S103 Polysomnographic features of narcolepsy types 1 and 2, and of idiopathic hypersomnia: Strengths and limitations

摘要

Objectives Current diagnostic criteria of narcolepsy types 1 (NT1), type 2 (NT2) and idiopathic hypersomnia (IH), including clinical, electrophysiological and biologic criteria are listed in the International classification of sleep disorders, 3rd edition (ICSD-3). Electrophysiological criteria have been recently weakened with the demonstration that the multiple sleep latency test (MSLT) has poor test/retest reliability. Thus the search for additional electrophysiological criteria for these central disorders of hypersomnolence. Methods To review recent electrophysiological strategies. aiming at reinforcing current electrophysiological criteria of NT1, NT2 and IH, namely analysis of sleep stage sequence organization and complexity, sleep stage sequence analysis of sleep onser REM periods, daytime continuous polysomnography and analysis of sleep onset criteria at the MSLT. Results Patients with NT1 differed significantly from the two other patient groups. The latter, in turn, were not different between each other. Discussion These results show the limits of polysomnography and MSLT in accurate phenotyping of NT2 and IH, hence calling for further clinical and biologic markers of these sleep disorders. Conclusion Recent additional electrophysiological strategies reinforce the identity of NT1, not these of either NT2 or IH. Significance In spite of sustained efforts, NT2 and IH lack sufficient electrophysiological diagnostic criteria. Further research is urgently needed. ]]>