Guideline sources The following summarized guidelines for the evaluation and management of central disorders of hypersomnolence are prepared by our editorial team based on guidelines from the American Academy of Sleep Medicine (AASM 2021; 2018) and the European Academy of Neurology (EAN 2021). 1 2 3 Guidelines 1. Diagnostic investigations Actigraphy: consider use actigraphy to monitor total sleep time before testing with the multiple sleep latency test in adult and pediatric patients with suspected central disorders of hypersomnolence. C 2. Specific circumstances Patients with narcolepsy, adults: As per AASM 2021 guidelines, offer the following medications for the treatment of excessive daytime sleepiness in adult patients with narcolepsy: modafinil pitolisant sodium oxybate solriamfetol. A https://web.pathway.md/diseases/recsahw5Srufo5C4g 1/3 6/29/23, 3:46 AM Central disorders of hypersomnolence Pathway Show 3 more As per EAN 2021 guidelines, offer the following medications as first-line therapy for excessive daytime sleepiness in adult patients with narcolepsy: modafinil pitolisant sodium oxybate solriamfetol. B Show 12 more Patients with narcolepsy, pediatrics: As per AASM 2021 guidelines, consider offering the following medications for the treatment of pediatric patients with narcolepsy: modafinil sodium oxybate. C As per EAN 2021 guidelines, offer sodium oxybate for the treatment of excessive daytime sleepiness, cataplexy, and disturbed nighttime sleep in > 6 years old pediatric patients with narcolepsy. Obtain a regular careful benefit-risk ratio assessment. B Show 5 more Patients with idiopathic hypersomnia: Offer modafinil for the treatment of adult patients with idiopathic hypersomnia. A Consider offering the following medications for the treatment of adult patients with idiopathic hypersomnia: clarithromycin methylphenidate pitolisant sodium oxybate. C Patients with Kleine-Levin syndrome: consider offering lithium for the treatment of adult patients with Kleine-Levin syndrome. C Patients with neurological diseases: Consider offering the following medications for the treatment of adult patients with hypersomnia secondary to Parkinson's disease: modafinil sodium oxybate. C Show 2 more Patients with myotonic dystrophy: consider offering modafinil for the treatment of adult patients with hypersomnia secondary to myotonic dystrophy. C Patients with post-traumatic hypersomnia: Consider offering the following medications for the treatment of adult patients with hypersomnia secondary to TBI: armodafinil modafinil. C https://web.pathway.md/diseases/recsahw5Srufo5C4g 2/3 6/29/23, 3:46 AM Central disorders of hypersomnolence Pathway References 1. Michael T Smith, Christina S McCrae, Joseph Cheung et al. Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2018 Jul 15;14 7 1231 1237. Open 2. Kiran Maski, Lynn Marie Trotti, Suresh Kotagal et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021 Sep 1;17 9 1881 1893. Open 3. Claudio L A Bassetti, Ulf Kallweit, Luca Vignatelli et al. European guideline and expert statements on the management of narcolepsy in adults and children. Eur J Neurol. 2021 Sep;28 9 2815 2830. Open https://web.pathway.md/diseases/recsahw5Srufo5C4g 3/3