![]() The diagnosis of IH is by excluding other reasons and causes of hypersomnia. However, history alone is insufficient to make the diagnosis of idiopathic hypersomnia. On polysomnography, they are more likely to have increased slow-wave sleep and present with a longer sleep latency on the multiple sleep latency test. Other symptoms such as automatic behaviors, sleep paralysis, and hypnogogic hallucinations- are common but non-specific.Ĭompared to narcolepsy, individuals with IH were more likely to have prolonged and unrefreshing daytime naps and have a family history of sleepiness. Specifically, individuals with IHwLST can present with a history of severe sleep inertia, fatigue, and evening chronotype tendency. Furthermore, a study of five-hundred sixty-three participants with idiopathic hypersomnia, brain fog, and sleep drunkenness were more common in IH associated with long sleep durations. Īlthough sleepiness is the hallmark of IH, symptoms of this condition are not limited to excessive daytime sleepiness and are frequently persistent despite treatment. Īge at disease onset is usually reported to be younger in the IHwLST group, and MSLT latency is longer, with naps that are non-refreshing. Individuals with long sleep time (>10 to 11 hours) tend to be younger at the time of disease onset, thinner, and have higher sleep efficiency. Two clinical subtypes of IH have been previously reported as IH with long sleep time (IHwLST, >10 hours) and IH without long sleep time (IHwoLST) in the second edition of ICSD. Patients commonly endorse symptoms of long daytime naps (>1 hour) which are typically non-refreshing but sleep attacks are not frequently reported. The onset of the disease is insidious, with symptoms appearing over weeks to months, making it difficult to elucidate any specific triggering factors. Treatment of idiopathic hypersomnia relies on stimulants, which are frequently less effective and less well tolerated than in narcolepsy.The usual presentation is chronic and disabling excessive daytime sleepiness in an adolescent or young adult, with the majority complaining of "sleep drunkenness" as difficulty waking up from sleep with transient confusion upon awakening. Several other disorders must be excluded before the diagnosis can be considered conclusive. Idiopathic hypersomnia is probably one of the most overdiagnosed sleep disorders. At least in the polysymptomatic form, however, continuous polysomnography on an ad lib protocol deserves to be performed to catch the abnormally long major sleep episode and the long unrefreshing naps. The most widely used laboratory procedures are nocturnal polysomnographic recording following by an MSLT demonstrating a mean sleep latency of less than 10 minutes. There are at least two forms of the disorder: (1) a polysymptomatic form, characterized by excessive daytime sleepiness, nocturnal sleep of abnormally long duration, and signs of sleep drunkenness on awakening, and (2) a monosymptomatic form that manifests only by excessive daytime sleepiness. ![]() Idiopathic hypersomnia is not as well delineated as narcolepsy and its history is much more recent.
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