0595 MSLT AND 24hr PSG for Diagnosing Idiopathic Hypersomnia. (12th April 2019)

• Record Type: Journal Article
• Authors: Honda, Makoto; Ito, Wakako
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A237
• Page End: A237
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.593
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: MSLT evaluates the ability to fall asleep in daytime nap opportunities, serving as the gold standard for the diagnosis of narcolepsy type 1. However, recent studies suggest the limitation of MSLT for the diagnosis of other hypersomnias. ICSD3 employed additional criteria of pathological sleepiness, "total sleep time is more than or equal to 660 minutes on 24hr PSG", which evaluate the extended sleep beyond "adequate" or "required" sleep time. We performed 24hr PSG followed by standard PSG and MSLT in order to compare the difference between the two criteria of pathological sleepiness in idiopathic hypersomnia. Methods: Twenty-six consecutive subjects who were suspected of idiopathic hypersomnia ( with long subjective sleep time and comorbid ANS symptoms) and gave written informed consents were evaluated in Seiwa Hospital, Tokyo during Nov 2016 to Dec 2018. Results: Two PLMD subjects and two data with poor quality were excluded. So data from a total of 22 subjects (M/F = 8/14, 18.7±3.9 years old) were studied. Fifteen of them were diagnosed as idiopathic hypersomnia according to 24hr PSG criteria (total sleep time 848±105min) but 13 of them did not meet the MSLT criteria (mean sleep latency 12.1±4.0min). According to the MSLT criteria, two patients were diagnosed as idiopathic hypersomnia and one as narcolepsy type2. Only one patient met the both criteria. Conclusion: Evaluation of pathological sleepiness in idiopathic hypersomnia patients using conventional PSG-MSLT can overlook most of the typical idiopathic hypersomnia cases. Our data suggest that 24hr PSG evaluation of total sleep time should be used as the cardinal diagnostic tool for typical IHS patients, with MSLT results as supportive data. Support (If Any): None