The Risks of Injury and Accident in Patients With Central Hypersomnia: A Cohort Study in Taiwan

Central hypersomnia disorder (CHD) may result in a higher risk of injury/accident. The present study aims to investigate the real-world risk by tracing patients in a clinical cohort for 4 years. We tracked the injury/accident risk of CHD clinical cohort patients from Taiwan's National Health Insurance Research Database (NHIRD) and compared it with controls. Data were collected based on the International Classification of Diseases, Tenth Revision. Patients were categorised by diagnosis, gender and age, with each subgroup compared to age- and gender-matched controls. Group differences were analysed using the Chi-square test and t-test. Bonferroni correction was used for post hoc analysis. A total of 386 CHD clinical cohort patients were included. Narcolepsy type 1 patients had the highest subjective and objective symptom severity (p < 0.001). Compared to controls, CHD patients had a significantly higher risk of injury and accident of up to 61.92% and 7.51% during the 4-year follow-up, necessitating clinical visits. Narcolepsy type 2 patients have the highest risk of injury (p = 0.005). Age/gender differences were found. Males had a higher specific-site injury risk (p = 0.045) than females, while females had a higher transportation accident risk than controls (p = 0.048). Children/adolescents had a higher risk in total injury and multiple-site injury than controls (p = 0.024, p = 0.014), and adults had a higher risk in specific-site injury and transportation accident (p = 0.020, p = 0.004). In conclusion, CHD patients had a higher risk of injury/accident, even among those with milder symptoms. Gender and age differences in these risks were observed. Our findings highlight the importance of hypersomnia treatment and individualised considerations in clinical practice.