Kido Keisuke, Sugita Naoko, Murai Toshiya, Tachibana Naoko, Kubota Manabu
Department of Psychiatry Graduate School of Medicine, Kyoto University Kyoto Japan.
PCN Rep. 2024 Nov 17;3(4):e70032. doi: 10.1002/pcn5.70032. eCollection 2024 Dec.
Although central disorders of hypersomnolence (CDH) and attention-deficit/hyperactivity disorder (ADHD) are frequently comorbid, they often remain underdiagnosed, leading to insufficient treatment and sociopsychological outcomes.
Here, we present a case of a male in his late 20s with ADHD and autism spectrum disorder who exhibited symptoms suggestive of idiopathic hypersomnia (IH), a subtype of CDH. The patient experienced difficulty waking up and dropped out of university. Additionally, although methylphenidate extended-release was prescribed, he often forgot to take his medication, resulting in difficulty waking up until late afternoon. No symptoms related to rapid eye movements sleep were observed. Considering the possibility of concurrent hypersomnia with neurodevelopmental disorders, we conducted 24-h polysomnography (PSG). The results demonstrated total sleep time of 774.5 min (≥660 min). Together with other criteria, we diagnosed him as having IH. Following discharge and discussion with the patient, we provided sleep hygiene education for him, and he resumed day care attendance to establish a social routine.
In cases where hypersomnia may co-occur with neurodevelopmental disorders, active utilization of 24-h PSG enables detailed evaluation of sleep-wake patterns and behaviors, facilitating effective guidance on sleep hygiene and promoting improvements in social rhythms and sociability.
尽管中枢性过度嗜睡症(CDH)和注意力缺陷多动障碍(ADHD)经常合并出现,但它们往往仍未得到充分诊断,导致治疗不足以及社会心理方面的后果。
在此,我们报告一例20多岁晚期男性患者,患有ADHD和自闭症谱系障碍,表现出提示特发性嗜睡症(IH)的症状,IH是CDH的一种亚型。该患者起床困难并从大学辍学。此外,尽管开了缓释哌甲酯,但他经常忘记服药,导致直到下午晚些时候都难以醒来。未观察到与快速眼动睡眠相关的症状。考虑到同时存在过度嗜睡症与神经发育障碍的可能性,我们进行了24小时多导睡眠图(PSG)检查。结果显示总睡眠时间为774.5分钟(≥660分钟)。结合其他标准,我们诊断他患有IH。出院并与患者讨论后,我们为他提供了睡眠卫生教育,他恢复了日间护理出勤以建立社交常规。
在过度嗜睡症可能与神经发育障碍同时出现的情况下,积极使用24小时PSG能够详细评估睡眠 - 觉醒模式和行为,有助于对睡眠卫生进行有效指导,并促进社会节律和社交能力的改善。