Update on Randomized Controlled Trials in CNS Hypersomnias

Purpose of ReviewThe goal of this manuscript is to review the randomized controlled trials (RCTs) published in the last 5 years on the treatment of central hypersomnias.Recent FindingsThe majority of published RCT data over the past 5 years are for the treatment of narcolepsy with a few studies focusing on idiopathic hypersomnia and other disorders of central hypersomnolence. Most data are focused on the treatment of the most debilitating symptoms, namely, excessive daytime sleepiness, and in the case of narcolepsy, cataplexy, rather than other associated symptoms.Recent published RCT data have predominantly been about narcolepsy, likely as it is the most commonly recognized primary hypersomnia. Other RCT studies evaluated subjects with idiopathic hypersomnia (IH) or residual sleepiness from obstructive sleep apnea (OSA). Successful treatments have been found with sodium oxybate and low sodium oxybate in idiopathic hypersomnia, the use of histamine receptor-3 (HR3) antagonists/inverse agonists, and combined dopamine and norepinephrine reuptake inhibitors in residual sleepiness of OSA and histamine receptor-3 antagonists/inverse agonists as well as the sodium oxybates in narcolepsy.