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特发性嗜睡症的药理学和非药理学干预措施的证据范围综述。

A scoping review of the evidence on pharmacological and nonpharmacological interventions for idiopathic hypersomnia.

机构信息

Sound Asleep Lab, Saginaw, Michigan.

CMU College of Medicine, Mount Pleasant, Michigan.

出版信息

J Clin Sleep Med. 2024 Oct 1;20(10):1685-1704. doi: 10.5664/jcsm.11250.

Abstract

STUDY OBJECTIVES

Idiopathic hypersomnia (IH) is characterized by excessive sleepiness during the day, prolonged sleep at night, and difficulty waking up. The true prevalence of IH is uncertain. The provides criteria for diagnosing IH; however, the definition has evolved. Managing IH involves using pharmacologic and nonpharmacologic approaches, although the most effective strategies are still unclear. The objective of this scoping review was to identify the extent, range, and nature of the available evidence, identify research gaps, and discuss the implications for clinical practice and policy.

METHODS

To conduct this review, a comprehensive search was conducted across scientific databases, without any restrictions on the date or study type. Eligible studies examined the effectiveness of pharmacologic and nonpharmacologic treatments for IH and reported the outcomes of these interventions. Data from the studies were screened, analyzed, and synthesized to provide an overview of the available literature landscape.

RESULTS

Fifty-one studies were included in this review, which used various methods and interventions. Pharmacological treatments, particularly modafinil, have been frequently studied and have yielded positive results. There is also emerging evidence for alternative medications such as low-sodium oxybate and pitolisant. Nonpharmacological approaches, such as cognitive behavioral therapy for hypersomnia and transcranial direct current stimulation have also shown promise in managing IH.

CONCLUSIONS

This review highlights the complexity of managing IH symptoms and emphasizes the need for personalized multidisciplinary approaches. Pharmacological interventions are important in managing IH and can be complemented by nonmedication strategies. Larger-scale studies are necessary to advance our understanding of IH and to improve treatment outcomes.

CITATION

Saini V, Saini S. A scoping review of the evidence on pharmacological and nonpharmacological interventions for idiopathic hypersomnia. . 2024;20(10):1685-1704.

摘要

研究目的

特发性嗜睡症(IH)的特征是白天过度嗜睡、夜间长时间睡眠和难以醒来。IH 的真实患病率尚不确定。提供了诊断 IH 的标准;然而,该定义已经演变。管理 IH 涉及使用药物和非药物方法,尽管最有效的策略仍不清楚。本范围综述的目的是确定现有证据的程度、范围和性质,确定研究空白,并讨论对临床实践和政策的影响。

方法

为了进行这项综述,我们在科学数据库中进行了全面搜索,对日期或研究类型没有任何限制。符合条件的研究检查了药物和非药物治疗 IH 的有效性,并报告了这些干预措施的结果。对研究数据进行筛选、分析和综合,以提供现有文献概况的概述。

结果

本综述共纳入 51 项研究,采用了各种方法和干预措施。药物治疗,特别是莫达非尼,已被广泛研究并取得了积极的结果。替代药物,如低钠羟丁酸钠和哌甲酯,也有新的证据。非药物方法,如针对嗜睡的认知行为疗法和经颅直流电刺激,在管理 IH 方面也显示出希望。

结论

本综述强调了管理 IH 症状的复杂性,并强调需要采用个性化的多学科方法。药物干预对于管理 IH 很重要,可以通过非药物策略来补充。需要更大规模的研究来深入了解 IH 并改善治疗结果。

引文

Saini V, Saini S. 对特发性嗜睡症的药物和非药物干预措施的证据进行范围综述。睡眠医学评论。2024;20(10):1685-1704.

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本文引用的文献

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Association between idiopathic hypersomnia and a genetic variant in the PER3 gene.
J Sleep Res. 2024 Oct;33(5):e14146. doi: 10.1111/jsr.14146. Epub 2024 Jan 22.
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Continuum (Minneap Minn). 2023 Aug 1;29(4):1045-1070. doi: 10.1212/CON.0000000000001265.
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