Self-reported symptoms and objective measures in idiopathic hypersomnia and hypersomnia associated with psychiatric disorders: a prospective cross-sectional study

Bušková, Jitka; Novák, Tomáš; Miletínová, Eva; Králová, Radana; Košťálová, Jana; Kliková, Monika; Veldová, Karolina

doi:10.5664/jcsm.9702

Cited by 11 publications

(7 citation statements)

References 39 publications

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“…The prevalence rates can only be superficially compared because we are considering lifetime occurrence of depression; on the other hand, we may have missed some cases that were not reported due to psychiatric stigma and cases of depression that were not examined by a psychiatrist. The prevalence of depression in IH is high, this fact has been reported by several authors (Galuskova & Sonka, 2021), and it is a difficult clinical decision whether a case should be diagnosed as IH or depression with hypersomnia (Buskova et al, 2022). The question still remains to what extent mood disorders are related to the biological background of IH and to what extent they are a psychophysiological consequence of IH and are biologically independent disorders.…”

Section: Discussionmentioning

confidence: 89%

Idiopathic hypersomnia years after the diagnosis

Šonka,

Feketeová,

Nevšímalová

et al. 2023

Journal of Sleep Research

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SummaryLittle attention has been paid to the long‐term development of idiopathic hypersomnia symptoms and idiopathic hypersomnia comorbidities. The aim of this study was to describe the general health of patients with idiopathic hypersomnia years after the initial diagnosis, focusing on current subjective hypersomnolence and the presence of its other possible causes. Adult patients diagnosed with idiopathic hypersomnia ≥ 3 years ago at sleep centres in Prague and Kosice were invited to participate in this study. A total of 60 patients were examined (age 47.3 ± SD = 13.2 years, 66.7% women). In all participants, their hypersomnolence could not be explained by any other cause but idiopathic hypersomnia at the time of diagnosis. The mean duration of follow‐up was 9.8 + 8.0 years. Fifty patients (83%) reported persisting hypersomnolence, but only 33 (55%) had no other disease that could also explain the patient's excessive daytime sleepiness and/or prolonged sleep. In two patients (3%), the diagnosis in the meantime had changed to narcolepsy type 2, and 15 patients (25%) had developed a disease or diseases potentially causing hypersomnolence since the initial diagnosis. Complete hypersomnolence resolution without stimulant treatment lasting longer than 6 months was reported by 10 patients (17%). To conclude, in a longer interval from the diagnosis of idiopathic hypersomnia, hypersomnolence may disappear or may theoretically be explained by another newly developed disease, or the diagnosis may be changed to narcolepsy type 2. Thus, after 9.8 years, only 55% of the examined patients with idiopathic hypersomnia had a typical clinical picture of idiopathic hypersomnia without doubts about the cause of the current hypersomnolence.

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Section: Discussionmentioning

confidence: 89%

Idiopathic hypersomnia years after the diagnosis

Šonka,

Feketeová,

Nevšímalová

et al. 2023

Journal of Sleep Research

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“…According to Arnulf et al [ 37 ], diseases of the central nervous system, mostly mood disorders, may be up to twelve times more prevalent in IH patients in comparison with the general population. However, the differentiation of idiopathic hypersomnia depression from hypersomnia associated with psychiatric disorder may sometimes be difficult and require skilled clinical sleep examination [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Central Disorders of Hypersomnolence: Association with Fatigue, Depression and Sleep Inertia Prevailing in Women

et al. 2022

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Fatigue, depression, and sleep inertia are frequently underdiagnosed manifestations in narcolepsy and idiopathic hypersomnia. Our cross-sectional study design included diagnostic interview accompanied by assessment instruments and aimed to explore how these factors influence disease severity as well as to elucidate any sex predisposition. One hundred and forty-eight subjects (female 63%) were divided into narcolepsy type 1 (NT1; n = 87, female = 61%), narcolepsy type 2 (NT2; n = 22, female = 59%), and idiopathic hypersomnia (IH; n = 39, female = 69%). All subjects completed a set of questionnaires: Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scales (HADS), Fatigue Severity Scale (FSS), and Sleep Inertia Questionnaire (SIQ). In narcoleptic subjects, questionnaire data were correlated with the Narcolepsy Severity Scale (NSS), and in subjects with idiopathic hypersomnia, with the Idiopathic Hypersomnia Severity Scale (IHSS). The highest correlation in narcoleptic subjects was found between NSS and ESS (r = 0.658; p < 0.0001), as well as FSS (r = 0.506; p < 0.0001), while in subjects with idiopathic hypersomnia, the most prominent positive correlations were found between IHSS and SIQ (r = 0.894; p < 0.0001), FSS (r = 0.812; p < 0.0001), HADS depression scale (r = 0.649; p = 0.0005), and HADS anxiety scale (r = 0.528; p < 0.0001). ESS showed an analogic correlation with disease severity (r = 0.606; p < 0.0001). HADS anxiety and depression scores were higher in females (p < 0.05 and p < 0.01), with similar results for FSS and SIQ scales (p < 0.05 for both), and a trend toward higher ESS values in females (p = 0.057). Our study illustrates that more attention should be focused on pathophysiological mechanisms and associations of fatigue, depression, as well as sleep inertia in these diseases; they influence the course of both illnesses, particularly in women.

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“…1,13 On the one hand, although mental disorders diagnoses are considered to be an exclusion criterion for diagnosis of idiopathic hypersomnia, psychiatric symptoms not fulfilling a psychiatric diagnosis are often present. [14][15][16] On the other hand, hypersomnia and/or EDS may persist as a particularly pertinacious symptom in (partially) remitted depression, and therefore, an MSLT sleep latency below eight minutes (ie, criterion for idiopathic hypersomnia) may not be rare. [16][17][18][19][20] This pleomorphic clinical picture complicates the reliable determination between psychiatric vs "organic" causes of hypersomnolence, which is of major importance due to their different treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16] On the other hand, hypersomnia and/or EDS may persist as a particularly pertinacious symptom in (partially) remitted depression, and therefore, an MSLT sleep latency below eight minutes (ie, criterion for idiopathic hypersomnia) may not be rare. [16][17][18][19][20] This pleomorphic clinical picture complicates the reliable determination between psychiatric vs "organic" causes of hypersomnolence, which is of major importance due to their different treatment approaches. 9,13,17 Eyelid metrics have been studied during simulated and real driving, the psychomotor vigilance test, and in the MSLT and maintenance of wakefulness test (MWT) and are accepted as indicators of increasing sleepiness and sleep-related performance deficits.…”

Section: Introductionmentioning

confidence: 99%

“… 14–16 On the other hand, hypersomnia and/or EDS may persist as a particularly pertinacious symptom in (partially) remitted depression, and therefore, an MSLT sleep latency below eight minutes (ie, criterion for idiopathic hypersomnia) may not be rare. 16–20 This pleomorphic clinical picture complicates the reliable determination between psychiatric vs “organic” causes of hypersomnolence, which is of major importance due to their different treatment approaches. 9 , 13 , 17 …”

Section: Introductionmentioning

confidence: 99%

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Eyelid Closure Behavior of Patients with Idiopathic and Nonorganic Hypersomnia, Narcolepsy-Cataplexy, and Healthy Controls in the Maintenance of Wakefulness Test

Santschi,

Schreier,

Hertig-Godeschalk

et al. 2023

NSS

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Differential diagnosis of central disorders of hypersomnolence remains challenging, particularly between idiopathic (IH) and nonorganic hypersomnia (NOH). We hypothesized that eyelid closure behavior in the maintenance of wakefulness test (MWT) could be a valuable biomarker. Patients and Methods: MWT recordings of patients with IH, NOH, narcolepsy-cataplexy (NC), and healthy sleep-deprived controls (H) were retrospectively analyzed (15 individuals per group). For each MWT trial, visual scoring of face videography for partial (50-80%) and full eyelid closure (≥80%) was performed from "lights off" to the first microsleep episode (≥3 s). Results: In all groups, the frequency and cumulative duration of periods with partial and full eyelid closure gradually increased toward the first microsleep episode. On the group level, significant differences occurred for the latency to the first microsleep episode (IH 21 min (18-33), NOH 23 min (17-35), NC 11 min (7-19), H 10 min (6-25); p = 0.009), the ratio between partial and full eyelid closure duration (IH 2.2 (0.9-3.1), NOH 0.5 (0-1.2), NC 2.8 (1.1-5), H 0.7 (0.4-3.3); p = 0.004), and the difference between full and partial eyelid closure duration in the five minutes prior to the first microsleep episode (∆full -partial eyelid closure duration: IH −16 s (−35 to 28); NOH 46 s (9-82); NC −6 s (−26 to 5); H 10 s (−4 to 18); p = 0.007). IH and NOH significantly differed comparing the ratio between partial and full eyelid closure (p = 0.005) and the difference between ∆full -partial eyelid closure duration in the five minutes prior to the first microsleep episode (p = 0.006). Conclusion:In the MWT, eyelid closure behavior (∆full -partial) in the period prior to the first microsleep episode could be of value for discriminating NOH from other etiologies of excessive daytime sleepiness, particularly IH.

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Self-reported symptoms and objective measures in idiopathic hypersomnia and hypersomnia associated with psychiatric disorders: a prospective cross-sectional study

Cited by 11 publications

References 39 publications

Idiopathic hypersomnia years after the diagnosis

Idiopathic hypersomnia years after the diagnosis

Central Disorders of Hypersomnolence: Association with Fatigue, Depression and Sleep Inertia Prevailing in Women

Eyelid Closure Behavior of Patients with Idiopathic and Nonorganic Hypersomnia, Narcolepsy-Cataplexy, and Healthy Controls in the Maintenance of Wakefulness Test

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