Differences in Nocturnal and Daytime Sleep Between Primary and Psychiatric Hypersomnia: Diagnostic and Treatment Implications
| Autor: | C Criley, Anthony Kales, Antonio Vela-Bueno, Edward O. Bixler, Alexandros N. Vgontzas |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Polysomnography Disorders of Excessive Somnolence Idiopathic Hypersomnia Sensitivity and Specificity Arousal Diagnosis Differential Predictive Value of Tests Sleep Disorders Circadian Rhythm mental disorders medicine Humans Psychiatry Applied Psychology Aged Analysis of Variance medicine.diagnostic_test business.industry Mental Disorders Case-control study Middle Aged medicine.disease Sleep in non-human animals Comorbidity Psychiatry and Mental health Case-Control Studies Predictive value of tests Female Differential diagnosis Sleep onset business |
| Zdroj: | Psychosomatic Medicine. 62:220-226 |
| ISSN: | 0033-3174 |
| DOI: | 10.1097/00006842-200003000-00013 |
| Popis: | OBJECTIVE The differential diagnosis of primary (idiopathic) vs. psychiatric hypersomnia is challenging because of the lack of specific clinical or laboratory criteria differentiating these two disorders and the frequent comorbidity of mental disorders in patients with primary hypersomnia. The aim of this study was to assess whether polysomnography aids in the differential diagnosis of these two disorders. METHODS After excluding patients taking medication and those with an additional diagnosis of sleep-disordered breathing, we compared the nocturnal and daytime sleep of 82 consecutive patients with a diagnosis of either primary hypersomnia (N = 59) or psychiatric hypersomnia (N = 23) and normal control subjects (N = 50). RESULTS During nocturnal sleep, patients with psychiatric hypersomnia showed significantly higher sleep latency, wake time after sleep onset, and total wake time and a significantly lower percentage of sleep time than patients with primary hypersomnia and control subjects (p < .05). In addition, the daytime sleep of patients with psychiatric hypersomnia was significantly higher in terms of sleep latency, total wake time, and percentage of light (stage 1) sleep and lower in terms of percentage of sleep time and stage 2 sleep than in patients with primary hypersomnia and control subjects (p < .05). The daytime sleep of patients with primary hypersomnia as compared with that of control subjects was characterized by lower sleep latency and total wake time and a higher percentage of sleep time (p < .05). Finally, a sleep latency of less than 10 minutes or a sleep time percentage greater than 70% in either of the two daytime naps was associated with a sensitivity of 78.0% and a specificity of 95.7%. CONCLUSIONS Our findings indicate that psychiatric hypersomnia is a disorder of hyperarousal, whereas primary hypersomnia is a disorder of hypoarousal. Polysomnographic measures may provide useful information in the differential diagnosis and treatment of these two disorders. |
| Databáze: | OpenAIRE |
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