Idiopathic Hypersomnia and Depression, the Challenge for Clinicians and Researchers

Galušková, Karolína; Šonka, Karel

doi:10.14712/23362936.2021.13

Cited by 8 publications

(3 citation statements)

References 58 publications

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“…The prevalence rates can only be superficially compared because we are considering lifetime occurrence of depression; on the other hand, we may have missed some cases that were not reported due to psychiatric stigma and cases of depression that were not examined by a psychiatrist. The prevalence of depression in IH is high, this fact has been reported by several authors (Galuskova & Sonka, 2021), and it is a difficult clinical decision whether a case should be diagnosed as IH or depression with hypersomnia (Buskova et al, 2022). The question still remains to what extent mood disorders are related to the biological background of IH and to what extent they are a psychophysiological consequence of IH and are biologically independent disorders.…”

Section: Discussionmentioning

confidence: 90%

Idiopathic hypersomnia years after the diagnosis

Šonka,

Feketeová,

Nevšímalová

et al. 2023

Journal of Sleep Research

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SummaryLittle attention has been paid to the long‐term development of idiopathic hypersomnia symptoms and idiopathic hypersomnia comorbidities. The aim of this study was to describe the general health of patients with idiopathic hypersomnia years after the initial diagnosis, focusing on current subjective hypersomnolence and the presence of its other possible causes. Adult patients diagnosed with idiopathic hypersomnia ≥ 3 years ago at sleep centres in Prague and Kosice were invited to participate in this study. A total of 60 patients were examined (age 47.3 ± SD = 13.2 years, 66.7% women). In all participants, their hypersomnolence could not be explained by any other cause but idiopathic hypersomnia at the time of diagnosis. The mean duration of follow‐up was 9.8 + 8.0 years. Fifty patients (83%) reported persisting hypersomnolence, but only 33 (55%) had no other disease that could also explain the patient's excessive daytime sleepiness and/or prolonged sleep. In two patients (3%), the diagnosis in the meantime had changed to narcolepsy type 2, and 15 patients (25%) had developed a disease or diseases potentially causing hypersomnolence since the initial diagnosis. Complete hypersomnolence resolution without stimulant treatment lasting longer than 6 months was reported by 10 patients (17%). To conclude, in a longer interval from the diagnosis of idiopathic hypersomnia, hypersomnolence may disappear or may theoretically be explained by another newly developed disease, or the diagnosis may be changed to narcolepsy type 2. Thus, after 9.8 years, only 55% of the examined patients with idiopathic hypersomnia had a typical clinical picture of idiopathic hypersomnia without doubts about the cause of the current hypersomnolence.

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Section: Discussionmentioning

confidence: 90%

Idiopathic hypersomnia years after the diagnosis

Šonka,

Feketeová,

Nevšímalová

et al. 2023

Journal of Sleep Research

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“…Thus, it can be speculated that the present dynamic structure at least partially reflects the conditions in the system that manifests as IH (12,15,26). Surprising was the low contribution rate for psychiatric disorders, which are outweighed by the resulting work and social influences (1,37,38). Twelve patients (27%) were diagnosed with depression in the whole cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Hypersomnias of central origin are of interest to clinicians and research groups for many reasons. The as-yet unresolved etiology and frequent resistance to therapeutic interventions pose a challenge for both groups (1). From the patient's point of view, it is a disorder with a significant impact on quality of life, and from society's point of view, sleep-wake disorders are a significant and, according to current research, an ever-increasing source of costs (2).…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Hypersomnia—A Dynamic Simulation Model

et al. 2022

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Aims of the study:Commonly used approach to illness assessment focuses on the patient's actual state supplemented by binary records of past events and conditions. This research project was designed to explain subjective experience in idiopathic hypersomnia (IH) patients influenced by their clinical symptoms and comorbidities.Material and MethodsForty-three IH patients of both sexes (female 60.5%, male 39.5%) were assessed using a detailed structured examination. The interview covered neurologic, psychiatric, and internal medicine anamnesis, medication past and current, substance abuse, work impairment, detailed sleep-related data, specific sleep medication, and a full-length set of questionnaires including depression, quality of life, sleepiness, anxiety, fatigue, insomnia, and sleep inertia. The data were digitized and imported into statistical software (SPSS by IBM), and dynamic simulation software (Vensim by Ventana Systems Inc.) was used to build a causal loop diagram and stocks and flows diagram as a simulation structure.ResultsThe overall raw data and simulation-based patterns fit at 76.1%. The simulation results also identified the parameters that contribute the most to patients' subjective experience. These included sleep inertia, the refreshing potential of naps, the quality of nocturnal sleep, and the social aspects of the patient's life. Psychiatric disorders influence the overall pattern at a surprisingly low level. The influence of medication has been studied in detail. Although its contribution to the dynamics looks marginal at first sight, it significantly influences the contribution of other variables to the overall patient experience of the disease.ConclusionEven the simplified dynamic structure designed by the research team reflects the real-life events in patients with IH at the acceptable level of 76.1% and suggests that a similar structure plays an important role in the course of the disease. Therapeutic focus on the parameters identified by the model should enhance the patients' subjective experience throughout illness duration and might even turn the progress from negative into positive. Further research is needed to understand the dynamics of idiopathic hypersomnia in greater detail to better understand the causes and design therapeutic approaches to improve patients' quality of life.

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