Diagnosis of central disorders of hypersomnolence: A reappraisal by European experts

Gert Jan Lammers, Claudio L.A. Bassetti, Leja Dolenc-Groselj, Poul J. Jennum, Ulf Kallweit, Ramin Khatami, Michel Lecendreux, Mauro Manconi, Geert Mayer, Markku Partinen, Giuseppe Plazzi, Paul J. Reading, Joan Santamaria, Karel Sonka, Yves Dauvilliers

Research output: Contribution to journalReview articlepeer-review

Abstract

The aim of this European initiative is to facilitate a structured discussion to improve the next edition of the International Classification of Sleep Disorders (ICSD), particularly the chapter on central disorders of hypersomnolence. The ultimate goal for a sleep disorders classification is to be based on the underlying neurobiological causes of the disorders with clear implication for treatment or, ideally, prevention and or healing. The current ICSD classification, published in 2014, inevitably has important shortcomings, largely reflecting the lack of knowledge about the precise neurobiological mechanisms underlying the majority of sleep disorders we currently delineate. Despite a clear rationale for the present structure, there remain important limitations that make it difficult to apply in routine clinical practice. Moreover, there are indications that the current structure may even prevent us from gaining relevant new knowledge to better understand certain sleep disorders and their neurobiological causes. We suggest the creation of a new consistent, complaint driven, hierarchical classification for central disorders of hypersomnolence; containing levels of certainty, and giving diagnostic tests, particularly the MSLT, a weighting based on its specificity and sensitivity in the diagnostic context. We propose and define three diagnostic categories (with levels of certainty): 1/“Narcolepsy” 2/“Idiopathic hypersomnia”, 3/“Idiopathic excessive sleepiness” (with subtypes).

Original languageEnglish
Article number101306
JournalSleep Medicine Reviews
Volume52
DOIs
Publication statusPublished - Aug 2020

Keywords

  • Cataplexy
  • Classification
  • Diagnosis
  • Excessive daytime sleepiness
  • Fatigue
  • Hypersomnia
  • Hypersomnolence
  • MSLT
  • Narcolepsy
  • Sleep
  • Sleep inertia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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