| 주간과다졸림의 원인이 되는 수면장애에서 약물 사용: 최신 진료지침과 국내 현황 |
| 최윤호1, 김경민2, 김병수3, 김희진4, 김승우2, 백경원5, 석진명6, 선우준상7, 송인욱1, 우호걸8, 이익성9, 정진만10, 최교민11, 양광익12, 대한신경과학회 진료지침위원회 |
1가톨릭대학교 의과대학 인천성모병원 신경과
2연세대학교 의과대학 신경과학교실
3이화여자대학교 의과대학 이대목동병원 신경과
4한양대학교 의과대학 신경과학교실
5고려대학교안암병원 신경과
6이화여자대학교 의과대학 이대서울병원 신경과
7강북삼성병원 신경과
8경희대학교 의과대학 경희대학교병원 신경과
9중앙병원 신경과
10고려대학교 의과대학 고려대학교안산병원 신경과
11건국대학교병원 신경과
12순천향대학교 의과대학 순천향대학교천안병원 신경과 |
| Pharmacotherapy for Excessive Daytime Sleepiness in Sleep Disorders: Comparative Guidelines and the Clinical Landscape in South Korea |
| Yun Ho Choi MD1, Kyung Min Kim MD, PhD2, Byung-Su Kim MD, PhD3, Hee-Jin Kim MD, PhD4, Seung Woo Kim MD, PhD2, Kyoungwon Baik MD, PhD5, Jin Myoung Seok MD, PhD6, Jun-Sang Sunwoo MD, PhD7, n-Uk Song MD, PhD1, Ho Geol Woo MD, PhD8, Eek-Sung Lee MD, PhD9, Jin-Man Jung MD, PhD10, Kyomin Choi MD, PhD11, Kwang Ik Yang MD, PhD12, on behalf of the Clinical Practice Guideline Committee of Korean Neurological Association |
1Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University, Seoul, Korea
2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
3Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans Univerrsity College of Medicine, Seoul, Korea
4Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
5Department of Neurology, Korea University Anam Hospital, Seoul, Korea
6Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans Univerrsity College of Medicine, Seoul, Korea
7Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
8Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
9Department of Neurology, Jungang Hospital, Jeju, Korea
10Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
11Department of Neurology, Konkuk University Medical Center, Seoul, Korea
12Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea |
Corresponding Author:
Yun Ho Choi ,Tel: +82-32-280-6657, Fax: +82-32-280-5244, Email: recluse21@naver.com
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Received: September 18, 2025 Revised: September 28, 2025 Accepted: September 29, 2025 Published online: November 1, 2025 |
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| Abstract |
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Excessive daytime sleepiness (EDS) is a prevalent symptom that significantly impairs quality of life and poses substantial public health risks. A precise differential diagnosis is crucial, beginning with common causes such as insufficient sleep, circadian rhythm sleep-wake disorders, and sleep-disrupting conditions like obstructive sleep apnea (OSA), before proceeding to the central disorders of hypersomnolence. This review provides a comprehensive overview of pharmacological agents for the treatment of EDS, including modafinil/armodafinil, pitolisant, solriamfetol, sodium oxybate, methylphenidate, and amphetamines. We provide a comparative analysis of clinical practice guidelines and regulatory status in the United States, Europe, and Japan, highlighting differences in first-line recommendations, approved indications, and therapeutic algorithms for conditions such as narcolepsy, idiopathic hypersomnia, residual EDS in OSA, and shift-work sleep disorder. Furthermore, we address the unique clinical landscape in South Korea, where significant discrepancies exist between drug approvals and reimbursement criteria. Limited health insurance coverage, the unavailability of key medications such as solriamfetol and sodium oxybate, and the recent withdrawal of pitolisant from the market severely restrict therapeutic options. These challenges create a substantial unmet need, particularly for pediatric patients and those with OSA-related residual sleepiness or shiftwork disorder. This review highlights the pressing need to improve patient access to evidencebased treatments in South Korea and to generate domestic real-world data to support clinical decision-making and health policy revision. |
| Key Words:
Sleepiness | Hypersomnolence disorders | Sleep apnea | obstructive | Sleep disorders | circadian rhythm | Real-world evidence |
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