the Department of Genetic at the Geneva
University Hospital-Switzerland (Professor
M. Tafti). Since 2007, Pr Dauvilliers is
a member of the scientific board of the
French Sleep Medicine and Research
Society, a member of the European Sleep
Research Society, International REM sleep
behaviour study group, and more recently of
the American Academy of Sleep Medicine.
He is the Director of the Sleep Disorders
Centre, Department of Neurology, Gui
de Chauliac Hospital, Montpellier since
2005, a member of the Clinical Research
Department, University Hospital, Mont-
pellier since 2000, associate coordinator of
the Gui-de-Chauliac University Hospital,
Montpellier-France, since 2012 and Member
of the Editorial Board of Sleep Medicine and
Sleep.
Alan Hoffman, MD
Dr. Hoffman is a Vancouver Island-based
Sleep Disorders Consultant, and Medical
Director of MedSleep Vancouver Island
(including the Nanaimo Sleep Clinic), and a
consultant Sleep Respirologist at MedSleep
Calgary and the Northern Alberta Sleep
Clinic, with a background in Internal
Medicine, Critical Care and Chest Medicine.
He is a frequent lecturer on a variety of
sleep medicine related topics, is a Medical
Surveyor for the Diagnostic Accreditation
Program of BC, and an Adjunct Professor at
Thompson Rivers University in Kamloops.
He has practiced in many locales including
the USA, Middle East and the UK, as well
as in several Provinces. He started out in the
late 1960’s as a hospital based respiratory
therapist, then became a biochemist, even-
tually running his own lipid biochemistry
and mass spectroscopy laboratory at the
National Institutes of Health in Bethesda,
as a Fogarty Visiting Scientist. His clinical
practice and focus now is devoted to the
science and medicine of sleep disorders.
He lives with his wife in Maple Bay in
the Cowichan valley, where they have a
photography studio, custom picture framing
workshop and art gallery.
■
Not Available: Louis Tartaglia, MD
Sam Dzodzomenyo, MD
AASM Membership Sections Newsletter
■
Issue # 4
American Academy
of Sleep Medicine
16
a maximum of 60 mg in twenty-four hours, continued to have
severe daytime sleepiness and was deemed not medically fit to
drive a motor vehicle. She also presented on several occasions
to the emergency department of her local hospital complain-
ing of anxiety-like symptoms, chest tightness and palpitations.
She was finally switched to lisdexamfetamine (Vyvanse®),
which has brought her Epworth score down to the normal
range, made it safe for her to drive, and reduced her unwanted
palpitations and anxiety side effects.
Anxiety is an unwelcome side effect of many central stimu-
lants, and it’s not uncommon in a large narcolepsy outpatient
practice, to encounter patients who simply cannot tolerate the
standard drugs at any but the lowest dosages, which often may
not convey any clinical benefit.
Lisdexamfetamine (Vyvanse®), is a fairly new long-acting
once a day amphetamine, and is currently marketed in dosage
forms of 20, 30, 40, 50, 60 and 70 mg. It was originally released
in 2007 for the treatment of ADHD (FDA and Canada Health
approved use), but is now finding a role in the sleep clinic (off
label). Starting with a 20 mg daily dose in the morning upon
awakening, and slowly increasing by 10 mg every 4-6 weeks
until optimal clinical response is achieved, can often attenuate
unwanted anxiety side effects. While this has been in the past
a very useful agent in the armamentarium of sleep psychia-
trists, it has seen lesser use by other sleep specialists such as
sleep pulmonologists, sleep internists etc.
If significant clinical anxiety symptoms still exist even in
the presence of long-acting stimulants such as lisdexamfet-
amine, adding a small daily dose of escitalopram 10 mg every
morning may just be what is needed to control any residual
anxiety.
In a multidisciplinary practice comprising sleep pulmon-
ologists, sleep psychiatrists, sleep neurologists and other sleep
specialists, the sleep psychiatrists frequently provide a unique
insight into the management of comorbid anxiety.
Anecdotal experience in our large cross-Canada series of
sleep clinics, indicates that lisdexamfetamine is becoming a
popular treatment choice for patients with concomitant hyper-
somnia and anxiety.
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