The International Classification for Sleep Disorders- third edition (ICSD-3)
has classified central disorders of hypersomnolence as, Narcolepsy type 1 and type 2,
idiopathic hypersomnia (IH), Kleine–Levin syndrome (KLS), hypersomnia due to a
medical or neurologic disorder, hypersomnia due to medication or substance,
hypersomnia associated with psychiatric disorders, and insufficient sleep syndrome. A
number of pharmacological treatment options are now available for Narcolepsy type 1
and type 2. However, for conditions like IH and KLS, much work is still being done to
understand the underlying pathophysiologic mechanisms and consequently, these
conditions have the least amount of high-grade evidence on pharmacologic options,
and most medicines are used ‘off-label’. This chapter focuses on treating non narcoleptic hypersomnia syndromes- those commonly encountered in Sleep disorders
clinics such as residual hypersomnia despite having a patient adherent to therapeutic
positive airway pressure settings, to some uncommon conditions like IH and an
exceedingly rare condition like KLS. New medications like solriamfetol and pitolisant
and their possible use in some of these conditions is also discussed in this chapter
Keywords: Hypersomnia, Idiopathic Hypersomnia, Kliene-Levin syndrome.
