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Cited by 488Sleep and Wakefulness ResearchSleep and related disordersObstructive Sleep Apnea Research

Practice Parameters for the Treatment of Narcolepsy and other Hypersomnias of Central Origin

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Morgenthaler, Timothy I., Kapur, Vishesh K., Brown, Terry M., Swick, Todd J., Alessi, Cathy, Aurora, R. Nisha, Boehlecke, Brian, Chesson, Andrew L. +5 more·2007·Sleep
DOI 10.1093/sleep/30.12.1705PMC PMC2276123
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Abstract

These practice parameters pertain to the treatment of hypersomnias of central origin. They serve as both an update of previous practice parameters for the therapy of narcolepsy and as the first practice parameters to address treatment of other hypersomnias of central origin. They are based on evidence analyzed in the accompanying review paper. The specific disorders addressed by these parameters are narcolepsy (with cataplexy, without cataplexy, due to medical condition and unspecified), idiopathic hypersomnia (with long sleep time and without long sleep time), recurrent hypersomnia and hypersomnia due to medical condition. Successful treatment of hypersomnia of central origin requires an accurate diagnosis, individual tailoring of therapy to produce the fullest possible return of normal function, and regular follow-up to monitor response to treatment. Modafinil, sodium oxybate, amphetamine, methamphetamine, dextroamphetamine, methylphenidate, and selegiline are effective treatments for excessive sleepiness associated with narcolepsy, while tricyclic antidepressants and fluoxetine are effective treatments for cataplexy, sleep paralysis, and hypnagogic hallucinations; but the quality of published clinical evidence supporting them varies. Scheduled naps can be beneficial to combat sleepiness in narcolepsy patients. Based on available evidence, modafinil is an effective therapy for sleepiness due to idiopathic hypersomnia, Parkinson's disease, myotonic dystrophy, and multiple sclerosis. Based on evidence and/or long history of use in the therapy of narcolepsy committee consensus was that modafinil, amphetamine, methamphetamine, dextroamphetamine, and methylphenidate are reasonable options for the therapy of hypersomnias of central origin.

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  • Methylphenidate, dextroamphetamine, and modafinil and combinations of modafinil and dextroamphetamine have been used to treat narcolepsy and excessive sleepiness.

    “Methylphenidate, dextroamphetamine, and modafinil and combinations of modafinil and dextroamphetamine have been used to treat narcolepsy and excessive sleepiness; practice parameters for their use have been published (4, 77).”

    From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [77]

    The Abstract and the section on traditional stimulants identify modafinil, dextroamphetamine, and methylphenidate as treatment options for narcolepsy-related sleepiness. The paper is itself a set of practice parameters, but the passages on combination treatment discuss modafinil with sodium oxybate, not modafinil with dextroamphetamine; that part of the claim is not supported. (LLM, conf=0.86)

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Research works printed but not linked: 32

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Cited by

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Authors
Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R.
Affiliations
  • Mayo Clinic (US)
  • University of Washington (US)
  • University of California, Los Angeles (US)
  • Louisiana State University in Shreveport (US)
  • University of North Carolina at Chapel Hill (US)
  • Stanford University (US)
  • Barrow Neurological Institute (US)
  • Rhode Island Hospital (US)
  • Icahn School of Medicine at Mount Sinai (US)
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2007-12
Volume
30
Issue
12
Pages
1705-1711
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/30.12.1705
PMC
PMC2276123
OpenAlex
W1241659441
Cited by
488
References
0
Citations by year
2026: 6 · 2025: 18 · 2024: 15 · 2023: 14 · 2022: 25 · 2021: 36 · 2020: 29 · 2019: 20 · 2018: 22 · 2017: 37 · 2016: 37 · 2015: 29 · 2014: 36 · 2013: 29 · 2012: 23
FWCI
13.36
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
narcolepsy, idiopathic hypersomnia, recurrent hypersomnia, cataplexy, sleep paralysis, hypnagogic hallucinations, excessive sleepiness, modafinil, sodium oxybate, amphetamine, methylphenidate, selegiline, tricyclic antidepressants, fluoxetine, Parkinson's disease, myotonic dystrophy, multiple sclerosis, treatment guidelines
MeSH terms
Modafinil, Central Nervous System Stimulants, Antidepressive Agents, Tricyclic, Benzhydryl Compounds, Cataplexy, Fluoxetine, Humans, Disorders of Excessive Somnolence, Narcolepsy, Treatment Outcome, Evidence-Based Medicine

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