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Psychological health in central hypersomnias: The French Harmony Study
  1. Y A Dauvilliers (ydauvilliers{at}yahoo.fr)
  1. Gui de Chauliac Hospital, CHU Montpellier, INSERM U8888, France
    1. Joël Paquereau
    1. Neurophysiologie clinique, CHU la Milètrie, Poitiers, France
      1. Hélène Bastuji
      1. Hôpital Neurologique Lyon, France
        1. Xavier Drouot
        1. Laboratoire du Sommeil, CHU Henri Mondor, France
          1. Jean-Sylvain Weil
          1. Céphalon-France, Maisons-Alfort, France
            1. Véronique Viot-Blanc
            1. Unité de Sommeil, Hôpital Lariboisière, Paris, France

              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 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 (EDS), polysomnography and Multiple Sleep Latency Test results. 517 (47.6% male, 52.4% female) were finally included: 82.0% C+, 13.2% C- and 4.8% IH. Face-to-face standardized clinical interviews plus questionnaires (Epworth Sleepiness Scale (ESS), Short-version Beck Depression Inventory (S-BDI), Pittsburgh Sleep Quality Index (PSQI) and SF-36) were performed. Patients affected with the different diagnosis, and with and without depressive symptoms were compared.

              Results: Mean ESS and body mass index were higher in C+ compared to C-/IH patients. Half 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 for 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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