Psychological health in central hypersomnias: the French Harmony study.
BACKGROUND
A large observational French study of central hypersomnia, including narcolepsy with cataplexy (C+), without cataplexy (C-) and idiopathic hypersomnia (IH), was conducted to clarify the relationships between the severity of the condition, psychological health and treatment response.


METHODS
601 consecutive patients over 15 years of age suffering from central hypersomnia were recruited on excessive daytime sleepiness, polysomnography and Multiple Sleep Latency Test (MSLT) results. 517 (47.6% men, 52.4% women) were finally included: 82.0% C+, 13.2% C- and 4.8% IH. Face to face standardised clinical interviews plus questionnaires (Epworth Sleepiness Scale (ESS), short version Beck Depression Inventory (S-BDI), Pittsburgh Sleep Quality Index (PSQI) and 36-item Short Form Health Survey (SF-36)) were performed. Patients affected with a different diagnosis and with and without depressive symptoms were compared.


RESULTS
Mean ESS and body mass index were higher in C+ compared with C-/IH patients. Half of the patients (44.9%) had no depressive symptoms while 26.3% had mild, 23.2% moderate and 5.6% severe depressive symptoms. C+ patients had higher S-BDI and PSQI and lower SF-36 scores than C-/IH patients. Depressed patients had higher ESS scores than non-depressed patients, with no difference in age, gender, duration of disease or MSLT parameters. Finally, C+ patients treated with anticataplectic drugs (38.7%) had higher S-BDI and lower SF-36 scores than C+ patients treated with stimulants alone.


CONCLUSIONS
Our data confirmed the high frequency of depressive symptoms and the major impact of central hypersomnias on health related quality of life, especially in patients with cataplexy. We recommend a more thorough assessment of mood impairment in central hypersomnias, especially in narcolepsy-cataplexy.
Dauvilliers
Y
Y
Département de Neurologie, Hôpital Gui de Chauliac, 80 av Augustin Fliche, Cedex 5, Montpellier 34295, France. y-dauvilliers@chu-montpellier.fr
Paquereau
J
J
Bastuji
H
H
Drouot
X
X
Weil
J-S
JS
Viot-Blanc
V
V
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D002385:Cataplexy / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D020177:Idiopathic Hypersomnia / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D009290:Narcolepsy / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D017060:Patient Satisfaction; D010555:Personality Inventory; D017286:Polysomnography; D011788:Quality of Life / Q000523:psychology
D000928:Antidepressive Agents; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil