Sleep abnormalities in patients with idiopathic intracranial hypertension: a cross-sectional study

Idiopathic Intracranial Hypertension (IIH) has been associated with comorbid sleep disorders. Although emerging evidence suggests a link between IIH and sleep disorders, yet this association remains underexplored. This case -control study aims to evaluate the prevalence of sleep-related abnormalities in patients with IIH using validated screening and severity assessment tools.

120 newly diagnosed, drug naive IIH patients and 40 age and gender matched controls were enrolled. Baseline characteristics and clinical parameters were evaluated. Headache severity was assessed using MIDAS and HIT6 questionnaires. Sleep disturbances were assessed using the Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), restless leg syndrome (RLS) scale, Berlin Questionnaire, and STOP-BANG questionnaire. Statistical analysis was conducted using SPSS v27.

The mean age of patients was 34.92 (9.42) years. IIH cases were predominately female (85%). Cases had significantly higher BMI (85% were overweight and obese). Poor sleep quality (PSQI ≥ 5) was significantly more common in IIH patients (46.67%) than controls (15%) (p < 0.001). High OSA risk was also more prevalent in IIH patients based on Berlin and STOP-BANG scores (p = 0.013 and p = 0.044 respectively). Although rates of Daytime sleepiness, RLS and Insomnia were higher in the IIH group, these differences were not statistically significant.

Patients with IIH exhibit significantly higher rates of sleep disturbances, particularly poor sleep quality, and increased risk of OSA based on screening tools, which were also associated with higher BMI and psychiatric comorbidities. These findings underscore the importance of routine sleep screening in IIH patients.