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Peter-Derex L, Subtil F, Lemaitre G, Ricordeau F, Bastuji H, Bridoux A, Onen F, Onen SH. Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia. J Clin Sleep Med 2021; 16:1507-1515. [PMID: 32406372 DOI: 10.5664/jcsm.8574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES First, to determine whether the 3-item Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) measures the degree of excessive daytime sleepiness in patients with suspected narcolepsy or idiopathic hypersomnia (IH). Second, to assess the correlation between the ODSI and the Epworth Sleepiness Scale (ESS) as well as objective polysomnographic measurements. Third, to test the accuracy of the ODSI to detect narcolepsy or IH (narcolepsy/IH) compared with the ESS. METHODS A total of 181 patients complaining of excessive daytime sleepiness filled in the ESS and the ODSI and underwent measurements including actigraphy, full-night polysomnography, Multiple Sleep Latency Test, and 24-hour bedrest sleep recording. RESULTS Narcolepsy or IH was diagnosed in 76 patients. The ODSI found excessive daytime sleepiness in 92.3% of all patients and in 98.7% of those diagnosed with narcolepsy/IH. In the whole population, the ODSI was significantly positively correlated with the ESS (R = .547; 95% confidence interval: .436, .642; P < .001) and weakly with 24-hour total sleep time on bedrest recording (R = .208; 95% confidence interval: .056, .350; P = .047) but not with the Multiple Sleep Latency Test. The ODSI offered a higher negative (92.9%) and positive (44.9%) predictive value to detect narcolepsy/IH than did the ESS (66.7% and 43.3%, respectively). In the IH group, the ODSI's third-item score (daily sleepiness duration) was significantly higher in patients with than without increased 24-hour total sleep time (P = .023). CONCLUSIONS The ODSI is a brief, simple first-line questionnaire that explores both intensity and duration of daytime sleepiness and offers a high sensitivity to detect narcolepsy and IH.
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Affiliation(s)
- Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon 1 University, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
| | - Fabien Subtil
- Lyon 1 University, Lyon, France.,Service de Biostatistiques, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
| | | | - François Ricordeau
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Hélène Bastuji
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
| | - Agathe Bridoux
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Fannie Onen
- Centre Hospitalier Universitaire Bichat Claude Bernard, Service de gériatrie, Assistance Publique, Hôpitaux de Paris, Paris, France.,INSERM 1178 and Centre de Recherche en Epidémiologie et Santé des Populations, Université Paris Sud, Paris, France.,Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - S-Hakki Onen
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
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Shen Y, Huang JY, Li J, Liu CF. Excessive Daytime Sleepiness in Parkinson's Disease: Clinical Implications and Management. Chin Med J (Engl) 2018; 131:974-981. [PMID: 29664059 PMCID: PMC5912065 DOI: 10.4103/0366-6999.229889] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Excessive daytime sleepiness (EDS) is one of the most common sleep abnormalities in patients with Parkinson's disease (PD), yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed. Data Sources English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms: "sleepiness", "sleep and Parkinson's disease", and "Parkinson's disease and treatment". Study Selection Original research articles and critical reviews related to EDS in PD were selected. Results EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic (i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation) and pharmacologic (i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine) treatments may be effective in treating EDS in PD. Conclusions EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.
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Affiliation(s)
- Yun Shen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Jun-Ying Huang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Jie Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu 215123, China
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Leiva S, Madrazo J, Podesta C. Narcolepsy with cataplexy and hyperthyroidism sudden appeared after H1N1 vaccination. Sleep Sci 2018; 11:34-36. [PMID: 29796199 PMCID: PMC5916574 DOI: 10.5935/1984-0063.20180008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Narcolepsy type 1 (NT1) is a chronic sleep disorder, characterized by excessive
daytime sleepiness, cataplexy and fragmented nocturnal sleep. It is caused by a
hypocretin deficiency due to a significant reduction of the neurons producing
it. In the last years, it has been postulated that an autoimmune mechanism would
be responsible for the destruction of these neurons in those genetically
predisposed patients. The increased incidence of narcolepsy after the pandemic
H1N1 influenza vaccination campaign in 2009-2010 is known. We present below the
case of an adult patient who, 10 days after receiving H1N1 vaccination, suffers
a traffic accident after falling asleep. Subsequent studies revealed
hyperthyroidism due to Graves disease. In spite of the treatment, the patient
persisted with daily and disabling daytime sleepiness, sleep attacks and
episodes of generalized muscle atony with preservation of consciousness. A
nocturnal polysomnography and multiple sleep latency test (MSLT) were performed
with a diagnosis of NT1. The particularity of this case is the presentation of 2
autoimmune diseases triggered by an H1N1 vaccine without adjuvant, so far there
is only evidence of NT1 associated with vaccines with adjuvant and viral
infection. The association of both entities has made us reflect on the
autoimmune mechanism, reinforcing the theory of its role in the onset of the
disease.
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Affiliation(s)
- Silvia Leiva
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Unidad de Medicina del Sueño - Capital Federal - Buenos Aires - Argentina
| | - Jimena Madrazo
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Unidad de Medicina del Sueño - Capital Federal - Buenos Aires - Argentina
| | - Claudio Podesta
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Unidad de Medicina del Sueño - Capital Federal - Buenos Aires - Argentina
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