Excessive daytime sleepiness The most common causes of excessive daytime sleepiness are sleep deprivation, obstructive sleep apnea, and sedating medications. Other potential causes of excessive daytime sleepiness include certain medical and psychiatric conditions and sleep disorders, such as narcolepsy.

1. Amr Hassan MD,FEBN
Professor of Neurology
Cairo University
Excessive Daytime Sleepiness

2. EDS: We need a wakeup call?
• Sleep wake cycle
• Neurobiology of sleep
• Neurotransmitters of sleep
• Overview on sleep disorders
• Excessive daytime sleepiness
• Alerting drugs
• Modafinil

3. Mechanism of
normal sleep and
wakefulness
Homeostasis
process
REM sleep NonREM sleep
Circadian process
- Melatonin
- Body temperature
- Cortisol.
Sleep wake cycle

4. 4
Sleep-wake cycle: the role of circadian regulation
The circadian rhythm
typically emerges two to
six months after birth
“early birds” Vs “night
owls”

5. Unique Circadian Alignments

6. Comparative studies of sleep

7. 7
Hypothalamic and brainstem sleep-wake regulation system

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Arousal pathways maintaining cortical activation in the waking
state

10. Neurobiology of sleep

11. 11
Neurobiology of sleep

12. Sleep disorders

13. 13
Consequences of EDS

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Consequences of EDS

15. 15
.
Copyright © 2020 American Academy of Neurology 15
Silber, Michael H.
CONTINUUM: Lifelong Learning in Neurology23(4):973-988, August 2017.
doi: 10.1212/CON.0000000000000491
Causes of hypersomnolence

16. 16
.
Copyright © 2020 American Academy of Neurology 16
Silber, Michael H.
CONTINUUM: Lifelong Learning in Neurology23(4):973-988, August 2017.
doi: 10.1212/CON.0000000000000491
Causes of hypersomnolence

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17

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Fatigue

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Kleine Levin Syndrome

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Narcolepsy

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Narcolepsy
Copyright © 2020 American Academy of Neurology
Silber, Michael H.
CONTINUUM: Lifelong Learning in Neurology23(4):973-988, August 2017.
doi: 10.1212/CON.0000000000000491

23. 23
Narcolepsy
Copyright © 2020 American Academy of Neurology
Silber, Michael H.
CONTINUUM: Lifelong Learning in Neurology23(4):973-988, August 2017.
doi: 10.1212/CON.0000000000000491

24. 24
Barateau, L., Lopez, R. & Dauvilliers, Y. Treatment options for narcolepsy. CNS Drugs 30, 369–379 (2016).
Algorithm for management of Narcolepsy

25. 25 25
Silber, Michael H.
CONTINUUM: Lifelong Learning in
Neurology23(4):973-988, August
2017.
doi:
10.1212/CON.0000000000000491
Algorithm for management of Narcolepsy
Silber, Michael H.
CONTINUUM: Lifelong Learning in Neurology23(4):973-988, August 2017.
doi: 10.1212/CON.0000000000000491

26. 26
Management of Narcolepsy

27. https://www.researchgate.net/figure/List-of-common-nootropics-mode-of-action-desirable-psychotropic-effects-and-adverse_tbl1_292502176
Alerting Drugs

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Eurogenics

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Modafinil mechanism of action

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Modafinil dose and AE

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32. Modafinil DDI

33. THANK YOU
amrhasanneuro@kasralainy.edu.eg