Hypersomnia.

OBJECTIVE

The purpose of this article is to provide an overview of how to evaluate, diagnose, and manage patients with hypersomnia disorders.

LATEST DEVELOPMENTS: The extended-release formulation of sodium oxybate to treat narcolepsy with a dosage of once a night, rather than twice a night, was approved in 2023 for adults and in 2024 for pediatric patients aged 7 years and older by the US Food and Drug Administration (FDA). The novel pharmacokinetics of this formulation may improve medication adherence and reduce nighttime disruptions and sleep fragmentation for patients and their bed partners. Orexin receptor 2 agonists are also being investigated for the treatment of narcolepsy and idiopathic hypersomnia. CSF orexin testing can be used to diagnose narcolepsy type 1.

ESSENTIAL POINTS: Patients with hypersomnia have excessive daytime sleepiness, which can be due to an underlying sleep disorder or can be secondary to another condition. Diagnostic tools are useful but imperfect. It is essential to obtain a detailed sleep history to understand how patient symptoms are affecting daily life.