Excessive daytime sleepiness also is a core symptom of several other neurologic disorders, such as myotonic dystrophy and Parkinson disease, and this discussion is relevant to these conditions as well. Narcolepsy and idiopathic hypersomnia are central disorders of hypersomnolence, with diagnosis based on clinical history and supportive neurophysiologic testing. Recognizing Central Disorders of Hypersomnolence Contemporary management of narcolepsy and idiopathic hypersomnia should account for the individual’s preferences and priorities to support optimal functioning in school, at work, and within social and family realms. These new medications allow for shared decision-making about how to best manage symptoms of severe sleepiness for people with these lifelong sleep disorders. However, efficient and accurate diagnosis of these conditions is important, as there is increasing availability of medications that improve quality of life and substantially alleviate symptoms of these disorders. Even with a high degree of clinical suspicion, current diagnostic tests have limitations for idiopathic hypersomnia 2 that may lead to delays in care for people with this condition. 1 Underrecognition of these disorders, symptom overlap with more common disorders, and limitations in diagnostic testing can make timely diagnosis challenging. Delayed diagnosis is a known problem for narcolepsy and idiopathic hypersomnia, often with years elapsing from symptom onset to diagnosis. The recent availability of a number of new medications for the management of excessive daytime sleepiness highlights the importance of efficient and accurate diagnosis of central disorders of hypersomnolence, such as narcolepsy and idiopathic hypersomnia.
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