Cirillo Flavia, Fernandes Mariana, Placidi Fabio, Izzi Francesca, Mercuri Nicola Biagio, Liguori Claudio
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
J Sleep Res. 2025 Aug;34(4):e14451. doi: 10.1111/jsr.14451. Epub 2025 Jan 1.
Seasonality of excessive daytime sleepiness has been proposed, yet no research has specifically investigated its impact on daytime sleepiness and cataplexy in central disorders of hypersomnolence. This study examined seasonal variations in daytime sleepiness and cataplexy in narcolepsy type 1, narcolepsy type 2 and idiopathic hypersomnia. Patients included in the study were on stable pharmacological treatment, and participated in sleep medicine interviews to assess diurnal sleepiness and daytime napping and completed the Epworth Sleepiness Scale to assess excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10). Patients with narcolepsy type 1 also maintained a cataplexy diary. Evaluations were conducted in autumn, winter, spring and summer. The study included 29 patients with narcolepsy type 1, 16 patients with narcolepsy type 2 and 10 patients with idiopathic hypersomnia. Patients with narcolepsy type 1 and narcolepsy type 2 showed higher Epworth Sleepiness Scale scores in summer compared with other seasons, while patients with idiopathic hypersomnia showed no changes in excessive daytime sleepiness across the four seasons. Epworth Sleepiness Scale scores were higher in idiopathic hypersomnia patients compared to narcolepsy type 1 and narcolepsy type 2 patients in spring, autumn, and winter; conversely, in summer there were no differences in Epworth Sleepiness Scale scores among the three groups. No significant differences in Epworth Sleepiness Scale scores were noted between patients with narcolepsy type 1 and narcolepsy type 2 throughout the year. Furthermore, no seasonal effect on cataplexy frequency was found in patients with narcolepsy type 1. This study demonstrates that seasonality may influence daytime sleepiness in patients with narcolepsy type 1 and narcolepsy type 2 but not in patients with idiopathic hypersomnia, while cataplexy symptoms remain unaffected by seasonal changes. The underlying mechanisms linking excessive daytime sleepiness to seasonality have yet to be explored, though social factors and vacation time may contribute to increased excessive daytime sleepiness in narcolepsy.
已有研究提出白天过度嗜睡存在季节性，但尚无研究专门调查其对发作性睡病中枢性过度嗜睡障碍患者白天嗜睡和猝倒的影响。本研究调查了1型发作性睡病、2型发作性睡病和特发性嗜睡症患者白天嗜睡和猝倒的季节性变化。纳入研究的患者接受稳定的药物治疗，并参与睡眠医学访谈以评估日间嗜睡和白天小睡情况，同时完成爱泼华嗜睡量表以评估白天过度嗜睡（爱泼华嗜睡量表≥10）。1型发作性睡病患者还记录了猝倒日记。评估在秋季、冬季、春季和夏季进行。该研究纳入了29例1型发作性睡病患者、16例2型发作性睡病患者和10例特发性嗜睡症患者。与其他季节相比，1型发作性睡病和2型发作性睡病患者在夏季的爱泼华嗜睡量表得分更高，而特发性嗜睡症患者在四季中白天过度嗜睡情况无变化。在春季、秋季和冬季，特发性嗜睡症患者的爱泼华嗜睡量表得分高于1型发作性睡病和2型发作性睡病患者；相反，在夏季，三组患者的爱泼华嗜睡量表得分无差异。全年中，1型发作性睡病和2型发作性睡病患者的爱泼华嗜睡量表得分无显著差异。此外，未发现1型发作性睡病患者的猝倒频率有季节性影响。本研究表明，季节性可能会影响1型发作性睡病和2型发作性睡病患者的白天嗜睡，但不会影响特发性嗜睡症患者，而猝倒症状不受季节变化影响。尽管社会因素和休假时间可能导致发作性睡病患者白天过度嗜睡增加，但将白天过度嗜睡与季节性联系起来的潜在机制尚待探索。
