TY - JOUR

T1 - Diagnosis of central disorders of hypersomnolence

T2 - A reappraisal by European experts

AU - Lammers, Gert Jan

AU - Bassetti, Claudio L.A.

AU - Dolenc-Groselj, Leja

AU - Jennum, Poul J.

AU - Kallweit, Ulf

AU - Khatami, Ramin

AU - Lecendreux, Michel

AU - Manconi, Mauro

AU - Mayer, Geert

AU - Partinen, Markku

AU - Plazzi, Giuseppe

AU - Reading, Paul J.

AU - Santamaria, Joan

AU - Sonka, Karel

AU - Dauvilliers, Yves

PY - 2020

Y1 - 2020

N2 - 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).

AB - 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).

KW - Cataplexy

KW - Classification

KW - Diagnosis

KW - Excessive daytime sleepiness

KW - Fatigue

KW - Hypersomnia

KW - Hypersomnolence

KW - MSLT

KW - Narcolepsy

KW - Sleep

KW - Sleep inertia

U2 - 10.1016/j.smrv.2020.101306

DO - 10.1016/j.smrv.2020.101306

M3 - Review

C2 - 32311642

AN - SCOPUS:85083310039

VL - 52

JO - Sleep Medicine Reviews

JF - Sleep Medicine Reviews

SN - 1087-0792

M1 - 101306

ER -