Talking Sleep Season 5 | Episode 21

Medications to manage central disorders of hypersomnolence


In the last few years, more medications have been available to treat central disorders of hypersomnolence. While treatments for narcolepsy and idiopathic hypersomnia are similar, there are some specific considerations when trying to determine which combination of medications is most appropriate for a patient. Significant payor coverage and formulary variability add another layer to this conversation. Some are considered off-label and others are on-label but may be cost-prohibitive. Dr. Hrayr Attarian explains some of the nuances of these newer medications, how they perform for specific symptoms, and how to consider tailoring medication regimens with shared decision-making.

Dr. Hrayr Attarian is a professor of neurology at Northwestern University. He has a special interest in central disorders of hypersomnolence and estimates that he has 300 patients with narcolepsy in his practice and 120 with IH.

Dr. Attarian has spent his entire career, 22 years, in academic sleep medicine. At the beginning of his career, his interests ranged from the interface of sleep disorders and epilepsy, to sleep disturbances in multiple sclerosis, to the unique physiology of sleep disturbances in women. Later, he got involved in humanitarian work as well as global health and education, where he started delving more into the impact of sleep disturbances on the health and well-being of refugee populations.