Comparison of clinical characteristics among narcolepsy with and without cataplexy and idiopathic hypersomnia without long sleep time, focusing on HLA-DRB1∗1501/DQB1∗0602 finding

Sasai, Taeko; Inoue, Yuichi; Komada, Yoko; Sugiura, Tatsuki; Matsushima, Eisuke

doi:10.1016/j.sleep.2008.12.007

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Volume 10, Issue 9 , Pages 961-966, October 2009

Comparison of clinical characteristics among narcolepsy with and without cataplexy and idiopathic hypersomnia without long sleep time, focusing on HLA-DRB1^∗1501/DQB1^∗0602 finding

Taeko Sasai
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Department of Psychiatry, Tokyo Medical University, 6-1-1 Shinjyuku, Shinjyuku-ku, Tokyo, Japan
- Corresponding author. Address: Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo, Japan. Tel.: +81 3 3374 2016; fax: +81 3 3374 2038.
Yoko Komada
- Department of Psychiatry, Tokyo Medical University, 6-1-1 Shinjyuku, Shinjyuku-ku, Tokyo, Japan
Tatsuki Sugiura
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
Eisuke Matsushima
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan

Received 2 August 2008; received in revised form 11 December 2008; accepted 23 December 2008.

Abstract

Background

Clinical characteristics of narcolepsy without cataplexy (NA w/o CA) and its relation to positivity of HLA-DRB1^∗1501/DQB1^∗0602 remain unclarified. We investigated clinical features of NA w/o CA, particularly addressing HLA-DRB1^∗1501/DQB1^∗0602.

Methods

Comparisons of the Epworth Sleepiness Scale (ESS), multiple sleep latency test (MSLT) variables, rapid eye movement (REM)-related symptoms, and treatment response to psychostimulant medication were made for four patient groups (narcolepsy with cataplexy; NA–CA, NA w/o CA HLA-positive, NA w/o CA HLA-negative, and idiopathic hypersomnia without long sleep time; IHS w/o LST).

Results

Mean sleep latency was significantly shorter and the rate of reduction of ESS after medication was lower in both NA–CA and NA w/o CA HLA-positive groups than those in the IHS w/o LST group. Among the three narcoleptic groups, the NA w/o CA HLA-negative group showed the lowest REM latency and the highest reduction rate of ESS after treatment. Neither these subjective and objective sleepiness measures nor the treatment response measure was significantly different between this group and the IHS w/o LST group.

Conclusions

In NA w/o CA, HLA-positivity might affect hypersomnia severity and REM propensity. The NA w/o CA HLA-negative group and the IHS w/o LST group exhibit equivalent hypersomnia severity.

Keywords: Narcolepsy, Narcolepsy without cataplexy, Idiopathic hypersomnia, HLA-DRB1^∗1501/DQB1^∗0602, Clinical characteristics, Multiple sleep latency test (MSLT)