Medication for daytime sleepiness in people with idiopathic hypersomnia
Modafinil improves drowsiness and the ability to stay awake during sleep lab tests. It possibly improves the overall severity of idiopathic hypersomnia, fatigue, and daytime performance. Modafinil may cause stomach symptoms such as headache and nausea.It is not known if clarithromycin helps with daytime sleepiness or other symptoms of idiopathic hypersomnia. Based on the information contained in this review, it is not known if there is a difference in side effects between clarithromycin and placebo.
QualityThe overall quality of evidence for the three studies was judged to range from high to low, depending on the results and the drug being studied All three studies were well conducted. The studies were small. Few studies were found that tested medications for idiopathic hypersomnia. More studies are needed to ascertain which medications are best suited to treat people with idiopathic hypersomnia.
Trotti LM, Becker LA, Friederich Murray C, HoqueR. Medications for daytime sleepiness in people with idiopathic hypersomnia. Cochrane Database of Systematic Reviews 2021, No. 5. Art. No.: CD012714. doi: 10.1002 /14651858.CD012714.pub2. Accessed May 26, 2021.
Commentary
This study investigates which medications help treat patients with idiopathic hypersomnia, a condition that causes severe daytime sleepiness and can interfere with daily life. The study was conducted in February 2021; it identified three studies, two of which tested modafinil and one of which tested clarithromycin.
The two studies that tested modafinil included a total of 102 patients with idiopathic hypersomnia, and most of these people reported sleeping less than 10 hours per night. The study, comparing modafinil to placebo, was conducted for three weeks and funded by a pharmaceutical company with a commercial interest in the study's results.
The study testing clarithromycin included a total of 20 people from a single U.S. sleep clinic, 10 of whom had idiopathic hypersomnia. Only information from the 10 people with idiopathic hypersomnia was collected for the review, and clarithromycin was compared to placebo. This intervention lasted five weeks, but only information from the first two weeks was included. The study was funded by the American Academy of Sleep Medicine Foundation, a charitable organization.
