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The clinical presentation and symptoms of central disorders of hypersomnolence (CDH) such as narcolepsy, idiopathic hypersomnia, or excessive daytime sleepiness secondary to shift work or obstructive sleep apnea may be confounded by physiological changes in sleep architecture and hormonal fluctuations occurring during pregnancy. These overlapping features may cause delays in diagnosis and treatment, impacting quality of life, maternal functioning, and overall health. Management of CDH during pregnancy and lactation requires careful consideration of maternal benefits, potential side effects of medications and fetal and neonatal safety. Here, we present a case of idiopathic hypersomnia and detail management and outcomes during pregnancy and lactation. We briefly review the existing literature on prevalence, pathophysiological mechanisms, diagnostic challenges, objective findings, and risks posed by CDH in pregnancy and lactation. In this narrative review for primary care clinicians, we also summarize currently available evidence regarding the efficacy, teratogenic and other risks of pharmacologic agents used in the treatment of CDH in pregnancy and lactation. Lastly, we provide a clinical algorithm for management of CDH during pregnancy and lactation.<\/jats:p>","DOI":"10.1177\/21501319261456031","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T08:48:31Z","timestamp":1780044511000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Central Disorders of Hypersomnolence in Pregnancy and Lactation"],"prefix":"10.1177","volume":"17","author":[{"given":"Zain Ul","family":"Abideen","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhanu Prakash","family":"Kolla","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Bernard","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika A.","family":"Jegen","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Furst","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghna P.","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1258\/om.2009.090015"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.17241\/smr.2022.01431"},{"key":"e_1_3_4_4_2","unstructured":"Jones CR. 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