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Disorders of Excessive Somnolence (Hypersomnia)

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Disorders characterized by hypersomnolence during normal waking hours that may impair cognitive functioning. Subtypes include primary hypersomnia disorders (e.g., IDIOPATHIC HYPERSOMNOLENCE; NARCOLEPSY; and KLEINE-LEVIN SYNDROME) and secondary hypersomnia disorders where excessive somnolence can be attributed to a known cause (e.g., drug affect, MENTAL DISORDERS, and SLEEP APNEA SYNDROME). (From J Neurol Sci 1998 Jan 8;153(2):192-202; Thorpy, Principles and Practice of Sleep Medicine, 2nd ed, p320)

Also Known As:

Hypersomnia; Hypersomnolence; DOES (Disorders of Excessive Somnolence); Excessive Somnolence Disorders; Hypersomnia, Recurrent; Hypersomnolence Disorders; Hypersomnolence Disorders, Primary; Hypersomnolence Disorders, Secondary; Primary Hypersomnolence Disorders; Secondary Hypersomnolence Disorders; DOESs (Disorders of Excessive Somnolence); Excessive Somnolence Disorder; Hypersomnias; Hypersomnias, Recurrent; Hypersomnolence Disorder; Hypersomnolence Disorder, Primary; Hypersomnolence Disorder, Secondary; Primary Hypersomnolence Disorder; Recurrent Hypersomnia; Recurrent Hypersomnias; Secondary Hypersomnolence Disorder; Somnolence Disorder, Excessive; Somnolence Disorders, Excessive

Networked: 361 relevant articles (35 outcomes, 25 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Narcolepsy
2.	Disorders of Excessive Somnolence (Hypersomnia)
3.	Cataplexy
4.	Hyperphagia
5.	Snoring

Experts

1.	Kanbayashi, Takashi: 21 articles (06/2015 - 07/2002)
2.	Nishino, Seiji: 13 articles (07/2010 - 10/2002)
3.	Mignot, Emmanuel: 10 articles (08/2015 - 10/2002)
4.	Dauvilliers, Yves: 9 articles (06/2015 - 01/2006)
5.	Shimizu, Tetsuo: 7 articles (06/2009 - 08/2003)
6.	Bayard, Sophie: 5 articles (01/2013 - 01/2010)
7.	Takahashi, Toshiyuki: 4 articles (06/2015 - 08/2011)
8.	Honda, Makoto: 4 articles (01/2013 - 01/2009)
9.	Lin, Ling: 4 articles (01/2013 - 11/2006)
10.	Veasey, Sigrid C: 4 articles (05/2012 - 06/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Disorders of Excessive Somnolence:

1.	modafinil (armodafinil)FDA Link 12/01/2007 - "However, the hypersomnia items on the 31-item Hamilton Depression Scale were significantly more improved with modafinil than placebo. " 12/01/2003 - "The addition of the selective psychostimulant modafinil resulted in significant improvement in the hypersomnia, with improvement in functioning. " 12/01/2003 - "The addition of modafinil to their medication regimen resulted in a decrease in hypersomnia and improvement in their level of functioning. " 03/01/2014 - "No study has up to now investigated the effect of modafinil (a reference drug to treat EDS in patients with hypersomnia) on on-road driving performance of patients suffering from central hypersomnia. " 08/01/2009 - "The aim of this study was to evaluate the efficacy and tolerability of modafinil for the treatment of hypersomnia in adults with MMD1. "
2.	orexins (orexin)IBA 02/01/2009 - "We report the case of a patient with a serum anti-AQP4 antibody who presented with recurrent hypersomnia, symmetrical hypothalamic lesions with long spinal cord lesions on MRI, and a reduced CSF orexin (hypocretin) level, all of which were improved simultaneously by steroid therapy. " 07/01/2008 - "Dysfunction of the hypocretin system has been reported in MS case reports with attacks of hypothalamic lesions, undetectable cerebrospinal fluid (CSF) hcrt-1 and hypersomnia, but not found during remission in small samples. " 08/01/2005 - "Hypersomnia and a decrease of the CNS orexin A improved after corticosteroid therapy. " 02/01/2009 - "Further studies should be performed to determine the roles of anti-AQP4 antibody positivity in patients with hypersomnia associated with orexin (hypocretin) deficiency and hypothalamic lesions." 01/01/2014 - "After recovering from the stupor, the patient exhibited the symptoms of hypersomnia with low orexin level in the CSF. "
3.	Sodium Oxybate (gamma Hydroxybutyrate)FDA Link 04/01/1981 - "[Sodium gamma-hydroxybutyrate in the treatment of essential hypersomnia]." 01/01/2009 - "In four randomised, double-blind, placebo-controlled studies and with a class A level of evidence, sodium oxybate has proved to be effective in improving the cardinal symptoms of narcolepsy-cataplexy, that is to say, hypersomnia, cataplexy and fragmentation of nocturnal sleep. " 12/01/2007 - "Several recent studies provide evidence that modafinil and sodium oxybate are effective for treatment of hypersomnia due to narcolepsy. " 12/01/2007 - "Several large randomized, placebo-controlled studies indicate that modafinil and sodium oxybate are effective for treatment of hypersomnia due to narcolepsy. " 01/01/2006 - "Available treatments include stimulants for hypersomnia with the quite recent widespread use of modafinil, antidepressants for cataplexy, and gamma-hydroxybutyrate for both symptoms. "
4.	Antidepressive Agents (Antidepressants)IBA 12/01/2006 - "The comparison between BP-II and UP showed differential phenomenology, such as hypersomnia, increased psychomotor activation, guilt feelings and suicidal thoughts in BP-II. Related data demonstrated the importance of CT in further qualifying of MDE to define a distinct, more severe ("darker") BP-II(1/2) variant of BP-II. Moreover, BP-III, arising from DT and associated with antidepressants, emerged as a valid soft bipolar variant on the basis of the phenomenology of hypomania and bipolar family history. " 12/01/1995 - "In addition, all antidepressants may eventually correct depressive hypersomnia, but in these cases, it is evidently preferable to prescribe non-sedative drugs. " 08/03/1974 - "Letter: Hypersomnia and MAOI antidepressants." 04/01/1999 - "In comparison with the CSR group, the ISR group had a longer duration of illness, more often used antidepressants, and improved significantly less after treatment with bright light for 6 days, whereas the symptomatology in winter (Montgomery-Asberg Depression Rating Scale plus hypersomnia, hyperphagia, and carbohydrate craving) was similar in the two groups. " 12/01/1995 - "However, it is very often of benefit to prescribe psychotropic agents, in particular antidepressants, not only in insomnia but also in certain cases of hypersomnia, parasomnia and dysomnia associated with organic diseases. "
5.	Thyroxine (Levothyroxine)FDA LinkGeneric 06/01/2011 - "Levothyroxine was effective for hypersomnia and well tolerated." 03/01/2009 - "Levothyroxine was effective for their hypersomnia and well tolerated. "
6.	Clarithromycin (Biaxin)FDA LinkGeneric 09/01/2015 - "Although additional studies are needed, this suggests that clarithromycin may be a reasonable treatment option in patients with treatment-refractory hypersomnolence. " 05/01/2011 - "In both cases the hypersomnia receded after cessation of clarithromycin therapy. " 05/01/2011 - "Clarithromycin-induced hypersomnia in children has not been reported before. " 05/01/2011 - "Two cases of hypersomnia in children caused by therapeutic doses of oral clarithromycin are presented. " 05/01/2011 - "Clarithromycin-induced hypersomnia in children."
7.	OxygenIBA 11/01/1986 - "Neither subjective nor objective hypersomnolence consistently improved after 1 month of oxygen administration. " 10/01/1995 - "Patients who experienced one of the following symptoms: association of body mass index (-weight/height2) above 27.5 and heavy snoring, breathing stops, or daytime hypersomnolence, were selected for a nocturnal oxygen saturation recording. " 07/01/1995 - "Patients with obstructive sleep apnea snore loudly and experience nocturnal oxygen desaturation and repetitive disruptions from sleep that eventually lead to daytime hypersomnolence. " 02/01/1994 - "We found symptoms of excessively loud snoring, witnessed apnoeic episodes and hypersomnolence, or obstructive sleep apnoea diagnosed by overnight oxygen saturation measurements to be statistically associated with failure of nasal surgery to improve snoring." 08/01/1990 - "However, oxygen did not reduce apneas or improve daytime hypersomnolence as well as nasal CPAP in patients with mild OSA. "
8.	Methylphenidate (Ritalin)FDA LinkGeneric 03/01/1978 - "An important point is emphasized in our case in which the patient reacted unfavorably to Ritalin, becoming sexually aroused, although his hypersomnia improved. " 03/01/1994 - "Pharmacokinetics and pharmacodynamics of (+)-threo-methylphenidate enantiomer in patients with hypersomnia." 05/01/1986 - "However, his hypersomnolence could be attributed to a central dysfunction, and during a follow-up period of 3 years, was successfully treated with methylphenidate." 03/01/1994 - "The pharmacokinetics of (+)-methylphenidate after oral administration of 20 mg racemic methylphenidate hydrochloride and the relationship between clinical effects of plasma (+)-methylphenidate concentration were investigated in 15 patients with hypersomnia and four healthy volunteers. " 06/24/2014 - "Among them, 93 patients with severe hypersomnolence had hypercapnic and hypoxic responsiveness tested before and after the treatment of methylphenidate and another 20 with severe cataplexy did the same before and after the treatment of chlorimiopramine. "
9.	Amphetamine (Amfetamine)FDA LinkGeneric 03/01/2000 - "These results indicate that modafinil is effective against somnolence and hypersomnia and does not produce a subsequent increase in sleep and suggest that the pharmacological profile of modafinil is different from that of amphetamine." 08/15/2014 - "The arousal response to mGluR2 blockade was not accompanied by sharp rebound hypersomnolence as found with the classical psycho-stimulant amphetamine. " 11/01/1997 - "Both rebound hypersomnolence and increased LMA intensity, which are undesirable features in wake-promoting drugs, were not observed after modafinil treatment, and thus further differentiated modafinil from amphetamine-like stimulants." 03/01/2000 - "Effects of amphetamine and modafinil on the sleep/wake cycle during experimental hypersomnia induced by sleep deprivation in the cat." 06/01/1994 - "Psychostimulant abusers often experience anhedonia, depression, fatigue, craving, and hypersomnia and increased propensity for rapid eye movement (REM) sleep during periods of acute and subacute withdrawal from cocaine and amphetamine. "
10.	Dopamine (Intropin)FDA LinkGeneric 11/01/2009 - "Rebound hypersomnolence, stimulant abuse, and DAT-mediated dopamine release." 01/01/1977 - "The probable role of dopamine in abnormalities in the sleep-waking cycle is discussed on the basis of results in experimental animal hypersomnias." 11/01/2009 - "The roles of dopamine transport inhibition and dopamine release facilitation in wake enhancement and rebound hypersomnolence induced by dopaminergic agents." 01/01/1977 - "Besides an increased 5-hydroxytryptamine turnover, mainly an increased dopamine turnover has been detected in both kinds of hypersomnia, and this finding was more remarkable in the case with sub-wakefulness. " 06/01/2009 - "Activation of the dopamine system is effective against hypersomnia, and activation of the noradrenaline system is effective against cataplexy. "

Therapies and Procedures

1.	Tracheostomy 11/28/1981 - "Treatment of hypersomnia with central stimulant drugs is often unsatisfactory, particularly in the elderly, and tracheostomy rather than medical treatment is sometimes essential in sleep apnoea." 01/01/1980 - "Therapeutic effects of tracheostomy in two cases of hypersomnia with respiratory disturbance during sleep." 02/01/1973 - "Effects of tracheostomy in two cases of hypersomnia with periodic breathing." 09/01/1972 - "Tracheostomy in hypersomnia with periodic breathing." 09/01/1984 - "Following tracheostomy, both the patient's sleep apnea and daytime hypersomnia were eliminated. "
2.	Aftercare (After-Treatment) 08/01/1986 - "In addition to the improvement in respiration during sleep, SSI decreased from a mean of 3.73 +/- 0.49 after the control night to 1.64 +/- 0.24 after treatment, reflecting an improvement in daytime hypersomnolence. " 12/14/1998 - "The patients were rated with the Montgomery-Asberg Depression Rating Scale (MADRS) and a scale for the 'atypical' symptoms hypersomnia, hyperphagia and carbohydrate craving (the ATYP scale) before and after treatment. " 04/01/1999 - "In comparison with the CSR group, the ISR group had a longer duration of illness, more often used antidepressants, and improved significantly less after treatment with bright light for 6 days, whereas the symptomatology in winter (Montgomery-Asberg Depression Rating Scale plus hypersomnia, hyperphagia, and carbohydrate craving) was similar in the two groups. " 05/01/2004 - "After treatment with steroids, this patient's subjective sleepiness, hypersomnia, and hypocretin deficiency partially improved. "
3.	Continuous Positive Airway Pressure 01/01/2010 - "Nasal continuous positive airway pressure was implemented effectively, reducing daytime hypersomnolence and significantly improving sleep parameters. " 02/01/2005 - "Continuous positive airway pressure therapy eliminated the abnormal behaviors, unpleasant dreams, snoring and daytime hypersomnolence. " 05/01/2004 - "After nasal continuous positive airway pressure (nCPAP) treatment, several symptoms such as hypersomnolence, daytime fatigue, and impaired concentration improve in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). " 01/01/1999 - "Therapeutic naps, medications, and supportive therapy are recommended for narcolepsy and hypersomnia; continuous positive airway pressure, weight loss, surgery, and oral devices are the common treatments for sleep apnea." 06/01/2007 - "(2) Modafinil, a non amphetamine psychostimulant already marketed for idiopathic narcolepsy and hypersomnia, is the first drug to be approved in France for the treatment of patients with residual daytime drowsiness despite nasal continuous positive airway pressure treatment. "
4.	Tonsillectomy 11/01/1983 - "Fourteen of the 23 patients (60.8%), 5 of the 7 who underwent tonsillectomy and 9 of the 16 treated by SMR, reported on a clinical improvement in the quality of their nocturnal sleep and diurnal hypersomnolence. " 08/01/1986 - "Tonsillectomy relieves hypersomnolence."
5.	Bariatric Surgery 05/01/2012 - "Clinical studies demonstrate that obesity without sleep apnea is also associated with a higher prevalence of hypersomnolence and that bariatric surgery can markedly improve hypersomnolence before resolution of obstructive sleep apnea. "