Update on Central Hypersomnia Disorders in Children

Purpose of Review To provide an update on central hypersomnia disorders in children because they are distinct from those seen in adults. Recent Findings Despite its striking clinical features, there are delays in the diagnosis of narcolepsy, especially in pre-school age children. The delay in diagnosis and instituting timely and appropriate management may contribute to adverse psychosocial consequences. Comorbidities of narcolepsy include depression, anxiety, precocious puberty, and obesity. Autonomic dysfunction is often present in adolescents at the onset of narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia, but may go unrecognized. It shows a female preponderance and can complicate management. There have been advances in pharmacological therapy of hypersomnia disorders, but challenges remain as some pediatric formulations have not received official regulatory approval. Though we now have a better understanding of the immunology of narcolepsy type 1, the current management is largely symptomatic in nature. Summary There is a need for early recognition and diagnosis of central hypersomnia disorders of childhood. There are significant comorbidities which can impact the quality of life. Pharmacological treatment efforts remain mainly on an “off-label” basis because many drugs have not received official regulatory approval for use in children.