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Published on: January 26, 2019
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Nocturnal sleep stage stability features in unexplained hypersomnolence
Jesse D Cook1, Meredith E Rumble1, Ana Maria Vascan1
1School of Medicine and Public Health, Department of Psychiatry, University of Wisconsin, Madison, Wisconsin.
Summary
Adults with hypersomnolence disorder (HD) show more stable sleep stages, particularly N2 and REM sleep, compared to healthy sleepers. These sleep stage stability (SSS) features may help define unexplained hypersomnolence.
Area of Science:
- Neurology
- Sleep Medicine
- Clinical Research
Background:
- Hypersomnolence disorder (HD) is characterized by excessive daytime sleepiness.
- Objective criteria for idiopathic hypersomnia (IH) can be present in some HD patients.
- Sleep stage stability (SSS) features from polysomnography (PSG) are not well-characterized in HD.
Purpose of the Study:
- To evaluate sleep stage stability (SSS) features in adult patients with hypersomnolence disorder (HD) using nocturnal polysomnography (PSG).
- To compare SSS features between HD patients with and without objective criteria for idiopathic hypersomnia (IH).
- To compare SSS features between HD patients and healthy sleeper controls (HSC).
Main Methods:
- Sixty unmedicated HD patients and 29 HSC underwent nocturnal PSG and multiple sleep latency testing.
- SSS features analyzed included bout counts, bout durations, and transition frequency.
- Statistical analyses included regression models, ANCOVA, and log-rank tests, controlling for age, sex, BMI, and depressive symptoms.
Main Results:
- HD patients exhibited longer N2 and REM sleep bouts and increased bout survival compared to HSC.
- HD patients had fewer N3 sleep bouts than HSC.
- HD patients with IH criteria (HD/IH+) showed increased N2 survival, longer sleep duration, and greater sleep continuity than HD patients without IH criteria (HD/IH-).
Conclusions:
- Adults with unexplained hypersomnolence demonstrate enhanced stability in N2 and REM sleep stages.
- Distinct SSS features may serve as reliable signatures for unexplained hypersomnolence.
- Findings support considering unexplained hypersomnolence as a spectrum including HD and IH.
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