Sleep Disorder Connect
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Idiopathic Hypersomnia Diagnosis

Idiopathic hypersomnia (IH) is a neurological sleep disorder characterized by chronic, excessive attacks of drowsiness during the day - excessive daytime sleepiness (EDS) - despite adequate or long sleep amounts. Other hallmark features include non-restorative sleep and extreme difficulty awakening from sleep despite sleeping for 10-11 hours per night which is typical for people with IH.



Misdiagnosis or underdiagnosis of IH is common since sleepiness is a central feature of multiple disorders, secondary symptoms of IH can be seen in other disorders, and because there is no validated biomarker for IH diagnosis. Considerations for differential diagnosis of IH include clinical features of insufficient sleep syndrome, narcolepsy type 1 and 2, delayed sleep phase syndrome, hypersomnia associated with psychiatric disorders, and hypersomnia due to medical disorders.



What are some of the key questions you ask patients to accurately diagnose their sleep disorder? What other approaches, tools, or tests do you use to diagnose idiopathic hypersomnia from other sleep disorders?



Trotti (2017) Sleep Medicine Clinics 12(3):331-344



 


  • 4yr
    Sleep is such an important part of our everyday and it is important to educate on the issues that can come up and when to seek help.
  • 4yr
    use the following scale to evaluate IH: Epworth Sleepiness Scale (ESS) , Patient Global Impression of Change (PGIc) and Idiopathic Hypersomnia Severity Scale (IHSS)—Assesses the severity of idiopathic hypersomnia symptoms, Show More

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4yr
A comparative study of three hypnotics: methyprylon, glutethimide and chloral hydrate

A comparative study of three hypnotics: methyprylon, glutethimide and chloral hydrate

Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1946598/

A controlled study designed to evaluate the hypnotic potentiality of methyprylon (300 mg.), glutethimide (500 mg.) and chloral hydrate (1000 mg.) was carried out on 50 in-patients experiencing long-standing insomina....


Conclusion/Relevance: Methyprylon was found statistically (P = .05) to be the fastest sleep-inducing agent, whereas glutethimide (Doriden) proved to be the slowest of the three hypnotics with respect to sleep induction time.

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4yr
COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia - PubMed

COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/35002346/

The coronavirus disease (COVID-19) has brought significant social and economic disruptions and devastating impacts on public health, and vaccines are being developed to combat the disease. Timely vaccination may prevent...


Conclusion/Relevance: We speculate that COVID-19 vaccine may potentially trigger the relapse of hypersomnia. The immune memory could be an explanation for the increased response to vaccine in patients with secondary hypersomnia. Caution should be warranted when administering COVID-19 vaccine in patients with hypersomnia secondary to infections.

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4yr
Prevalence of obstructive sleep apnea as assessed by polysomnography in psychiatric patients with sleep-related problems - PubMed

Prevalence of obstructive sleep apnea as assessed by polysomnography in psychiatric patients with sleep-related problems - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/35029795/

doi: 10.1007/s11325-022-02566-6. Online ahead of print. 1 Department of Psychiatry, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan. 2 Kariya Toyota General Hospital, Kariya, Aichi,...


Conclusions: PSG revealed that moderate to severe OSA was common in psychiatric patients with or without snoring. Subjective symptoms and psychotropics did not predict OSA. Therefore, PSG is needed to reveal sleep conditions in patients with psychiatric disorders.

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4yr
Treatment of insomnia - effect of trazodone and hypnotics on sleep - PubMed

Treatment of insomnia - effect of trazodone and hypnotics on sleep - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/34994734/

Sedative antidepressants are commonly used drugs in the treatment of insomnia. However, some recommendations claim that only hypnotics have been proven effective in the treatment of sleep initiation and maintenance...



Conclusion/Relevance: The main mechanism through which trazodone promotes sleep is its antagonistic effect on 5-HT2 serotonin receptors, while hypnotics are agonists of gamma-aminobutyric acid GABAA receptors, and other sedative antidepressants block H1 histamine receptors. This is associated with a low risk of weight gain, which is rare with...