Behavioral and psychiatric treatments for sleepiness

Introduction Effective treatment of excessive daytime sleepiness (EDS) is often influenced by the underlying cause. This chapter presents an overview of many behavioral strategies implemented to combat EDS. These techniques are varied in their approach and can include the use of appropriate timing of light therapy for circadian rhythm disorders, scheduled naps, CPAP compliance for sleep-related breathing disorders, extension of bed and/or wake times, and psychotherapeutic techniques for EDS secondary to psychiatric disorders. A brief discussion of general strategies to help combat and cope with EDS in all patients, regardless of the underlying cause, is also included. Sleepiness due to narcolepsy EDS can significantly interfere with a patient's quality of life, and impact one's ability to work, socialize and drive. People with narcolepsy often lack the energy to participate in daily activities. Although patients may fall asleep during times of inactivity or boredom, they may also do so during inappropriate or dangerous times such as at work, mid-conversation, driving. After brief sleep episodes, patients often feel refreshed until the next episode. Proper treatment strategies are highly important given the significant negative impact narcolepsy can have in the daily life of patients. Pharmacological methods are considered the primary treatment for managing symptoms of narcolepsy, and behavioral methods play a large role in adjunctive treatment.