Identifying subtypes of Hypersomnolence Disorder: a clustering analysis
J D Cook1, M E Rumble2, D T Plante2
1Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA.
Sleep Medicine
|November 1, 2019
Summary
Clustering analysis identified two distinct Hypersomnolence Disorder subtypes. One subtype exhibits more severe symptoms and is associated with elevated depressive symptoms, suggesting a need for tailored treatments.
Area of Science:
- Sleep Medicine
- Psychiatry
- Data Science
Background:
- Patient heterogeneity complicates Hypersomnolence Disorder (HSD) assessment and treatment.
- Clustering analysis offers a method to create homogenous patient subclassifications.
- Identifying HSD subtypes is crucial for personalized medicine.
Purpose of the Study:
- To identify more homogeneous subclassifications of Hypersomnolence Disorder using clustering analysis.
- To explore potential phenotypic differences between HSD subtypes.
Main Methods:
- Recruited patients undergoing polysomnography (PSG) and multiple sleep latency test (MSLT).
- Selected 62 participants with Hypersomnolence Disorder for analysis.
- Utilized self-report total sleep time, Epworth Sleepiness Scale (ESS), and Sleep Inertia Questionnaire (SIQ) scores as clustering variables.
- Employed Ward's D hierarchical clustering to generate two distinct clusters.
Main Results:
- The two identified clusters differed significantly across subjective and objective hypersomnolence measures.
- One cluster represented a more severe HSD phenotype, characterized by greater daytime sleepiness, sleep inertia, and functional impairment.
- This severe phenotype cluster also exhibited elevated depressive symptoms, longer sleep duration, and worse vigilance.
Conclusions:
- Findings support the reformulation of hypersomnolence nosology, particularly concerning its association with psychiatric disorders.
- Further research is needed to fully conceptualize and characterize unexplained hypersomnolence, with and without psychiatric comorbidities.
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