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Excessive Daytime Sleepiness: A Clinical Review
Kriti D Gandhi1, Meghna P Mansukhani2, Michael H Silber3
1Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
Mayo Clinic Proceedings
|April 12, 2021
Summary
Excessive daytime sleepiness (EDS) is common and has many causes. Effective treatment involves diagnosing the cause and using medications and behavioral strategies to improve wakefulness.
Area of Science:
- Neurology
- Sleep Medicine
- Internal Medicine
Background:
- Excessive daytime sleepiness (EDS) is a prevalent condition linked to significant morbidity.
- Causes are diverse, including sleep deprivation, sleep disorders, and central disorders of hypersomnolence like narcolepsy.
Purpose of the Study:
- To review the epidemiology, assessment, and latest treatment options for EDS.
- To provide guidance on diagnosing and managing EDS, particularly when secondary to central disorders of hypersomnolence.
Main Methods:
- Literature review using PubMed and MEDLINE with keywords: excessive sleepiness, hypersomnia, hypersomnolence, treatment.
- Inclusion of the latest practice parameters from the American Academy of Sleep Medicine.
Main Results:
- Assessment involves detailed history, examination, actigraphy, polysomnography, multiple sleep latency testing, and CSF hypocretin-1 measurement.
- Pharmacologic treatments include wakefulness-promoting agents, stimulants, and newer agents, often combined with behavioral interventions.
Conclusions:
- Accurate diagnosis of EDS requires comprehensive evaluation to identify underlying causes.
- Treatment strategies should be tailored to the specific cause of EDS, focusing on improving wakefulness and managing primary conditions.
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