Since the underlying mechanism is not yet fully understood, treatment efforts have usually focused on symptom management. In August 2021, low-sodium oxybate (Xywav) became the first U.S. FDA-approved treatment for<unk> . Wake-promoting medications used in narcolepsy are also commonly used off-label to help manage the excessive daytime sleepiness of IH. CNS stimulants tend to be less effective for IH than they are for narcolepsy and may be less well tolerated. Stimulants The main treatment of excessive daytime sleepiness is done through central nervous system stimulants. Methylphenidate and Dextroamphetamine are most used stimulants to controlled EDS. Increased dopamine release is felt to be the main property explaining wake-promotion from these medications. Insomnia is another common side effect and may require additional treatment. Non-stimulant wake-promoting medications Solriamfetol is the first and only dual-acting dopamine and norepinephrine reuptake inhibitor approved by the FDA to improve wakefulness in adults living with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea. Pitolisant, a selective histamine 3 (H3) receptor antagonist/inverse agonist, was approved by FDA during August 2019. It works by increasing the synthesis and release of histamine, a wake-promoting neurotransmitter in the brain. Modafinil and Armodafinil elevate hypothalamic histamine levels, and they are known to bind to the dopamine transporter, thereby inhibiting dopamine reuptake. Modafinil can cause uncomfortable side effects, including nausea, headache, and a dry mouth for some patients, while other patients report no noticeable improvement even on relatively high dosages. They may also "interact with low-dose contraceptives, potentially reducing efficacy, although the scientific data supporting this claim is weak and rests on poorly documented anecdotes." Sleep promoting medications Sodium oxybate is an orphan drug which was designed specifically for the treatment of narcolepsy. Common side effects include nausea, dizziness, and hallucinations. A 2016 study by Leu-Semenescu et al. found sodium oxybate reduced daytime sleepiness in IH to the same degree as in patients with narcolepsy type 1, and the drug improved severe sleep inertia in 71% of the<unk>  patients. In July 2020, the FDA approved Xywav™ (calcium, magnesium, potassium, and sodium oxybates), an oral solution for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Cognitive Behavioral Therapy Although behavioral approaches have not been demonstrated to improve clinical markers of IH, cognitive behavioral therapy has been found to potentially reduce depressive symptoms and improve self-efficacy in people suffering from central disorders of hypersomnolence.
Idiopathic hypersomnia
Strephosymbolia
Psychoorganic syndrome
Nightmare disorder
Erotolepsy
Interictal dysphoric disorder
Narcolepsy
Klazomania