Chepke Craig, Benca Ruth M, Cutler Andrew J, Krystal Andrew D, Watson Nathaniel F
Excel Psychiatric Associates, Huntersville, North Carolina.
Corresponding Author: Craig Chepke, MD, DFAPA, Excel Psychiatric Associates, 10225 Hickorywood Hill Ave, Suite B, Huntersville, NC 28078 (
J Clin Psychiatry. 2025 Jun 2;86(3):24nr15718. doi: 10.4088/JCP.24nr15718.
This review of the relationship between idiopathic hypersomnia and psychiatric disorders describes considerations in recognizing and managing complaints of excessive daytime sleepiness (EDS) in patients in psychiatric clinical practice. Terms including "idiopathic hypersomnia" and "psychiatric" were used to search PubMed and Embase for English-language publications of human studies from inception to July 2024. Articles were manually screened for relevance to idiopathic hypersomnia pathophysiology, diagnosis, and treatment and EDS in psychiatric populations. Reference lists of identified articles were manually searched for additional relevant publications. Formal data charting was not performed. A total of 119 articles were included. Idiopathic hypersomnia is a central sleep disorder with the primary complaint of EDS, diagnosed prevalence of 0.037%, and estimated population prevalence up to 1.5%. Other prominent symptoms include sleep inertia, long sleep time, autonomic nervous system dysfunction, brain fog, and cognitive complaints. A high proportion of patients with idiopathic hypersomnia experience psychiatric comorbidities, including mood disorders and attention-deficit/hyperactivity disorder. Assessing individuals with psychiatric disorders and complaints of hypersomnolence can pose diagnostic challenges. Diagnosis and treatment may be complicated by possible exacerbation of EDS by psychiatric medications and, conversely, exacerbation of psychiatric symptoms by idiopathic hypersomnia treatments. Psychiatric clinicians are more likely to encounter patients with idiopathic hypersomnia than would be expected given its overall prevalence due to increased rate of psychiatric symptom comorbidity in this population. Recognizing and managing idiopathic hypersomnia for individuals with psychiatric conditions may lead to improvements in treatment outcome for patients.
这篇关于特发性嗜睡症与精神障碍之间关系的综述描述了在精神科临床实践中识别和处理患者日间过度嗜睡（EDS）主诉的注意事项。使用“特发性嗜睡症”和“精神科”等术语在PubMed和Embase数据库中检索从创刊至2024年7月的英文人类研究出版物。人工筛选文章以确定其与特发性嗜睡症的病理生理学、诊断、治疗以及精神科人群中的EDS的相关性。对已识别文章的参考文献列表进行人工检索以查找其他相关出版物。未进行正式的数据图表绘制。共纳入119篇文章。特发性嗜睡症是一种中枢性睡眠障碍，主要主诉为EDS，诊断患病率为0.037%，估计人群患病率高达1.5%。其他突出症状包括睡眠惰性、睡眠时间长、自主神经系统功能障碍、脑雾和认知方面的主诉。很大一部分特发性嗜睡症患者伴有精神科共病，包括情绪障碍和注意力缺陷多动障碍。评估患有精神障碍且有嗜睡主诉的个体可能会带来诊断挑战。精神科药物可能会加重EDS，反之，特发性嗜睡症的治疗可能会加重精神症状，这可能会使诊断和治疗变得复杂。由于该人群中精神症状共病率增加，精神科临床医生比根据特发性嗜睡症的总体患病率预期的更有可能遇到患有特发性嗜睡症的患者。识别和处理患有精神疾病个体的特发性嗜睡症可能会改善患者的治疗效果。
