Idiopathic hypersomnia with and without long sleep time: a controlled series of 75 patients.
OBJECTIVE
To characterize the clinical, psychological, and sleep pattern of idiopathic hypersomnia with and without long sleep time, and provide normative values for 24-hour polysomnography.


METHODS
University Hospital.


METHODS
Controlled, prospective cohort.


METHODS
75 consecutive patients (aged 34 +/- 12 y) with idiopathic hypersomnia and 30 healthy matched controls.


METHODS
Patients and controls underwent during 48 hours a face-to-face interview, questionnaires, human leukocyte antigen genotype, a night polysomnography and multiple sleep latency test (MSLT), followed by 24-h ad libitum sleep monitoring.


RESULTS
Hypersomniacs had more fatigue, higher anxiety and depression scores, and more frequent hypnagogic hallucinations (24%), sleep paralysis (28%), sleep drunkenness (36%), and unrefreshing naps (46%) than controls. They were more frequently evening types. DQB1*0602 genotype was similarly found in hypersomniacs (24.2%) and controls (19.2%). Hypersomniacs had more frequent slow wave sleep after 06:00 than controls. During 24-h polysomnography, the 95% confidence interval for total sleep time was 493-558 min in controls, versus 672-718 min in hypersomniacs. There were 40 hypersomniacs with and 35 hypersomniacs without long ( > 600 min) sleep time. The hypersomniacs with long sleep time were younger (29 +/- 10 vs 40 +/- 13 y, P = 0.0002), slimmer (body mass index: 26 +/- 5 vs 23 +/- 4 kg/m2; P = 0.005), and had lower Horne-Ostberg scores and higher sleep efficiencies than those without long sleep time. MSLT latencies were normal (> 8 min) in 71% hypersomniacs with long sleep time.


CONCLUSIONS
Hypersomnia, especially with long sleep time, is frequently associated with evening chronotype and young age. It is inadequately diagnosed using MSLT.
Vernet
Cyrille
C
Unité des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, Paris, France.
Arnulf
Isabelle
I
D000328:Adult; D000367:Age Factors; D000483:Alleles; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D015992:Body Mass Index; D016022:Case-Control Studies; D002940:Circadian Rhythm; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005602:France; D005787:Gene Frequency / Q000235:genetics; D005838:Genotype; D006683:HLA-DQ Antigens / Q000235:genetics; D059866:HLA-DQ beta-Chains; D006801:Humans; D020177:Idiopathic Hypersomnia / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D055815:Young Adult
D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D008562:Membrane Glycoproteins