Nocturnal sleep stage stability features in unexplained hypersomnolence.

Authors

Jesse D Cook, Meredith E Rumble, Ana Maria Vascan, Kieulinh M Tran, Michael L Prairie, Jessica Love, David T Plante

Published in

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. Jul 01, 2025. Epub Jul 01, 2025.

Abstract

Evaluate nocturnal polysomnography (PSG) sleep stage stability (SSS) features in an adult, sample of hypersomnolence disorder (HD) clinical patients against healthy sleeper controls (HSC). Explore differences in SSS features across HD who displayed objective criteria for idiopathic hypersomnia (HD/IH+) and those who did not (HD/IH-).
Sixty unmedicated HD clinical patients (average age = 28.6±8.6 years; percentage female = 78.3%) and 29 HSC underwent ad libitum nocturnal PSG and daytime multiple sleep latency testing. SSS features included number of stage bouts, median stage bout duration, number of transitions between stages, and survival analysis of stage bouts. Regression and cox proportional hazards models compared HD against HSC. ANCOVA, log-rank tests, and pairwise comparisons explored differences between HSC, HD/IH+ (n=14), and HD/IH-. All analyses accounted for age, sex, body mass index, and depressive symptom severity.
HD displayed longer N2 bouts (p=0.02) and increased survival of N2 (p<0.0001) and REM (p<0.0001) bouts, relative to HSC, with fewer N3 bouts (p=0.02) that were comparable in duration and survival. Many phenotypic similarities were observed between HD/IH+ and HD/IH-, though HD/IH+ displayed significantly increased N2 survival (p=0.03), longer sleep duration (p=0.004), and greater sleep continuity (p=0.003).
Our findings demonstrate enhanced N2 and REM stability in adult clinical patients with unexplained hypersomnolence. Follow-up studies are necessary to determine the role of distinct SSS features as valid, reliable and specific signatures of unexplained hypersomnolence. These results may also be useful for future nosological frameworks that consider unexplained hypersomnolence along a continuum of severity that includes both HD and IH.

PMID:
40590081
Bibliographic data and abstract were imported from PubMed on 01 Jul 2025.

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