Center for Sleep Medicine, Weill Cornell Medical College of Cornell University, 425 East 61st Street, 5th Floor, New York, NY 10065, USA. Electronic address:

Unlike other reviews written on this topic, the focus of this article is primarily on nonpharmacologic treatments for daytime sleepiness that is not secondary to other medical or psychological conditions. To provide an appropriate background on primary excessive daytime sleepiness, what is considered optimal sleep in terms of sleep duration, sleep insufficiency, and sleep need is discussed in detail. This discussion is followed by an examination of the behavioral strategy of banking sleep. Read More

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A review on modafinil: the characteristics, function, and use in critical care.

J Drug Assess 2020 4;9(1):82-86. Epub 2020 Apr 4.

Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

In critically ill patients, sleep is generally interrupted. Some factors that lead to such sleep interruption include the intensive care unit (ICU) circumstance, primary medical disease itself, mental stress, and impacts of many drugs and other managements utilized to treat ICU patients. Another illness that may cause profound daytime somnolence is narcolepsy. Read More

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Non-motor Symptoms in Chinese Patients With Isolated Generalized Dystonia: A Case-Control Study.

Front Neurol 2020 8;11:209. Epub 2020 Apr 8.

Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Previous studies have indicated that non-motor symptoms are primary problems in focal dystonia, but limited data are available about non-motor problems and their correlation with motor severity in generalized dystonia (GD). In the present study, we performed a case-control study and enrolled isolated inherited or idiopathic GD patients and age- and sex-matched healthy controls (HC). Clinical characteristics, motor symptoms, non-motor problems, including psychiatric co-morbidity, sleep problems, fatigue, and quality of life (QoL) were assessed in both groups using various rating scales and assessments. Read More

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Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

Cochrane Database Syst Rev 2020 04 7;4:CD007736. Epub 2020 Apr 7.

Royal Papworth Hospital, Respiratory Support and Sleep Centre, Papworth Everard, Cambridge, UK, CB23 3RE.

Background: Although highly effective in the treatment of obstructive sleep apnoea (OSA), continuous positive airway pressure (CPAP) is not universally accepted by users. Educational, supportive and behavioural interventions may help people with OSA initiate and maintain regular and continued use of CPAP.

Objectives: To assess the effectiveness of educational, supportive, behavioural, or mixed (combination of two or more intervention types) strategies that aim to encourage adults who have been prescribed CPAP to use their devices. Read More

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Sleep disorders in myotonic dystrophies.

Muscle Nerve 2020 09 10;62(3):309-320. Epub 2020 Apr 10.

Department of Molecular Genetics & Microbiology, Center for NeuroGenetics, UF Genetics Institute, University of Florida College of Medicine, Gainesville, Florida.

Myotonic dystrophies (DM), the most common muscular dystrophies, are known to have significant sleep disturbances. We analyzed the literature on sleep and excessive daytime sleepiness (EDS) in DM over the past 30 years. In this review we provide a brief overview of sleep, sleep disorders, and methods of assessment. Read More

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September 2020

Effects of an individualized exercise training program on severity markers of obstructive sleep apnea syndrome: a randomised controlled trial.

Sleep Med 2020 06 18;70:33-42. Epub 2020 Feb 18.

Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France; INSERM, U1061, Neuropsychiatry, Montpellier, France; University Montpellier, Montpellier, France. Electronic address:

Objective: Obstructive sleep apnea (OSA) is a high prevalent disorder with severe consequences including sleepiness, metabolic, and cardiovascular disorders. The aim of this study was to assess the effect of an individualized exercise-training (IET) program with educational sessions vs educational sessions alone on severity markers of OSA over an eight-week duration.

Methods: This was a randomised, controlled, parallel-design study. Read More

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Effects of repetitive transcranial magnetic stimulation in subjects with sleep disorders.

Sleep Med 2020 07 19;71:113-121. Epub 2020 Feb 19.

Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria; University for Medical Informatics and Health Technology, UMIT, Hall in Tirol, Austria.

In this review, we aimed at identifying the studies that have employed repetitive transcranial magnetic stimulation (rTMS) in patients with sleep disorders. Low-frequency (LF) rTMS stimulating the right dorsolateral prefrontal cortex (DLPFC) or the posterior parietal cortex (PPC) was found to be effective to reduce cortical hyperexcitability and improve the sleep quality in subjects with chronic primary insomnia (PI). Both high-frequency (HF) and LF rTMS applied over the primary motor cortex or the supplementary motor cortex seem to have transient beneficial effects in patients with restless legs syndrome (RLS). Read More

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Neuroimaging of Narcolepsy and Primary Hypersomnias.

Neuroscientist 2020 08 28;26(4):310-327. Epub 2020 Feb 28.

Brain and Mind Institute, Western University, London, Ontario, Canada.

Advances in neuroimaging open up the possibility for new powerful tools to be developed that potentially can be applied to clinical populations to improve the diagnosis of neurological disorders, including sleep disorders. At present, the diagnosis of narcolepsy and primary hypersomnias is largely limited to subjective assessments and objective measurements of behavior and sleep physiology. In this review, we focus on recent neuroimaging findings that provide insight into the neural basis of narcolepsy and the primary hypersomnias Kleine-Levin syndrome and idiopathic hypersomnia. Read More

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