Surgical – For many PSS cases surgery is the treatment of choice. The abnormal vessel that is shunting blood around the liver is identified and closed (ligated) to minimize blood flowing through it. When the abnormal blood vessel is ligated blood will now flow through the liver instead of around it. This is readily accomplished for solitary extrahepatic shunts. Intrahepatic shunts can be more difficult
to identify and ligate. Post surgical monitoring is important. If the pressure within the liver becomes too high due to the increased blood flow through the liver then the ligation on the shunting vessel(s) must be reduced or removed.
Alternatives: As with insomnia (see benzodiazepine hypnotics, above), it's important to identify the cause of excessive daytime sleepiness. Other medications you're taking — whether prescription or over the counter — could be responsible. Drugs with sedating effects, for example, are among the most common causes of excessive daytime sleepiness. (These include alpha- and beta-blockers, anti-diarrheal agents, antihistamines, antipsychotics, antispasmodics, cough suppressants, epilepsy drugs, skeletal muscle relaxants, Parkinson's drugs and some antidepressant medications.)