Differences in findings of nocturnal polysomnography and multiple sleep latency test between narcolepsy and idiopathic hypersomnia

Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo, Japan.
Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology (Impact Factor: 3.1). 06/2011; 123(1):137-41. DOI: 10.1016/j.clinph.2011.05.024
Source: PubMed


To compare differences in nocturnal and daytime polysomnographic findings between narcolepsy (NA) with and without cataplexy (CA) and idiopathic hypersomnia without long sleep time (IHS w/o LST).
Nocturnal polysomnography (n-PSG) and multiple sleep latency test (MSLT) findings were compared among subjects with NA with CA (n=52), NA without CA (n=62), and IHS w/o LST (n=50).
The NA with CA group had significantly more disrupted and shallower nocturnal sleep than the other groups. On MSLT, the IHS w/o LST group had significantly longer sleep latency (SL) compared with the two NA groups. The latter two groups did not show statistical differences in diurnal variation of SL.
The IHS w/o LST group had milder objective daytime sleepiness compared with the NA groups. In patients with NA, nocturnal sleep disturbances appeared only in cases with CA, despite a similar trend in diurnal changes in sleep propensity between the two NA groups.
Objective nocturnal sleep disturbances are specific to NA patients with CA, whereas diurnal variations of sleep propensity are observed irrespective of the presence of CA among NA patients. These findings could be helpful for choosing optimal treatment plans for patients with these disorders.

31 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Narcolepsy is a common sleep disorder with a prevalence of about 0.02%. However, it may remain largely unrecognized in the Indian population owing to the perceived low prevalence. To the best of our knowledge there is only one case of narcolepsy reported from India so far. We present a case of narcolepsy with cataplexy with classical clinical and polysomnographic findings of narcolepsy.
    Neurology India 01/2011; 60(1):79-81. DOI:10.4103/0028-3886.93605 · 1.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Inefficient sleep leading to excessive daytime sleepiness is a common complaint encountered by GPs and sleep physicians. Common causes of excessive daytime sleepiness include circadian rhythm disorder/shiftwork, sleep apnoea syndrome, psychiatric disorders, restless leg syndrome, medication effect, narcolepsy and idiopathic hypersomnia. Objective: This short review discusses the available objective and subjective testing measures in office evaluation of sleepy patients, predominantly in the primary care setting. Discussion: Beyond affecting patients' quality of life, mood and functionality, excessive sleepiness can become a public health concern when affecting critical job holders. Therefore, a clear understanding of its importance and applying current standards in evaluating patients with such a complaint are of great necessity. Apart from the clinical assessments, including a thorough history taking and physical examination, measures to assess sleepiness and ability to maintain wakefulness are available.
    Australian family physician 10/2012; 41(10):787-90. · 0.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated nocturnal sleep abnormalities in 19 patients with idiopathic hypersomnia without long sleep time (IH) in comparison with two age- and sex- matched control groups of 13 normal subjects (C) and of 17 patients with narcolepsy with cataplexy (NC), the latter considered as the extreme of excessive daytime sleepiness (EDS). Sleep macro- and micro- (i.e. cyclic alternating pattern, CAP) structure as well as quantitative analysis of EEG, of periodic leg movements during sleep (PLMS), and of muscle tone during REM sleep were compared across groups. IH and NC patients slept more than C subjects, but IH showed the highest levels of sleep fragmentation (e.g. awakenings), associated with a CAP rate higher than NC during lighter sleep stages and lower than C during slow wave sleep respectively, and with the highest relative amount of A3 and the lowest of A1 subtypes. IH showed a delta power in between C and NC groups, whereas muscle tone and PLMS had normal characteristics. A peculiar profile of microstructural sleep abnormalities may contribute to sleep fragmentation and, possibly, EDS in IH.
    Journal of Sleep Research 10/2012; 22(2). DOI:10.1111/j.1365-2869.2012.01061.x · 3.35 Impact Factor
Show more