1
|
Deshaies-Rugama AS, Mombelli S, Blais H, Sekerovic Z, Massicotte M, Thompson C, Nigam M, Carrier J, Desautels A, Montplaisir J, Gosselin N. Sleep architecture in idiopathic hypersomnia: the influence of age, sex, and body mass index. Sci Rep 2024; 14:16407. [PMID: 39013985 PMCID: PMC11252996 DOI: 10.1038/s41598-024-67203-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024] Open
Abstract
This study aimed to progress the understanding of idiopathic hypersomnia (IH) by assessing the moderating influence of individual characteristics, such as age, sex, and body mass index (BMI) on sleep architecture. In this retrospective study, 76 IH participants (38.1 ± 11.3 years; 40 women) underwent a clinical interview, an in-laboratory polysomnography with a maximal 9-h time in bed and a multiple sleep latency test (MSLT). They were compared to 106 healthy controls (38.1 ± 14.1 years; 60 women). Multiple regressions were used to assess moderating influence of age, sex, and BMI on sleep variables. We used correlations to assess whether sleep variables were associated with Epworth Sleepiness Scale scores and mean sleep onset latency on the MSLT in IH participants. Compared to controls, IH participants had shorter sleep latency (p = 0.002), longer total sleep time (p < 0.001), more time spent in N2 sleep (p = 0.008), and showed trends for a higher sleep efficiency (p = 0.023) and more time spent in rapid eye movement (REM) sleep (p = 0.022). No significant moderating influence of age, sex, or BMI was found. More severe self-reported sleepiness in IH patients was correlated with shorter REM sleep latency and less N1 sleep in terms of proportion and duration (ps < 0.01). This study shows that, when compared to healthy controls, patients with IH had no anomalies in their sleep architecture that can explain their excessive daytime sleepiness. Moreover, there is no moderating influence of age, sex, and BMI, suggesting that the absence of major group differences is relatively robust.
Collapse
Affiliation(s)
- Anne-Sophie Deshaies-Rugama
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Samantha Mombelli
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
| | - Zoran Sekerovic
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
| | - MiaClaude Massicotte
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Cynthia Thompson
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
| | - Milan Nigam
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Neuroscience, Université de Montréal, Montreal, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Neuroscience, Université de Montréal, Montreal, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Research Center of the Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Canada.
- Department of Psychology, Université de Montréal, Montreal, Canada.
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Office J-5135, Montréal, Québec, H4J 1C5, Canada.
| |
Collapse
|
2
|
Current Understanding of Narcolepsy 1 and its Comorbidities: What Clinicians Need to Know. Adv Ther 2022; 39:221-243. [PMID: 34894325 PMCID: PMC8799537 DOI: 10.1007/s12325-021-01992-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022]
Abstract
Narcolepsy is a chronic neurologic disorder associated with the dysregulation of the sleep–wake cycle that often leads to a decreased quality of life and results in a considerable health burden. There is often a delay to diagnosis of narcolepsy, mainly due to the lack of recognition of this disorder. One of the main factors hindering the diagnosis of narcolepsy is the association of comorbidities, which include other sleep disorders, psychiatric disorders, cardiovascular disorders, and metabolic disorders. The signs and symptoms of these comorbidities often overlap with those of narcolepsy, and some of the medications used for their treatment may obscure the symptoms of narcolepsy, leading to a delay in diagnosis. This review is targeted to clinicians unaccustomed to working with sleep disorders and aims to increase recognition and improve the management of narcolepsy.
Collapse
|
3
|
Sleep disordered breathing in patients with Prader willi syndrome: Impact of underlying genetic mechanism. Respir Med 2021; 187:106567. [PMID: 34411906 DOI: 10.1016/j.rmed.2021.106567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/05/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sleep-disordered breathing (SDB) is common in children with PWS. In the current study, we aimed to evaluate the severity of SDB in patients with PWS using polysomnography (PSG), and assess the effect of the underlying genetic mechanism on PSG parameters. METHODS Children with PWS, referred to our sleep laboratory between March 2016 and January 2020 were enrolled. PSG parameters, demographic data, body mass index (BMI), and symptoms related to SDB were recorded. The effect of non-invasive ventilation strategies and the outcome of therapy on PSG parameters were evaluated. RESULTS In our study, 64.5% of the patients had severe sleep apnea syndrome (total apnea hypopnea index (AHI) ≥10 events/hour). 22.6% had significantly high (>5 events/hour) central sleep apnea. Patients with a deletion had significantly lower initial and mean SaO2, longer sleep time SaO2 under 90%, oxygen desaturation % and total AHI when compared to those with uniparental disomy. PSG parameters were similar between patients who did or didn't receive growth hormone treatment. CONCLUSION The majority of the PWS patients had severe sleep apnea syndrome characterized mainly by hypopneas which were accompanied by central apneas. There was a more severe impact on oxygen parameters and total AHI in patients with deletions.
Collapse
|
4
|
Barker EC, Flygare J, Paruthi S, Sharkey KM. Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns. Nat Sci Sleep 2020; 12:453-466. [PMID: 32765142 PMCID: PMC7371435 DOI: 10.2147/nss.s162762] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/17/2020] [Indexed: 12/21/2022] Open
Abstract
Narcolepsy is a neurological disorder of the sleep-wake cycle characterized by excessive daytime sleepiness (EDS), cataplexy, nighttime sleep disturbances, and REM-sleep-related phenomena (sleep paralysis, hallucinations) that intrude into wakefulness. Dysfunction of the hypocretin/orexin system has been implicated as the underlying cause of narcolepsy with cataplexy. In most people with narcolepsy, symptom onset occurs between the ages of 10 and 35 years, but because the disorder is underrecognized and testing is complex, delays in diagnosis and treatment are common. Narcolepsy is treated with a combination of lifestyle modifications and medications that promote wakefulness and suppress cataplexy. Treatments are often effective in improving daytime functioning for individuals with narcolepsy, but side effects and/or lack of efficacy can result in suboptimal management of symptoms and, in many cases, significant residual impairment. Additionally, the psychosocial ramifications of narcolepsy are often neglected. Recently two new pharmacologic treatment options, solriamfetol and pitolisant, have been approved for adults, and the indication for sodium oxybate in narcolepsy has been expanded to include children. In recent years, there has been an uptick in patient-centered research, and promising new diagnostic and therapeutic options are in development. This paper summarizes current and prospective pharmacological therapies for treating both EDS and cataplexy, discusses concerns specific to children and reproductive-age women with narcolepsy, and reviews the negative impact of health-related stigma and efforts to address narcolepsy stigma.
Collapse
Affiliation(s)
- Emily C Barker
- Case Western Reserve University School of Medicine, Department of Pediatrics, Cleveland, OH, USA
| | | | - Shalini Paruthi
- Sleep Medicine and Research Center, St. Luke’s Hospital, St. Louis, MO, USA
- Saint Louis University School of Medicine, Departments of Medicine and Pediatrics, St. Louis, MO, USA
| | - Katherine M Sharkey
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
5
|
Georgiou N, Fasoulakis Z, Theodora M, Pappas VA, Papamanolis V, Kalagasidou S, Blontzos N, Kambas NJ, Kontomanolis EN. Association of Pregestational Maternal Sleeping Disorders and Preeclampsia: A Retrospective Cohort Study and Review of the Literature. Cureus 2019; 11:e4338. [PMID: 31187003 PMCID: PMC6541156 DOI: 10.7759/cureus.4338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In this retrospective cohort study, primigravidas with normal pregnancies and women who developed preeclampsia (PE) were assigned to complete sleeping disorder questionnaires. The Crown-Rump length (CRL) of the first prenatal screening was used to determine the gestational age and the participants were assigned to complete the following questionnaires according to their everyday life before pregnancy: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Epworth Sleepiness Scale (ESS), and (3) Athens Insomnia Scale (AIS). Women were also asked to evaluate their stress before pregnancy with the Beck Anxiety Inventory (BAI). The results of the women developing preeclampsia were analyzed to test the primary hypothesis that women with pre-existing to pregnancy sleep disorders are more likely to develop preeclampsia. Statistically significant differences were found between women who developed preeclampsia and women in the control group concerning sleeping disorder features before pregnancy of all three research tools, namely AIS (p<0.001), PSQI (p<0.001), and ESS (p=0.012<0.05). The results support that there is a possible statistical effect of pre-existing to pregnancy sleep disorders on the development of preeclampsia and women with pregestational sleep disorders request strict monitoring during pregnancy, however, further investigation with larger studies is needed to reach safe conclusions.
Collapse
Affiliation(s)
- Nikolaos Georgiou
- Internal Medicine, East Kent University Hospitals NHS Trust, Kent, GBR
| | | | - Marianna Theodora
- Obstetrics and Gynecology, National and Kapodistrian University, Athens, GRC
| | | | | | - Sofia Kalagasidou
- Obstetrics and Gynecology, Bodosakio General Hospital of Ptolemaida, Ptolemaida, GRC
| | - Nikolaos Blontzos
- Obstetrics and Gynecology, National and Kapodistrian University, Athens, USA
| | - Nikolaos J Kambas
- Obstetrics and Gynecology, General Hospital of Korinth, Korinth, GRC
| | - Emmanuel N Kontomanolis
- Obstetrics and Gynecology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| |
Collapse
|
6
|
|
7
|
Easow Mathew M, Biswas T, Fahad S, Patnaik M. Modafinil for excessive daytime sleepiness. Hippokratia 2017. [DOI: 10.1002/14651858.cd010843.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Manu Easow Mathew
- Christian Medical College; South Asian Cochrane Network & Center, Prof. BV Moses Center for Evidence-Informed Health Care and Health Policy; Carman Block II Floor CMC Campus, Bagayam Vellore Tamil Nadu India 632002
| | | | - Shabin Fahad
- Kasturba Medical College; Department of General Surgery; Light House Hill Road Mangalore Karnataka India 575001
| | - Mitali Patnaik
- Drexel University, College of Medicine, Hahnemann University Hospital; Department of Psychiatry; 230 North Broad Street Philadelphia Pennsylvania USA 19130
| |
Collapse
|
8
|
Kim T, Lee JH, Lee CS, Yoon IY. Different fates of excessive daytime sleepiness: survival analysis for remission. Acta Neurol Scand 2016; 134:35-41. [PMID: 26392230 DOI: 10.1111/ane.12504] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS) is a symptom frequently presented in sleep clinics. Only a paucity of data has addressed clinical courses of sleep disorders with EDS. Therefore, we sought to compare clinical outcomes of patients presenting EDS. METHODS A retrospective observational study was performed in the setting of sleep laboratory and outpatient department in a university hospital. One hundred and eight patients who presented EDS underwent polysomnography and multiple sleep latency test. Each patient was diagnosed as one of the following four categories: (1) narcolepsy with cataplexy (N + C; n = 29); (2) narcolepsy without cataplexy (N - C; n = 22); (3) idiopathic hypersomnia (IH; n = 24); and (4) subjective hypersomnolence (SH; n = 33) with mean sleep latency >8 min. Remission of EDS and treatment response were determined based on clinical evaluation. Kaplan-Meier survival analysis was performed. RESULTS Remission rates were significantly different (P < 0.001, overall log-rank test) among four groups except those between N - C and IH (P = 0.489). While N + C showed no remission, predicted remission rates of N - C and IH group were 44.6% at 5 years and 32.5% at 5.5 years after diagnosis. The predicted remission rate of SH group was 71.7% at 3 years after diagnosis. CONCLUSIONS The similarity of clinical courses between N - C and IH suggests that N - C may be more related to IH compared to N + C. Considering different clinical courses among EDS patients, thorough evaluation of EDS should be warranted before starting treatment.
Collapse
Affiliation(s)
- T. Kim
- Department of Neuropsychiatry; Seoul National University Bundang Hospital; Gyeonggi-do Korea
- Department of Psychiatry; Kyung Hee University Hospital at Gangdong; Seoul Korea
| | - J. H. Lee
- Department of Neuropsychiatry; Seoul National University Bundang Hospital; Gyeonggi-do Korea
| | - C. S. Lee
- Department of Neuropsychiatry; Seoul National University Bundang Hospital; Gyeonggi-do Korea
| | - I. Y. Yoon
- Department of Neuropsychiatry; Seoul National University Bundang Hospital; Gyeonggi-do Korea
- Department of Psychiatry; Seoul National University College of Medicine; Seoul Korea
| |
Collapse
|
9
|
Sowa NA. Idiopathic Hypersomnia and Hypersomnolence Disorder: A Systematic Review of the Literature. PSYCHOSOMATICS 2016; 57:152-64. [DOI: 10.1016/j.psym.2015.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 01/26/2023]
|
10
|
Holst SC, Valomon A, Landolt HP. Sleep Pharmacogenetics: Personalized Sleep-Wake Therapy. Annu Rev Pharmacol Toxicol 2016; 56:577-603. [DOI: 10.1146/annurev-pharmtox-010715-103801] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sebastian C. Holst
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
| | - Amandine Valomon
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
| |
Collapse
|
11
|
Affiliation(s)
- Abdulkhader Shehna
- Department of Radiation Oncology, Government Medical College, Thrissur, Kerala, India
| | - Firosh Khan
- Department of Neurology, Mother Hospital, Thrissur, Kerala, India
| | | |
Collapse
|