Last Updated: 2009-06-03 16:32:19 -0400 (Reuters Health)
Patients with central hypersomnias face depression and lower quality of life, according to a report by French investigators.
Physicians should "take into account the psychological status and quality of life of these patients, especially in the presence of cataplexy, even if they are treated with anticataplectic drugs," Dr. Yves Dauvilliers from Hopital Gui de Chauliac, Montpellier, told Reuters Health.
Dr. Dauvilliers and colleagues investigated the relationships between the severity of central hypersomnia, psychological health, and treatment response in 517 patients with central hypersomnia.
About one quarter of the population had mild (26.3%) or moderate (23.2%) depression, the authors report, and 5.6% had severe depression, Dr. Dauvilliers and co-investigators report in the June issue of the Journal of Neurology, Neurosurgery, and Psychiatry.
Patients showed significant impairment in quality of life, with below normal scores in global physical activity and mental health on the SF-36 questionnaire.
Although polysomnography results differed for patients with idiopathic hypersomnia and patients with central hypersomnia without cataplexy, the two groups did not differ significantly in Beck Depression Inventory or SF-36 results.
In contrast, patients with central hypersomnia with cataplexy differed from the other two groups in having significantly higher Beck Depression Inventory results and depression frequency, as well as worse quality of life.
Higher Epworth Sleepiness Scale scores were associated with more severe depression, the researchers note, as were more severe alterations in quality of life and sleep quality.
Unexpectedly, patients treated with stimulants and anticataplectics had significantly higher Beck Depression Inventory scores, higher depression frequency, and greater impairment in quality of life.
Dr. Dauvilliers plans to next examine the psychological status of these patients at baseline and again after they are treated for narcolepsy and cataplexy to pinpoint partial or no improvements in mood disorders.
J Neurol Neurosurg Psychiatry 2009;80:636-641.