Abstract Details

Title Autonomic Symptom Burden in Idiopathic Hypersomnia

Topic Sleep

Presentation(s) S46 - Sleep Science and Therapy Updates (1:44 PM-1:55 PM)

Poster/Presentation
Number 005

Background ANS impairment has been reported in other central nervous system hypersomnias, however data on ANS impairment in IH are limited.

Objective To assess the symptom severity of autonomic nervous system (ANS) impairment in individuals with idiopathic hypersomnia (IH).

Design/Methods

272 participants with IH and 145 healthy controls completed a battery of online questionnaires including the Composite Autonomic Symptom Score 31 (COMPASS 31), Epworth Sleep Scale (ESS), Morningness-Eveningness Questionnaire (MEQ-SA), Chalder Fatigue Questionnaire (CFQ), Insomnia Severity Index (ISI), RLS single item screen, STOP-Bang Questionnaire, and the RAND 36-Item Health Survey (RAND-36). A descriptive analysis was performed to assess for differences in scores between groups and to assess correlations among individual questionnaires. Because scores were not normally distributed for any measure, median and inter-quartile range are reported, and continuous measures were compared by Wilcoxon rank sum. Participants were identified as cases if they self-reported a formal diagnosis of IH by a physician. All subjects were recruited through the Hypersomnia Foundation website.

Results Participants with IH reported significantly higher COMPASS 31 scores (30 [25-36] vs. 20 [16.7-23]; p<0.001, d=1.42). IH participants also reported higher ESS scores (16 [13-19] vs. 6 [4-9]; p<0.001, d=2.18) and CFQ scores (30 [26-34] vs. 14 [13-18]; p<0.001, d=2.09). Consistent with these group-wise differences, COMPASS 31 scores showed a strong positive correlation with both ESS (r=0.61, p<0.001) and CFQ (r=0.63, p<0.001) scores.

Conclusions

Symptoms of ANS impairment, sleepiness, and fatigue are more severe in individuals with IH compared to controls. Moreover, ANS symptom burden correlates moderately with higher levels of sleepiness and fatigue. Future analysis will focus on COMPASS subscores and objective autonomic testing to help identify symptomatic domains, with the goal of more focused therapeutic targets for patients with IH.

Authors/Disclosures
Paul Kim, MD (Stanford Sleep Medicine Center) PRESENTER	No disclosure on file
Joseph Cheung, MD (Mayo Clinic)	Dr. Cheung has nothing to disclose.
Logan D. Schneider, MD (Stanford/VA Alzheimer's Center)	Dr. Schneider has received personal compensation for serving as an employee of Alphabet, Inc. Dr. Schneider has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Jazz Pharmaceuticals. Dr. Schneider has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Avadel Pharmaceuticals. Dr. Schneider has received intellectual property interests from a discovery or technology relating to health care.
LynnMarie Trotti, MD (Emory University School of Medicine)	Dr. Trotti has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for American Academy of Sleep Medicine. Dr. Trotti has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Association of Chest Physicians. The institution of Dr. Trotti has received research support from NIH. The institution of Dr. Trotti has received research support from American Academy of Sleep Medicine Foundation . Dr. Trotti has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with AASM, CHEST, Medscape, SRS Foundation, PER CME, Haymarket CME. Dr. Trotti has received personal compensation in the range of $0-$499 for serving as a DSMB member with NIH. Dr. Trotti has received personal compensation in the range of $0-$499 for serving as a Reviewer with Lancet journals. Dr. Trotti has a non-compensated relationship as a Medical advisory board member with Hypersomnia Foundation that is relevant to AAN interests or activities. Dr. Trotti has a non-compensated relationship as a Board member with AASM Foundation that is relevant to AAN interests or activities. Dr. Trotti has a non-compensated relationship as a Board member with ABSM that is relevant to AAN interests or activities.
Mitchell G. Miglis, MD, FAAN (Stanford University Medical Center)	Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Infinite MD. Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint, LLC. Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for 2nd MD. Dr. Miglis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Miglis has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Van Cott and Talamante. The institution of Dr. Miglis has received research support from Dysautonomia International. The institution of Dr. Miglis has received research support from National Institute of Health. Dr. Miglis has received publishing royalties from a publication relating to health care.

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