Anderson Jack, Yee Brendon J, Grunstein Ronald, Matar Elie, Chadwick Michelle, Machan Elizabeth, Chapman Julia, Tai Jian, Saini Bandana, Sivam Sheila
University of Sydney, Sydney, New South Wales, Australia.
Brain and Mind Centre, Sydney, New South Wales, Australia.
J Clin Sleep Med. 2024 Dec 1;20(12):1955-1964. doi: 10.5664/jcsm.11298.
Idiopathic hypersomnia (IH) is a disorder of central hypersomnolence that results in excessive daytime sleepiness in the absence of another identifying cause. Case studies from sleep clinic patients may not be a fair representation of the wider IH population. This study aims to better characterize patients diagnosed with IH in Australia and New Zealand using online patient-driven survey data.
A retrospective analysis of 686 participants from the Hypersomnolence Australia Patient Data Registry diagnosed with either IH (n = 554), narcolepsy type 1 (n = 54), or narcolepsy type 2 (n = 78) between January 2013 and October 2022 was performed.
Participants with IH reported additional sleep disorders such as obstructive sleep apnea (16.4%) and restless legs syndrome (7.9%), and notable comorbidities included depression (46.2%) and anxiety (50%). There was a mean delay in diagnosis of 10 years in participants with IH, when compared to symptom onset. IH presents with unique but also overlapping symptomatology with narcolepsy type 2, with similar reporting of long daytime naps, unrefreshed sleep, and automatic behavior. Modafinil was the most common medication (45.5%) used by participants with IH, followed by dexamphetamine (44.2%). Most participants with IH reported receiving physicians' advice regarding positive lifestyle changes but recommend that newly diagnosed patients be given more advice about medication use.
This study demonstrates a delay in IH diagnosis when compared to symptom onset and overlapping features of IH and narcolepsy type 2. It also highlights the heterogeneous presentation of IH and the value of large patient registries in future research.
Anderson J, Yee BJ, Grunstein R, et al. Insights from a 10-year Australasian idiopathic hypersomnia patient data registry study. 2024;20(12):1955-1964.
特发性嗜睡症(IH)是一种中枢性过度嗜睡障碍,在没有其他明确病因的情况下导致白天过度嗜睡。睡眠诊所患者的病例研究可能无法公平地代表更广泛的IH人群。本研究旨在利用在线患者驱动的调查数据,更好地描述在澳大利亚和新西兰被诊断为IH的患者特征。
对2013年1月至2022年10月期间来自澳大利亚嗜睡症患者数据登记处的686名参与者进行回顾性分析,这些参与者被诊断为IH(n = 554)、1型发作性睡病(n = 54)或2型发作性睡病(n = 78)。
患有IH的参与者报告了其他睡眠障碍,如阻塞性睡眠呼吸暂停(16.4%)和不宁腿综合征(7.9%),显著的合并症包括抑郁症(46.2%)和焦虑症(50%)。与症状出现相比,患有IH的参与者诊断平均延迟10年。IH与2型发作性睡病有独特但也有重叠的症状,在白天长时间小睡、睡眠未恢复精力和自动行为方面有类似的报告。莫达非尼是患有IH参与者最常用的药物(45.5%),其次是右旋苯丙胺(44.2%)。大多数患有IH的参与者报告接受了医生关于积极生活方式改变的建议,但建议新诊断的患者应获得更多关于药物使用的建议。
本研究表明与症状出现相比,IH诊断存在延迟,以及IH与发作性睡病2型的重叠特征。它还强调了IH的异质性表现以及大型患者登记处在未来研究中的价值。
Anderson J, Yee BJ, Grunstein R,等。来自一项为期10年的澳大利亚特发性嗜睡症患者数据登记处研究的见解。2024;20(12):1955 - 1964。