Precision Medicine for Idiopathic Hypersomnia.

Idiopathic hypersomnia (IH) includes a clinical phenotype resembling narcolepsy (with repeated, short restorative naps), and a phenotype with an excess of sleep, sleep drunkenness, drowsiness, and infrequent long, nonrestorative naps. Sleep tests reflect this heterogeneity. MSLTs are greater than 8 min in 2/3 of the cases and poorly repeatable. Sleep excess is better captured by extended monitoring identifying 11 to 16h of sleep/24 h. Patients with IH are young and more often female. Possible mechanisms of IH include deficiencies in arousal systems, inappropriate stimulation of sleep-inducing systems, and long biological night. Treatments now include robust studies of modafinil, clarithromycin, and sodium oxybate.

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Déclaration de conflit d'intérêts

Disclosure The authors declare that they have no conflicts of interest related to this article. The authors are members of the National Reference Center for Rares Hypersomnias, which receives annuities from the French Health Ministry to electively diagnose and treat these patients, as well as to develop medical and social awareness for these disorders, consensus, cohorts, and retrospective studies. National Reference Center for Rare Hypersomnias, Pitie-Salpetriere University Hospital, APHP, and Sorbonne University, 483 Boulevard de l’Hopital, Paris 75013, France.