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Isotretinoin-Induced Hypersomnia: A Cross-sectional Study and Literature Review
Ahmed Shawky1, Mohamed Elsheikh, Emad M Elrewiny
1At Al-Azhar University, Cairo, Egypt, Ahmed Shawky, MD, is Assistant Professor, Department of Dermatology, Faculty of Medicine; Mohamed Elsheikh, MD, is Assistant Professor, Department of Psychiatry, Faculty of Medicine; Emad M. Elrewiny, MD, is Assistant Professor, Department of Dermatology, Faculty of Medicine; Mohamed Adwi, MBBCh, is General Practitioner, Faculty of Medicine; and Mahmoud A. Rageh, MD, is Lecturer, Department of Dermatology, Faculty of Medicine.
Background:
Isotretinoin is an oral retinoic drug for severe resistant acne cases that has controversially been associated with multiple psychiatric adverse effects. Research has primarily focused on depression and suicidality; however, a few case studies reported hypersomnia and sleep changes after isotretinoin initiation.
Objective:
To assess sleep quality and measure rates of hypersomnia, depression, and anxiety in patients undergoing isotretinoin therapy.
Methods:
This cross-sectional study was conducted at outpatient clinics of the university hospital. The rate of self-reported oversleeping was measured. In addition, researchers used the Pittsburgh Sleep Quality Index to assess sleep quality and conducted semistructured clinical interviews to detect depression and anxiety.
Results:
Of 123 patients with acne on isotretinoin, 77 (62.6%) reported oversleeping. Nearly half (60 patients, 48.8%) were categorized as poor sleepers according to the Pittsburgh Sleep Quality Index. The interviews revealed anxiety and depression percentages among 9.8% and 4.9% of participants, respectively.
Conclusions:
Hypersomnia was noticeably high in this study sample; thus, it may cautiously suggest a possible link between isotretinoin and hypersomnia. However, more research is needed to investigate this potential relationship.
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