Idiopathic Hypersomnia Treatment Overview

When to see a healthcare provider

Always see a healthcare provider—either your primary care provider or a sleep medicine specialist—to get treated for idiopathic hypersomnia. Symptoms include excessive daytime sleepiness, sleep that isn’t refreshing, difficulty waking up from sleep, and feeling foggy when you wake up (sleep drunkenness).

It is important to see a provider because the sleepiness can be severe. You may fall asleep while driving or operating machinery, which could lead to serious injury or death. Your doctor will also want to rule out other sleep disorders, like narcolepsy and sleep apnea.

Getting diagnosed

There is no single test for idiopathic hypersomnia. It is diagnosed after ruling out other types of sleep disorders.

• Polysomnogram (sleep study) measures functions like brainwaves, breathing rate, and eye and leg movements while you are sleeping.
• Multiple sleep latency test is usually conducted the day after a polysomnogram.
• You may be asked to nap at set times, and your sleep stages are measured during the naps.
• Epworth sleepiness scale is a self-questionnaire that assesses how likely you are to fall asleep during certain situations and activities.
• You may be asked to keep a sleep diary so your provider can look at your sleep patterns.

What to expect from your doctor visit

Medication is often prescribed to improve daytime alertness. These may include:

• Modafinil (Provigil) is often the first treatment prescribed for idiopathic hypersomnia. It is a stimulant that promotes wakefulness. Other stimulants include methylphenidate (Concerta, Ritalin) or amphetamine/dextroamphetamine (Adderall).
• You may be prescribed other types of medications that support wakefulness, including the antidepressant bupropion (Wellbutrin) and the antibiotic clarithromycin (Biaxin).
• Calcium, magnesium, potassium, and sodium oxybates (Xywav) may be recommended to take at night to improve the amount of deep sleep you get, which can help you feel less sleepy during the day.
• Your provider may also ask you about any OTC and prescription medications that you take to make sure none have sedating effects.
• Your provider may also recommend therapy to help you learn skills and make behavioral changes that can help you manage the fatigue.

Prescription idiopathic hypersomnia medications

• Stimulants: methylphenidate (Concerta, Ritalin), amphetamine/dextroamphetamine (Adderall), lisdexamfetamine (Vyvanse), armodafinil (Nuvigil), pitolisant (Wakix)
• Bupropion (Wellbutrin)
• Clarithromycin (Biaxin)
• Calcium, magnesium, potassium, and sodium oxybates (Xywav)

Types of idiopathic hypersomnia providers

• A primary care provider can screen you for idiopathic hypersomnia.
• It is likely you’ll be referred to a sleep medicine specialist, who has advanced training in treating sleep disorders, for testing and treatment.

Managing idiopathic hypersomnia at home

Idiopathic hypersomnia should be treated by a healthcare provider, but making certain lifestyle changes may help you feel more alert.

• Limit alcohol. It interferes with your ability to get good quality sleep.
• Stick to a regular sleep schedule. Set a goal to go to sleep and wake up at the same time every day.
• Try not to take naps, which don’t usually help people with hypersomnia feel any less tired.
• Exercising and being in the sun during the day may increase alertness.
• Consider joining a support group for people with sleep disorders to help you better understand and deal with the condition.