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Sleep overestimation differentiates between participants with suspected idiopathic hypersomnia
Tugdual Adam1,2, Sofiene Chenini2, Alexandre Derré2
1Institute of Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France.
Sleep
|May 29, 2025
Summary
Patients with hypersomnolence, particularly nonspecified hypersomnia (NSH) and idiopathic hypersomnia without long sleep time (IH-nLST), frequently overestimate sleep duration during polysomnography (PSG). This sleep overestimation correlates with daytime sleepiness and increased sleep bouts.
Area of Science:
- Sleep Medicine
- Neurology
- Clinical Neurophysiology
Background:
- Idiopathic hypersomnia (IH) is a sleep disorder characterized by excessive daytime sleepiness.
- Distinguishing between different subtypes of IH and other hypersomnias is crucial for accurate diagnosis and management.
- Understanding the discrepancy between subjective sleep perception and objective sleep measures is essential for patient care.
Purpose of the Study:
- To compare sleep perception during a 32-hour continuous polysomnography (PSG) in patients with idiopathic hypersomnia (IH), nonspecified hypersomnia (NSH), and healthy controls (HC).
- To investigate the relationship between objective sleep duration, subjective sleep estimation, and clinical parameters in hypersomnolence disorders.
- To identify factors contributing to the mismatch between perceived and actual sleep in patients with hypersomnia.
Main Methods:
- A 32-hour continuous bedrest polysomnography (PSG) protocol was conducted without circadian synchronizers.
- Participants included patients with suspected IH (diagnosed as IH with long sleep time [IH-LST], IH without long sleep time [IH-nLST], or NSH) and healthy controls (HC).
- Relative errors in sleep duration estimation were calculated and compared across groups, analyzed against clinical and sleep parameters.
Main Results:
- Nonspecified hypersomnia (NSH) and IH-nLST groups exhibited significantly higher relative errors in sleep duration estimation compared to IH-LST and HC groups.
- Sleep overestimation was more pronounced during daytime and the second night of the PSG in NSH and IH-nLST.
- A negative association was found between relative error and objective sleep duration, with shorter sleepers overestimating their sleep more, particularly in NSH and IH-nLST.
Conclusions:
- Overestimation of sleep duration is common in patients with hypersomnolence disorders, especially in IH-nLST and NSH, during free-running PSG.
- This finding highlights a significant mismatch between subjective sleep complaints and objective sleep measures in these patients.
- Further research is needed to fully understand and address this discrepancy in clinical practice.
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