The graphic below (Figure 1) shows potential treatments for patients with IH. The vast majority of patients with IH (96%) typically use at least one non-pharmacologic strategy, which may include caffeine, daytime naps and scheduling of nighttime sleep.1 Other such as exercise, diet, temperature manipulations, chewing gum, mindfulness, and yoga can also be tried. However, these methods are often ineffective or difficult to sustain.
FDA Approved Option: Lower-Sodium Oxybate
Use of calcium, magnesium, potassium and sodium oxybates – also known as lower-sodium oxybate – was the first treatment approved for IH by the FDA. As the name suggests, “lower-sodium” oxybate contains 92% less sodium than regular sodium oxybate.3,4 This is important when considering cardiovascular health. Ordinary sodium oxybate increases sodium intake to at least 550 to 1640 mg daily from medication doses alone. This may increase CV risk by raising blood pressure and elevating the risk of CV events such as strokes.5,6 Patients with IH have an elevated baseline CV risk compared with comparable individuals lacking sleep disorders. Thus, thinking about CV risk is a crucial element of care for patients.7
Off-Label (Non-FDA-Approved) Options2
Based on your individual symptoms and history, your doctor or caregivers may use one of the above agents. Also, since IH symptoms can vary over time, your caregiver should be checking in with you at each office visit to make sure the medication is working for you.
