Abstract Details

Title REM Sleep Distribution and Timing in Hypersomnia

Topic Sleep

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 467

Objective Idiopathic hypersomnia (IH) is a rare and debilitating neurologic disorder characterized by long sleep times and excessive daytime sleepiness. In this study, we highlight the limitations of existing diagnostic paradigms for the evaluation of hypersomnia and differentiation of IH from narcolepsy.

Background Evaluation of hypersomnia routinely includes polysomnography (PSG) followed by multiple sleep latency testing (MSLT). In most centers, the overnight portion of the study will be terminated in the morning, rather than allowing spontaneous awakening, to begin sleep latency testing. For patients with prolonged sleep duration, this interruption may result in rapid-eye-movement (REM) sleep on nap testing that reflects continuation of their biological night, rather than abnormalities in REM sleep regulation, as are seen in narcolepsy.

Design/Methods 56 consecutive extended sleep studies for patients with a total sleep time greater than 600 minutes were reviewed. For studies with sleep onset before midnight, we evaluated REM sleep time and distribution.

Results 40/56 (71%) had sleep onset before midnight (12 AM) and were included in the analysis. 36/40 (90%) of hypnograms reviewed had REM sleep after 8 AM, 21/40 (53%) had REM sleep after 10 AM, with the onset of the final REM period ranging from 3:45-13:20 for patients with sleep onset time before midnight (12 AM).

Conclusions Termination of overnight polysomnography to initiate multiple sleep latency testing, as is standard in many sleep labs, may influence the presence of REM sleep on MSLT for patients with prolonged total sleep duration. These results may have implications for the interpretation of the MSLT for patients with long sleep duration, and the diagnostic differentiation of narcolepsy and IH.

Authors/Disclosures
Margaret Blattner, MD (Beth Israel Deaconess Medical Center) PRESENTER	Dr. Blattner has nothing to disclose.
Robert J. Thomas, MD (Beth Israel Deaconess Medical Center)	Dr. Thomas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Councils. Dr. Thomas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Thomas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Thomas has received intellectual property interests from a discovery or technology relating to health care. Dr. Thomas has received publishing royalties from a publication relating to health care.

��ɫ��

��ɫ��