Idiopathic Hypersomnia and Other Hypersomnia Syndromes

Neurotherapeutics. 2021 Jan;18(1):20-31. doi: 10.1007/s13311-020-00919-1.


There are numerous disorders of known or presumed neurologic origin that result in excessive daytime sleepiness, collectively known as the central disorders of hypersomnolence. These include narcolepsy types 1 and 2, idiopathic hypersomnia, Kleine-Levin syndrome, and hypersomnia due to or associated with medical disease, neurologic disease, psychiatric disease, medications or substances, and insufficient sleep durations. This chapter focuses on the treatment of nonnarcoleptic hypersomnia syndromes, from those that are commonly encountered in neurologic practice, such as hypersomnia due to Parkinson's disease, to those that are exceedingly rare but present with dramatic manifestations, such as Kleine-Levin syndrome. The level of evidence for the treatment of sleepiness in these disorders is generally lower than in the well-characterized syndrome of narcolepsy, but available clinical and randomized, controlled trial data can provide guidance for the management of each of these disorders. Treatments vary by diagnosis but may include modafinil/armodafinil, traditional psychostimulants, solriamfetol, pitolisant, clarithromycin, flumazenil, sodium oxybate, melatonin, methylprednisolone, and lithium.

Keywords: Idiopathic hypersomnia; Kleine–Levin syndrome; lithium; methylprednisolone; modafinil; psychostimulants.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Central Nervous System Stimulants / therapeutic use*
  • Disorders of Excessive Somnolence / diagnosis*
  • Disorders of Excessive Somnolence / drug therapy
  • Humans
  • Idiopathic Hypersomnia / diagnosis*
  • Idiopathic Hypersomnia / drug therapy
  • Wakefulness-Promoting Agents / therapeutic use*


  • Central Nervous System Stimulants
  • Wakefulness-Promoting Agents