Clinical significance and correlates of behaviorally induced insufficient sleep syndrome

Komada, Yoko; Inoue, Yuichi; Hayashida, Kenichi; Nakajima, Toru; Honda, Makoto; Takahashi, Kiyohisa

doi:10.1016/j.sleep.2007.08.018

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Volume 9, Issue 8 , Pages 851-856, December 2008

Clinical significance and correlates of behaviorally induced insufficient sleep syndrome

Yoko Komada
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
- Corresponding author. Tel.: +81 3 3374 9112; fax: +81 3 3374 9125.
Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
Kenichi Hayashida
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
- Department of Psychiatry, The Jikei University School of Medicine, 6-41-2 Aoto, Katsushika, Tokyo, Japan
Toru Nakajima
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
- Department of Neuropsychiatry, Kyorin University Medical School, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
Makoto Honda
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
- Sleep Disorder Research Project, Tokyo Institute of Psychiatry, 2-1-8 Kami-Kitazawa, Setagaya, Tokyo, Japan
Kiyohisa Takahashi
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya, Tokyo, Japan
- Aino University, 4-5-4 Higashi-Ohda, Ibaraki, Osaka, Japan

Received 11 May 2007; received in revised form 26 July 2007; accepted 19 August 2007.

Abstract

Background and purpose

The aim of this study was to investigate the demographic variables and clinical characteristics of behaviorally induced insufficient sleep syndrome (BIISS) and to compare it with the other major hypersomnia disorders.

Patients and methods

One-thousand two-hundred forty-three consecutive patients referred to the outpatient clinic for complaint of excessive daytime sleepiness (EDS) were retrospectively investigated.

Results

The rate of BIISS in patients with EDS was 7.1%, predominant in males. The mean age of initial visit was younger than that for obstructive sleep apnea syndrome (OSAS), while the mean age of onset of symptoms was older than that for idiopathic hypersomnia, narcolepsy, and circadian rhythm sleep disorders. The mean Epworth sleepiness scale (ESS) score before treatment was lower than that for narcolepsy but higher than that for both OSAS and circadian rhythm sleep disorders. Twenty-two percent of BIISS cases reported having accidents or near-miss accidents during the five-year period preceding the investigation, and this group showed higher ESS scores than the group without accidents.

Conclusions

Our findings showed that an unignorably large number of people suffer from BIISS, and that people with severe cases of the disorder are at high risk for getting into an accident. Characteristics and demographic information could be helpful for making a differential diagnosis of BIISS.

Keywords: BIISS, Excessive daytime sleepiness, Prevalence, Clinical settings, Accident, Hypersomnia