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Different fates of excessive daytime sleepiness: survival analysis for remission
Author(s) -
Kim T.,
Lee J. H.,
Lee C. S.,
Yoon I. Y.
Publication year - 2016
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12504
Subject(s) - narcolepsy , multiple sleep latency test , polysomnography , excessive daytime sleepiness , medicine , cataplexy , pediatrics , epworth sleepiness scale , retrospective cohort study , log rank test , survival analysis , sleep onset latency , sleep disorder , physical therapy , insomnia , psychiatry , modafinil , apnea
Background Excessive daytime sleepiness ( EDS ) is a symptom frequently presented in sleep clinics. Only a paucity of data has addressed clinical courses of sleep disorders with EDS . Therefore, we sought to compare clinical outcomes of patients presenting EDS . Methods A retrospective observational study was performed in the setting of sleep laboratory and outpatient department in a university hospital. One hundred and eight patients who presented EDS underwent polysomnography and multiple sleep latency test. Each patient was diagnosed as one of the following four categories: (1) narcolepsy with cataplexy (N + C; n = 29); (2) narcolepsy without cataplexy (N − C; n = 22); (3) idiopathic hypersomnia ( IH ; n = 24); and (4) subjective hypersomnolence ( SH ; n = 33) with mean sleep latency >8 min. Remission of EDS and treatment response were determined based on clinical evaluation. Kaplan–Meier survival analysis was performed. Results Remission rates were significantly different ( P < 0.001, overall log‐rank test) among four groups except those between N − C and IH ( P = 0.489). While N + C showed no remission, predicted remission rates of N − C and IH group were 44.6% at 5 years and 32.5% at 5.5 years after diagnosis. The predicted remission rate of SH group was 71.7% at 3 years after diagnosis. Conclusions The similarity of clinical courses between N − C and IH suggests that N − C may be more related to IH compared to N + C. Considering different clinical courses among EDS patients, thorough evaluation of EDS should be warranted before starting treatment.