Idiopathic Hypersomnie

The idiopathic hypersomnie , is a very rare disease, characterized by an excessive diurnal somnolence whose origin is unknown.

Epidemiology

The demonstrations generally begin in the young adult, before 30 years. He could exist a family component.
La frequency of the disease although difficult to estimate because of her scarcity, 1 person would touch on: 500000 {} inhabitants (5 to 10 times rarer than the narcolepsy).
Aucune cause is not found with this [hypersomnie], therefore one qualifies it the idiopathique one with the difference of the secondary hypersomnie whose origin could be highlighted (cerebral lesion). == Diagnostic == The diagnosis is done by exclusion of the others turbid being able to cause this somnolence: apnea of the sleep, syndrome of the legs without rest, bad hygiene of sleep… === clinical Aspects === It is about a quasi-permanent excessive somnolence diurnal, not very fluctuating during the day. This somnolence obliges the subject to make one or more naps in the course of the day, which can then last several hours. One of the key elements of the clinical diagnosis, it is that these naps are not refreshing which they have normally or in the other close disease that is the narcolepsy (the subject is always also tired with leaving this nap). Their sleep of night is generally of very good quality, with very few awakenings. On the other hand, the alarm clock is particularly difficult and one notes an inertia with the alarm clock (intoxication of sleep), i.e. the subject is very slowed down on the psychomotor level, being able to go until a state of confusion. One notes at the subjects reached, a reduction in the mental performances and difficulties of concentration. 2 clinical forms are distinguished: * with increase in the total time of sleep, the nights are abnormally long and the day marked by naps of several hours; * without increase in the total time of sleep, with subnormal nights of normal duration or (6-10h), but of the more or less irrepressible accesses of sleep the day. What makes the difference with the narcolepsy, it is that one does not find a cataplexies, and seldom paralyzes of the sleep or hallucinations hypnagogic. === complementary Examinations === Complementary examinations aiming at seeking a particular cause (imagery by [[tomodensitometry]] (scanner), [[Imagery by magnetic resonance|IRM]], examinations biological etc…) do not raise any anomaly. One [[polysomnography]] (recording of the sleep) is necessary. It especially makes it possible to eliminate the secondary causes of hypersomnies (ventilatory disorder, periodic movements of the legs…) and to eliminate a narcolepsy (Sleep of bad quality and SOREM). The BAST ([[iterative Test of latency to drowsiness]]) show a drowsiness during the day, that Ci is not always abnormally fast, but it is always done in the absence of SOREM. A last type of examination of the sleep is sometimes useful to highlight the capacity of the day to sleep of very many hours, the '' Bed Rest ''. It is about a recording [[Electroencephalography|EEG]] during 48 H, at the hospital, in an isolated room, in the absence of watch and of index of light of day. The patient is in free wheel, it asks for his meals when it for of feels the need. {{reference necessary|One highlights during these '' bed rest '' one duration of sleep on 48 H very often higher than 24:00, even much more.}} == Traitement == It rests as for the narcolepsy on [[modafinil]], or the derivatives amphetaminic as it [[méthylphénidate]] but in the event of failure one can test other treatments like the teronac or the dexamine. These drugs make it possible to decrease the diurnal accesses of sleep, but the alarm clock remains generally also difficult. Stimulative antidepressants can be useful. The councils of hygiene of [[sleep]], in particular the prohibition of the naps also form part of the tools to relieve the handicap created by this disease. == Sources == * Sleep disorders, Mr. Billiard, Y. Dauvilliers at Masson * [http://onirolabe.bbfr.net Onirolabe] == external Liens == * [http://hypersomnie.fr Hypersomnie.fr] * [http://hypersomnies.fr Hypersomnies.fr] {{gate medicine}} [[Category: Sleep disorder]] [[Category: Medical term starting with H

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