Central Hypersomnias
Hypersomnia refers to a large group of disorders. Excessive daytime sleepiness (EDS) is the main characteristic of hypersomnia. In the International Classification of Sleep Disorder (American Academy of Sleep Medicine 2001), narcolepsy, recurrent hypersom
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Azmeh Shahid, Jianhua Shen, and Colin M. Shapiro
13.1 Introduction Hypersomnia refers to a large group of disorders. Excessive daytime sleepiness (EDS) is the main characteristic of hypersomnia. In the International Classification of Sleep Disorder (American Academy of Sleep Medicine 2001), narcolepsy, recurrent hypersomnia, idiopathic hypersomnia and post-traumatic hypersomnia are independently listed in the section of dyssomnia, while in the revised International Classification of Sleep Disorders (American Academy of Sleep Medicine 2005), hypersomnia includes primary hypersomnia (narcolepsy, idiopathic hypersomnia and recurrent hypersomnia) and secondary hypersomnia (such as hypersomnia induced by sleep apnoea). However, in the recently published 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V, American Psychiatric Association 2013), hypersomnia is described as ‘hypersomnolence disorder’, while narcolepsy is separately listed as an independent sleep disorder. Both hypersomnolence disorder and narcolepsy are under the category of sleep-wake disorders. In this chapter, hypersomnia disorders including narcolepsy, recurrent hypersomnia, idiopathic hypersomnia and post-traumatic hypersomnia are discussed.
A. Shahid · C. M. Shapiro (*) Youthdale Child and Adolescent Sleep Centre, Toronto, ON, Canada Youthdale Treatment Centre, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada Department of Psychiatry, University Health Network, Toronto, ON, Canada Sleep Research Unit University Health Network, Toronto, ON, Canada J. Shen Sleep Research Unit University Health Network, Toronto, ON, Canada © Springer-Verlag GmbH Germany, part of Springer Nature 2018 H. Selsick (ed.), Sleep Disorders in Psychiatric Patients, https://doi.org/10.1007/978-3-642-54836-9_13
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Although hypersomnia has been described and researched for more than 200 years, significant insight about these conditions has only occurred recently. The use of overnight polysomnographic sleep studies and the multiple sleep latency test (MSLT) has greatly improved the accuracy of the diagnosis and differential diagnosis. Neurophysiological findings in this field, such as hypocretin changes in narcoleptic patients, have added new knowledge and enhanced our understanding of the causes and genetics of the disorders. The interplay between hypersomnia-related disorders and psychiatric disease has increasingly received attention. In order to recognize the symptomatology and presentation of sleep disorders and their interdigitation with psychiatric illness, it is important to familiarize oneself with the relationship between psychiatric conditions and sleep. This can help in not only identifying sleep problems but also in treating them and thus preventing their perpetuation into symptoms mimicking a psychiatric disorder or indeed triggering one (commonly a mood disorder). Hypersomnia can have many different presentations, and it is associated with psychiatric illness both in adults and children. It
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