When Sleep Steals the Day: Diagnosing and Treating Central Disorders of Hypersomnia

Karl Doghramji, MD, FAASM, DFAPA

Excessive daytime sleepiness (EDS) is often misattributed to fatigue, leading to missed diagnoses and persistent functional impairment. In this presentation, Dr. Karl Doghramji provides a comprehensive overview of sleep-wake disorders within psychiatric practice, emphasizing the frequent underrecognition of hypersomnia and narcolepsy in psychiatric populations. Evidence-based therapeutic approaches are reviewed, including pharmacologic treatments, behavioral strategies, and interdisciplinary care coordination. The session concludes with practical guidance on integrating sleep and psychiatric care, balancing treatment approaches, and optimizing functional outcomes in complex patients.

Industry Session^†: Managing Excessive Daytime Sleepiness (EDS) and Cataplexy in Narcolepsy

Chris Winter, MD

Sponsored by Harmony Biosciences

Break

Sleepless Minds: Managing Insomnia Amid Psychiatric Overlap

Jeffrey R. Strawn, MD

Chronic insomnia reflects persistent hyperarousal rather than a simple deficit in sleep drive and is highly prevalent and bidirectionally linked with mood, anxiety, and psychotic disorders. In this presentation, Dr. Jeffrey Strawn examines the multifaceted presentation of insomnia within psychiatric practice, highlighting how it manifests differently across conditions such as generalized anxiety disorder, major depressive disorder, bipolar disorder, PTSD, psychotic-spectrum disorders, ADHD, and substance use disorders. Participants will review a variety of treatment strategies, including cognitive behavioral therapy for insomnia (CBT-I) and pharmacologic approaches such as DORAs/SORAs, and melatoninergic agents.

Decoding Sleep: From Neurobiology to Treatment Strategies

From the 2025 Sleep Workshop: "Refreshing Sleep: A Brief Review of the Neurobiology of the Sleep-Wake Cycle"

Thomas L. Schwartz, MD

In this session, Dr. Thomas Schwartz will review the major neural circuits, brain regions, and neurotransmitter systems that regulate sleep and wakefulness. He will outline the interplay between homeostatic sleep pressure and circadian rhythms, highlight the role of REM and non-REM stages, and introduce key regulatory structures of sleep.

From the 2025 Child Adolescent Academy: "Sleep Show: Pharmacological Strategies for Addressing Sleep-Wake Conditions in Children and Adolescents"

Jeffrey R. Strawn, MD

Pharmacologic treatment can play a key role in managing pediatric sleep-wake disorders when behavioral strategies alone are insufficient. In this presentation, Dr. Jeffrey Strawn will review the current evidence base and clinical indications for commonly used sleep medications in children and adolescents. He will discuss melatonin and melatonin receptor agonists to highlight new data on reduced self-harm risk and discuss other agents such as antihistamines, antiadrenergics, benzodiazepines, and z-drugs. Attendees will leave with a clearer understanding of how to implement safe, effective pharmacologic strategies tailored to pediatric patients with complex sleep needs.

Live Panel Q&A