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(Marina Kljaji) and L.K

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PWH may need to try different medicines and doses As you work with a PWH to try different hypersomnia medicines, it may be helpful to keep in mind: Some PWH may benefit from medicines in combination PWH should avoid medicines and substances (such as alcohol and opioids) that can worsen daytime sleepiness PWH may need to try several different doses For stimulants, effectiveness may be improved by medicine holidays and/or different doses for different days, such as: A usual dose for most days A lower dose for days with better symptoms or fewer activities A higher dose for days with worse symptoms or many activities planned A higher dose for PWH who have worse symptoms during the luteal phase of their menstrual cycle (the 2 weeks before their period)

However, due to their large number of subjective factors, the West-Haven criteria suffer from significant interobserver deviation, which makes it difficult to diagnose the first stage (grade 1) of HE in a clinical setting