Department of Neurology, Boston Children's Hospital, Boston, Massachusetts. Department of Neurology, Emory University School of Medicine, Atlanta, Georgia. Department of Neurology, Mayo Clinic, Rochester, Minnesota. Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota. Neuroscience's Clinical Division, Takeda Pharmaceuticals. Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan. American Academy of Sleep Medicine, Darien, Illinois. Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2021;17(9):1895-1945
INTRODUCTION This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central disorders of hypersomnolence in adults and children. The review focuses on prescription medications with U.S. Food & Drug Administration approval and nonpharmacologic interventions studied for the treatment of symptoms caused by central disorders of hypersomnolence. METHODS The American Academy of Sleep Medicine
commissioned a task force of experts in sleep medicine to perform a systematic review. Randomized controlled trials and observational studies addressing pharmacological and nonpharmacological interventions for central disorders of hypersomnolence were identified. Statistical analyses were performed to determine the clinical significance of all outcomes. Finally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence for the purpose of making specific treatment recommendations. RESULTS The literature search identified 678 studies; 144 met the inclusion criteria and 108 provided data suitable for statistical analyses. Evidence for the following interventions is presented: armodafinil, clarithromycin, clomipramine, dextroamphetamine, flumazenil, intravenous immune globulin (IVIG), light therapy, lithium, l-carnitine, liraglutide, methylphenidate, methylprednisolone, modafinil, naps, pitolisant, selegiline, sodium oxybate, solriamfetol, and triazolam. The task force provided a detailed summary of the evidence along with the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations. CITATION Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17(9):1895-1945.