Pharmacologic management of daytime sleepiness.
Excessive daytime sleepiness and abnormal sleep-wake patterns are becoming increasingly pervasive in modern society. The major causes of excessive daytime sleepiness include pathologic abnormalities of the central nervous system, such as narcolepsy and idiopathic hypersomnia; deficiencies in quality or quantity of sleep, such as those caused by sleep apnea and poor sleep hygiene; disturbances to the body's natural circadian rhythm, such as those caused by shift work or jet lag; and drugs, which can increase sleepiness either therapeutically or as a side effect. Determining the cause of daytime sleepiness is the first step in treating it. Setting appropriate and realistic treatment goals with the patient and initiating treatment are the next steps. Although the medications available to improve daytime wakefulness (e.g., amphetamines, methylphenidate, pemoline, and modafinil) are effective, they are not a substitute for sleep. Finally, timely follow-up is necessary to monitor treatment adherence, response, and side effects.
Schwartz
Jonathan R L
JR
Integris Sleep Disorders Center of Oklahoma, Oklahoma City, OK 73109, USA. jonathan.schwartz@integris-health.com
D000662:Amphetamines / Q000627:therapeutic use*; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use*; D000077408:Modafinil; D010347:Patient Care Planning; D010389:Pemoline / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'
D000662:Amphetamines; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D010389:Pemoline; D000077408:Modafinil