Ohara Shinji, Takaki Ryusuke, Sasaki Shigeto
Department of Neurology, Iida Hospital, Iida City, Nagano Prefecture, Japan.
Department of Internal Medicine, Iida Hospital, Iida City, Nagano Prefecture, Japan.
Sleep Sci. 2024 May 10;17(4):e461-e465. doi: 10.1055/s-0044-1780503. eCollection 2024 Dec.
We herein describe the cases of two young Japanese adults who presented with excessive daytime sleepiness (EDS). Based on their history, the postprandial nature of the sleepiness was suspected, although the patients themselves were not aware of the association. Oral glucose tolerance tests (OGTTs) reproduced the sleepiness and showed the patterns of insulin resistance (IR) compatible with type-2 diabetes mellitus (T2DM) in one patient and glucose intolerance in the other. There was no evidence of chronic hyperglycemia in either patient. Antidiabetic medications resulted in the disappearance of EDS in both patients; in one, a repeat OGTT revealed improved IR. We suggest that postprandial somnolence can present with EDS, and it can be effectively treated with antidiabetic medications, and that the OGTT can be useful in identifying IR, which may be the underliyng cause of the excessive postprandial somnolence.
我们在此描述了两名出现日间过度嗜睡（EDS）的年轻日本成年人的病例。根据他们的病史，尽管患者自身并未意识到这种关联，但怀疑嗜睡具有餐后性质。口服葡萄糖耐量试验（OGTT）重现了嗜睡症状，其中一名患者显示出与2型糖尿病（T2DM）相符的胰岛素抵抗（IR）模式，另一名患者则表现为葡萄糖不耐受。两名患者均无慢性高血糖的证据。抗糖尿病药物使两名患者的EDS症状消失；其中一名患者再次进行OGTT显示IR有所改善。我们认为餐后嗜睡可表现为EDS，并且可用抗糖尿病药物有效治疗，而且OGTT有助于识别IR，而IR可能是餐后过度嗜睡的潜在原因。
