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KMID : 1034320120030020039
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Sleep Medicine Research
2012 Volume.3 No. 2 p.39 ~ p.44
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Clinical and Polysomnographic Comparison between Narcolepsy without Cataplexy and Idiopathic Hypersomnia
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Kim Tae-Won
Chang Se-Yeon
Joo Soo-Hyun
Seo Ho-Jun
Jeong Jong-Hyun
Han Jin-Hee
Mignot Emmanuel
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Abstract
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Background and Objective The aim of this study is to compare the clinical, electrophysiological (Polysomnography, PSG; Multiple Sleep Latency Test, MSLT) and biological data (HLA DQB1*0602 typing) in idiopathic hypersomnia with narcolepsy without cataplexy.
Methods: 80 patients with narcolepsy without cataplexy and 71 patients with idiopathic hypersomnia without a long sleep time were recruited at the Sleep Center of St. Vincent’s Hospital. MSLT data and PSG findings from the time of their diagnosis were reviewed. HLA typing was performed.
Results: Results indicated that the idiopathic hypersomnia group showed a significant longer mean sleep latency in MSLT compared with the narcolepsy without cataplexy group. But there was no significant difference in the Epworth Sleepiness Scale (ESS) scores between the two groups. Although HLA positivity of both groups was not statistically significant (p = 0.065), HLA positivity tended to be higher in the narcolepsy without cataplexy group than the idiopathic hypersomnia group. The number of awakenings was slightly higher in the idiopathic hypersomnia group, but there was no statistical significance. The number of spontaneous arousal and total arousal indices was not significantly different between the groups. For the PSG, the idiopathic hypersomnia group showed a significantly longer sleep latency than the narcolepsy without cataplexy group (p = 0.009). REM sleep latency (REML) was significantly shorter in the narcolepsy without cataplexy group compared to the idiopathic hypersomnia group. The percentage of REM (SREM) was significantly higher in the narcolepsy without cataplexy group, and the percentage of the wake time during sleep period (SWT) was significantly lower in the narcolepsy without cataplexy group.
Conclusions: There were no significant differences of subjective sleep measures such as ESS, disturbed nocturnal sleep, number of naps, age of onset of hypnagogic hallucination, and age of onset of sleep paralysis between patients with narcolepsy without cataplexy and idiopathic hypersomnia. So, the use of objective tests such as the PSG and MSLT may be inevitable for the differential diagnosis of narcolepsy without cataplexy from idiopathic hypersomnia.
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KEYWORD
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Narcolepsy, Cataplexy, Idiopathic hypersomnia, HLA
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