Idiopathic hypersomnia

Clinical features and response to treatment

Mohsin Ali, Robert R Auger, Nancy L. Slocumb, Timothy Ian Morgenthaler

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Objective: A recent American Academy of Sleep Medicine publication identified a need for research regarding idiopathic hypersomnia. We describe various clinical and Polysomnographic features of patients with idiopathic hypersomnia, with an emphasis on response to pharmacotherapy. Methods: A retrospective review of our database initially identified 997 patients, utilizing "idiopathic hypersomnia," "hypersomnia NOS," and "primary hypersomnia" as keywords. The charts of eligible patients were examined in detail, and data were abstracted and analyzed. Response to treatment was graded utilizing an internally developed scale. Results: Eighty-five patients were ultimately identified (65% female). Median (interquartile range) ages of onset and diagnosis were 19.6 (15.5) and 33.7 (15.5), respectively. During a median follow-up duration of 2.4 (4.7) years, 65% of patients demonstrated a "complete response" to pharmacotherapy as assessed by the authors' grading schema. Methylphenidate was most commonly used as a first-line agent prior to December 1998, but subsequently, modafinil became the most common first drug. At the last recorded follow-up visit, 92% of patients were on monotherapy, with greater representation of methylphenidate versus modafinil (51% vs. 32%). Among these patients, methylphenidate produced a higher percentage of "complete" or "partial" responses than modafinil, although statistical significance was not reached (38/40 [ 95%] vs 22/25 [88%], respectively, p= 0.291). Conclusions: The majority of patients with idiopathic hypersomnia respond well to treatment. Methylphenidate is chosen more often than modafinil as final monotherapy in the treatment of idiopathic hypersomnia, despite the fact that it is less commonly used initially. Further prospective comparisons of medications should be explored.

Original languageEnglish (US)
Pages (from-to)562-568
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume5
Issue number6
StatePublished - Dec 15 2009

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Idiopathic Hypersomnolence
Methylphenidate
Disorders of Excessive Somnolence
Therapeutics
Drug Therapy
Age of Onset
Publications
Sleep
Medicine
Databases

Keywords

  • Idiopathic hypersomnia
  • Methylphenidate
  • Modafinil
  • Stimulants
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

Idiopathic hypersomnia : Clinical features and response to treatment. / Ali, Mohsin; Auger, Robert R; Slocumb, Nancy L.; Morgenthaler, Timothy Ian.

In: Journal of Clinical Sleep Medicine, Vol. 5, No. 6, 15.12.2009, p. 562-568.

Research output: Contribution to journalArticle

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