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Psychological health in central hypersomnias: the French Harmony study
  1. Y Dauvilliers1,2,
  2. J Paquereau3,
  3. H Bastuji4,
  4. X Drouot5,
  5. J-S Weil6,
  6. V Viot-Blanc6,7
  1. 1
    Département de Neurologie, Hôpital Gui-de-Chauliac, CHU Montpellier, France
  2. 2
    INSERM U888, Montpellier, France
  3. 3
    Neurophysiologie clinique, CHU la Milètrie, Poitiers, France
  4. 4
    Unité d'Hypnologie, Hôpital Neurologique, Bron, France
  5. 5
    Laboratoire du Sommeil, CHU Henri Mondor, Créteil, France
  6. 6
    Céphalon-France, Maisons-Alfort
  7. 7
    Unité de Sommeil, Hôpital Lariboisière, Paris, France
  1. Professor Y Dauvilliers, Département de Neurologie, Hôpital Gui de Chauliac, 80 av Augustin Fliche, Cedex 5, Montpellier 34295, France; y-dauvilliers{at}chu-montpellier.fr

Abstract

Background: A large observational French study of central hypersomnia, including narcolepsy with cataplexy (C+), without cataplexy (C−) and idiopathic hypersomnia (IH), was conducted to clarify the relationships between the severity of the condition, psychological health and treatment response.

Methods: 601 consecutive patients over 15 years of age suffering from central hypersomnia were recruited on excessive daytime sleepiness, polysomnography and Multiple Sleep Latency Test (MSLT) results. 517 (47.6% men, 52.4% women) were finally included: 82.0% C+, 13.2% C− and 4.8% IH. Face to face standardised clinical interviews plus questionnaires (Epworth Sleepiness Scale (ESS), short version Beck Depression Inventory (S-BDI), Pittsburgh Sleep Quality Index (PSQI) and 36-item Short Form Health Survey (SF-36)) were performed. Patients affected with a different diagnosis and with and without depressive symptoms were compared.

Results: Mean ESS and body mass index were higher in C+ compared with C−/IH patients. Half of the patients (44.9%) had no depressive symptoms while 26.3% had mild, 23.2% moderate and 5.6% severe depressive symptoms. C+ patients had higher S-BDI and PSQI and lower SF-36 scores than C−/IH patients. Depressed patients had higher ESS scores than non-depressed patients, with no difference in age, gender, duration of disease or MSLT parameters. Finally, C+ patients treated with anticataplectic drugs (38.7%) had higher S-BDI and lower SF-36 scores than C+ patients treated with stimulants alone.

Conclusion: Our data confirmed the high frequency of depressive symptoms and the major impact of central hypersomnias on health related quality of life, especially in patients with cataplexy. We recommend a more thorough assessment of mood impairment in central hypersomnias, especially in narcolepsy–cataplexy.

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Footnotes

  • Funding: The study was supported by Cephalon, which participated in the data collection and analysis.

  • Competing interests: All authors have received honoraria from Cephalon Inc as investigators.

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