Hypersomnia and depressive symptoms: methodological and clinical aspects

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modafinil 2 sleepmedicinediseasesdrugs
sleep disorder 11 sleepmedicinediseases
sleep paralysis 3 sleepmedicinediseases
sodium oxybate 2 sleepmedicinediseasesdrugs
hypersomnia 76 sleepmedicinediseases
methylphenidate 1 sleepmedicinediseasesdrugs

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methylphenidate 28795 and major depression.Although there is no cure for narcolepsy, psychostimulants such as modafinil, methylphenidate , amphetamine, and sodium oxybate are used to treat EDS and sleep attacks. Cataplexy is managed with
modafinil 26958 by the disease per se, and symptoms were resolved when the dose was lowered or treatment changed to modafinil [[73]]. Another case–control study found mood disorder symptoms in one-third of narcolepsy patients.
modafinil 28784 narcolepsy and major depression.Although there is no cure for narcolepsy, psychostimulants such as modafinil , methylphenidate, amphetamine, and sodium oxybate are used to treat EDS and sleep attacks. Cataplexy
sodium oxybate 28829 there is no cure for narcolepsy, psychostimulants such as modafinil, methylphenidate, amphetamine, and sodium oxybate are used to treat EDS and sleep attacks. Cataplexy is managed with sodium oxybate and antidepressant
sodium oxybate 28911 amphetamine, and sodium oxybate are used to treat EDS and sleep attacks. Cataplexy is managed with sodium oxybate and antidepressant drugs [[59]]. Hence, most drugs used to manage cataplexy have mood-modifying properties.
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hypersomnia 831 (collection): /2013Publication date (epub): 3/2013AbstractThe associations between depressive symptoms and hypersomnia are complex and often bidirectional. Of the many disorders associated with excessive sleepiness in the
hypersomnia 1085 are mental health disorders, particularly depression. However, most mood disorder studies addressing hypersomnia have assessed daytime sleepiness using a single response, neglecting critical and clinically relevant
hypersomnia 1658 subjective sleep complaint than an objective finding. Mood symptoms have also been frequently reported in hypersomnia disorders of central origin, especially in narcolepsy. Hypocretin deficiency could be a contributing
hypersomnia 1915 interventional studies are needed to explore whether management of sleep complaints improves mood symptoms in hypersomnia disorders and, conversely, whether management of mood complaints improves sleep symptoms in mood disorders.IntroductionExcessive
hypersomnia 2472 circadian rhythm sleep disorders, and restless legs syndrome. In addition, it is a marker symptom in rare hypersomnia s of central origin. However, the most frequent associations are mental health disorders and, particularly,
hypersomnia 4634 alternatively, mediated by increased activation of REM sleep mechanisms [[10]].In this article, we describe hypersomnia assessment methods, define hypersomnia in mood disorders, and review studies that have examined mood
hypersomnia 4673 of REM sleep mechanisms [[10]].In this article, we describe hypersomnia assessment methods, define hypersomnia in mood disorders, and review studies that have examined mood disorder symptoms in hypersomnias of central
hypersomnia 4768 define hypersomnia in mood disorders, and review studies that have examined mood disorder symptoms in hypersomnia s of central origin.Definition and assessment of hypersomniasIn the literature, hypersomnia refers to
hypersomnia 4828 have examined mood disorder symptoms in hypersomnias of central origin.Definition and assessment of hypersomnia sIn the literature, hypersomnia refers to a specific sleep-disorder-related diagnosis, such as narcolepsy
hypersomnia 4859 symptoms in hypersomnias of central origin.Definition and assessment of hypersomniasIn the literature, hypersomnia refers to a specific sleep-disorder-related diagnosis, such as narcolepsy in the International Classification
hypersomnia 5451 episodes or daytime sleep episodes occurring almost daily.Excessive daytime sleepinessThe terms ‘ hypersomnia ,’ ‘excessive somnolence,’ ‘excessive sleepiness’ and ‘EDS’ are often used interchangeably,
hypersomnia 7725 sleepiness.Excessive quantity of nocturnal sleepAbnormally long nighttime sleep may be a major complaint in central hypersomnia s (that is, idiopathic hypersomnia) and in the presence of associated conditions. Excessive sleep quantity
hypersomnia 7759 sleepAbnormally long nighttime sleep may be a major complaint in central hypersomnias (that is, idiopathic hypersomnia ) and in the presence of associated conditions. Excessive sleep quantity varies across subjects and with
hypersomnia 9643 [[22],[23]]. Actigraphy permits the documentation of extended nocturnal sleep and daytime naps in clinical hypersomnia populations, but again with a tendency to overestimate sleep instead of rest, and to underestimate wake
hypersomnia 10420 gender-normative data. Nevertheless, without this procedure, it is difficult to distinguish whether hypersomnia consists of actual extended sleep or whether it simply represents an extra time spent in bed without
hypersomnia 10642 necessarily sleeping, known as clinophilia.Hypersomnia associated with mood disordersDiagnostic criteria for hypersomnia associated with mood disorders are described in three classification systems: the DSM-IV-TR [[7]], the
hypersomnia 11054 evidenced by either prolonged or daytime sleep episodes occurring almost daily, is mandatory for a hypersomnia diagnosis related to other mental disorders under the DSM-IV. A complaint of EDS or excessive sleep
hypersomnia 11199 disorders under the DSM-IV. A complaint of EDS or excessive sleep is required for the diagnosis of hypersomnia not due to substance abuse or known physiological condition (nonorganic hypersomnia) under the ICSD-2.
hypersomnia 11283 the diagnosis of hypersomnia not due to substance abuse or known physiological condition (nonorganic hypersomnia ) under the ICSD-2. Excessive daytime sleep or sleep attacks not accounted for by inadequate sleep and/or
hypersomnia 11512 transition to the fully aroused state upon awakening (sleep drunkenness) are criteria for non-organic hypersomnia under the ICD-10.The ICD-10 and DSM-IV-TR include a symptom duration criterion of at least one month,
hypersomnia 12220 for sleep-wake disorders nosology planned for publication this year included major changes regarding hypersomnia with elimination of the diagnosis of ‘primary hypersomnia’ in favor of ‘hypersomnia disorder,’
hypersomnia 12280 this year included major changes regarding hypersomnia with elimination of the diagnosis of ‘primary hypersomnia ’ in favor of ‘hypersomnia disorder,’ with concurrent specification of clinically comorbid conditions
hypersomnia 12310 regarding hypersomnia with elimination of the diagnosis of ‘primary hypersomnia’ in favor of ‘ hypersomnia disorder,’ with concurrent specification of clinically comorbid conditions [[28]]. These modifications
hypersomnia 12592 another mental disorder’ and ‘sleep disorder due to a general medical condition,’ in favor of ‘ hypersomnia disorder’ with concurrent specification of clinically comorbid medical and psychiatric conditions.
hypersomnia 13089 not sleep disorder specialists, new DSM5 sleep-wake disorders criteria also included aggregation of hypersomnia disorder and narcolepsy without cataplexy, which will be distinguished from narcolepsy-cataplexy/hypocretin-1
hypersomnia 13304 narcolepsy-cataplexy/hypocretin-1 deficiency disorder. Based on a recent cross-sectional telephone survey, a new definition of hypersomnia has been proposed in the upcoming DSM-5 revision including a frequency of ‘excessive sleepiness’
hypersomnia 14091 of either sad mood and/or anhedonia plus four out of nine additional symptoms, including insomnia or hypersomnia [[7]]. Atypical depression may be considered a distinct entity or else a phase of MDD that evolves over
hypersomnia 14410 patient must experience significant mood reactivity plus at least two other features, also including hypersomnia [[7]]. Dysthymic disorder (DD) diagnosis requires low mood present almost daily for two years plus at
hypersomnia 14564 requires low mood present almost daily for two years plus at least two other MDD symptoms, including hypersomnia [[7]]. Three bipolar-related diagnoses (BD) have been individualized: BD-I, BD-II, and cyclothymia.
hypersomnia 14814 symptoms of each BD subtype, with reduced need for sleep for manic and hypomanic episode and insomnia or hypersomnia for depressive episode. The initial description of seasonal affective disorder (SAD) stipulated frequent
hypersomnia 14945 episode. The initial description of seasonal affective disorder (SAD) stipulated frequent occurrence of hypersomnia , dysphoria, hyperphagia, and weight gain [[29]]. Currently, SAD is not considered a separate disorder,
hypersomnia 16596 questionnaires often over-identify depression in clinical populations [[37]], such as patients with central hypersomnia s.Hypersomnia associated with mood disordersSubjective assessment of hypersomniaThe hypersomnia symptoms
hypersomnia 16676 patients with central hypersomnias.Hypersomnia associated with mood disordersSubjective assessment of hypersomnia The hypersomnia symptoms associated with mood disorders are not specific and may include non-imperative
hypersomnia 16691 central hypersomnias.Hypersomnia associated with mood disordersSubjective assessment of hypersomniaThe hypersomnia symptoms associated with mood disorders are not specific and may include non-imperative EDS, long non-refreshing
hypersomnia 17226 in mood disorders. It is also particularly difficult to differentially diagnose between idiopathic hypersomnia and less severe forms of depression (for example, dysthymia).Albeit a diagnostic symptom for mood disorders,
hypersomnia 17347 severe forms of depression (for example, dysthymia).Albeit a diagnostic symptom for mood disorders, hypersomnia is largely understudied in this area. A recent review reported widely varying estimates of hypersomnia
hypersomnia 17450 hypersomnia is largely understudied in this area. A recent review reported widely varying estimates of hypersomnia in MDD across age, gender and studies, ranging from 8.9% in childhood (<13 years) to 75.8% in young
hypersomnia 17658 young adulthood [[2]], with a higher prevalence in females. Few studies have explored the presence of hypersomnia symptoms in MDD with atypical features, with frequency varying from 24% to 56% [[38],[39]]. The large
hypersomnia 17829 varying from 24% to 56% [[38],[39]]. The large frequency range likely reflects ambiguous definitions of hypersomnia , which vary between studies and are mostly based on a response to a single question [[40]-[42]]. The
hypersomnia 17951 vary between studies and are mostly based on a response to a single question [[40]-[42]]. The basis of hypersomnia in MDD is poorly understood; one may hypothesize that hypersomnia is related to abnormal sleep homeostasis
hypersomnia 18017 question [[40]-[42]]. The basis of hypersomnia in MDD is poorly understood; one may hypothesize that hypersomnia is related to abnormal sleep homeostasis in MDD. Interestingly, a recent high density electroencephalography
hypersomnia 18175 MDD. Interestingly, a recent high density electroencephalography study suggested that the presence of hypersomnia in MDD is associated with reduced parieto-occipital slow wave activity compared to those without hypersomnia
hypersomnia 18284 hypersomnia in MDD is associated with reduced parieto-occipital slow wave activity compared to those without hypersomnia [[43]].Hypersomnia assessed with a single yes/no response (for example, ‘sleeping too much’) was
hypersomnia 18596 remitted [[44],[45]]. Hypersomnia may also predict the onset of a major depressive episode [[5],[42]], and hypersomnia persistence after depressive symptoms have been managed may be a condition in those at risk for developing
hypersomnia 18915 ‘increased sleep’ was reported by 37.6% and 24%, respectively [[38]]. Another study in BD exploring hypersomnia complaints that used several questionnaires and a sleep diary for seven days between episodes showed
hypersomnia 19033 complaints that used several questionnaires and a sleep diary for seven days between episodes showed that hypersomnia may predict the risk of future depressive symptoms, with no interaction with baseline depressive symptoms
hypersomnia 19295 episodes were also associated with persistent EDS in an elderly population [[4]]. The frequency of hypersomnia symptoms in SAD ranged from 67% to 76% across studies [[2],[48]-[52]]. However, these studies used different
hypersomnia 19523 diagnostic tools to assess sleep complaints. One study used an original methodological approach to explore hypersomnia complaints in patients with SAD: a standard interview guide, questionnaires, and sleep diaries [[53]].
hypersomnia 19880 and again with a tendency to overestimate total sleep time using self-reports.Objective assessment of hypersomnia A few studies have used objective methods to investigate extended nocturnal sleep and EDS in mood disorders,
hypersomnia 20526 pathological sleep latencies on the MSLT nor abnormal total sleep time on prolonged PSG in patients with hypersomnia associated with mood disorders, that is, dysthymia, BD, and recurrent MDD [[55]]. Normal MSLT latency
hypersomnia 20717 [[55]]. Normal MSLT latency was also reported in dysthymic patients compared to patients with idiopathic hypersomnia and healthy controls [[56]]. Using the PSG and a non-conventional objective measure of EDS (that is,
hypersomnia 21030 objective sleepiness of drug-free patients with diagnosis of primary (idiopathic) versus psychiatric hypersomnia (that is, mood, somatoform, anxiety, and personality disorders) [[57]]. This group found that patients
hypersomnia 21162 somatoform, anxiety, and personality disorders) [[57]]. This group found that patients with psychiatric hypersomnia , although having complaints of EDS, showed both during the day and during the night lower sleep propensity
hypersomnia 21363 sleep propensity (that is, higher sleep latency and total wake time) than patients with idiopathic hypersomnia and controls [[57]].Taken together, there is no objective evidence supporting the view that patients
hypersomnia 21844 distress and impacts on the natural course of mood disorders.One may question whether the diagnosis of hypersomnia requires objective evidence of daytime/nighttime sleepiness or hypersomnia may be resumed as a ‘subjective
hypersomnia 21919 whether the diagnosis of hypersomnia requires objective evidence of daytime/nighttime sleepiness or hypersomnia may be resumed as a ‘subjective sleep complaint.’ The complaint of EDS is rarely corroborated by
hypersomnia 22140 results, particularly in the context of associated mood disorders. Paralleling PSG-MSLT studies of hypersomnia in mood disorders, PSG evidence for insomnia often does not match self-report, and yet insomnia is currently
hypersomnia 22316 match self-report, and yet insomnia is currently considered an independent disorder. We do believe that hypersomnia diagnosed by a structured clinical interview as in proposed DSM-5 criteria merits clinical attention
hypersomnia 22443 structured clinical interview as in proposed DSM-5 criteria merits clinical attention [[28]]. Thus, hypersomnia associated with mood disturbances may be a clinically-defined condition with significant socio-economic
hypersomnia 22666 [[58]] that may justify a treatment. To date, no pharmacological drugs have been approved to manage hypersomnia in depressive disorders. The management bias is a concern, with potential interactions between EDS,
hypersomnia 23309 may be considered for patients when a mood disorder cannot be definitely ruled out as the cause of hypersomnia . However, complaints of EDS and extended nocturnal sleep may persist as refractory symptoms, despite
hypersomnia 23626 assessments, including objective measures of EDS, may then be useful to formally exclude an underlying central hypersomnia disorder.Mood symptoms associated with hypersomnia disordersComorbidity between hypersomnia disorders
hypersomnia 23677 useful to formally exclude an underlying central hypersomnia disorder.Mood symptoms associated with hypersomnia disordersComorbidity between hypersomnia disorders and mood symptoms, particularly depression, is frequently
hypersomnia 23718 central hypersomnia disorder.Mood symptoms associated with hypersomnia disordersComorbidity between hypersomnia disorders and mood symptoms, particularly depression, is frequently reported in both clinical and research
hypersomnia 24056 misdiagnosed as depression, because MDD symptoms according to the DSM-IV-TR are common features of hypersomnia disorders.Narcolepsy with cataplexyNarcolepsy is an orphan sleep disorder (0.026% of the general population)
hypersomnia 30988 knowledge, no studies have reported whether CSF hypocretin-1 levels are altered in depressive patients with hypersomnia or not. However, some recent results hold promise for the use of non-selective hypocretin-1 and −2
hypersomnia 31308 drug addiction. Nevertheless, potential unwanted side effects must be carefully monitored.Idiopathic hypersomnia The prevalence of idiopathic hypersomnia (IH) in the general population is unknown. The age of symptom
hypersomnia 31348 unwanted side effects must be carefully monitored.Idiopathic hypersomniaThe prevalence of idiopathic hypersomnia (IH) in the general population is unknown. The age of symptom onset varies, but is frequently between
hypersomnia 32962 24-hour continuous PSG under an ad libitum sleep/wake protocol (for IH with LST) to objectively confirm hypersomnia , ascertain the diagnosis and rule out other causes of hypersomnia (for example, insufficient sleep,
hypersomnia 33028 with LST) to objectively confirm hypersomnia, ascertain the diagnosis and rule out other causes of hypersomnia (for example, insufficient sleep, sleep apnea syndrome, narcolepsy).Depressive symptoms were noted in
hypersomnia 33734 disorders and depressive symptom severity in both forms of IH. However, we may suggest a bridge between hypersomnia associated with mood disorders or with depressive symptoms only and IH, with difficulty distinguishing
hypersomnia 35489 potentially bidirectional. The greatest challenges in the literature are the varying definitions of hypersomnia and the wide clinical heterogeneity of depression. Although objective tools such as PSG enable direct
hypersomnia 35795 Given the different methods used, the conflicting results are unsurprising. Nevertheless, no objective hypersomnia has been recorded consequent to mood disorders. Conversely, mood symptoms are frequently reported in
hypersomnia 35908 has been recorded consequent to mood disorders. Conversely, mood symptoms are frequently reported in hypersomnia disorders of central origin. Further interventional studies are needed to explore whether the management
hypersomnia 36071 studies are needed to explore whether the management of sleep complaints improves mood symptoms in hypersomnia disorders and whether the management of mood complaints improves sleep symptoms in mood disorders.AbbreviationsBDI-II:
hypersomnia 36888 (self-rating); IDS-C30: Inventory of Depressive Symptomatology (clinician rating scale); IH: idiopathic hypersomnia ; LST: long sleep time; MADRS-S: self-assessment version of the Montgomery Åsberg Rating Scale; MDD:
sleep disorder 2297 reported in the literature, indicating a multifactorial mechanism [[1]]. EDS is associated with many sleep disorder s, such as insomnia, obstructive sleep apnea syndrome, circadian rhythm sleep disorders, and restless
sleep disorder 2383 associated with many sleep disorders, such as insomnia, obstructive sleep apnea syndrome, circadian rhythm sleep disorder s, and restless legs syndrome. In addition, it is a marker symptom in rare hypersomnias of central origin.
sleep disorder 3189 of associated daytime impairment. In that study, EDS was associated with insufficient sleep, several sleep disorder s, and general organic diseases in addition to psychiatric conditions (including anxiety and depressive
sleep disorder 4025 of the disorder due to disturbances in monoamine activity [[8]]. Recent studies have suggested that sleep disorder s may precede depression [[5]] and that non-depressed subjects with a family history of depression commonly
sleep disorder 5653 interchangeably, and EDS tends to be considered a disease or disorder. However, EDS is a symptom of a sleep disorder or other disease but not a disease per se[[12]]. Another problem with EDS is its definition, which is
sleep disorder 8595 nighttime sleep is rarely an isolated symptom, as it frequently coexists with other organic, mental, and sleep disorder s.Because most studies report the total amount of nighttime sleep or sleep across a 24-hour period using
sleep disorder 8952 sleep-wake patterns over a period of weeks [[21]]. Extensively used in insomnia and circadian rhythm sleep disorder s, the sleep diary allows quantifying extended nocturnal sleep and daytime naps along with available
sleep disorder 12463 specification of clinically comorbid conditions [[28]]. These modifications will also lead to elimination of ‘ sleep disorder related to another mental disorder’ and ‘sleep disorder due to a general medical condition,’ in
sleep disorder 12523 modifications will also lead to elimination of ‘sleep disorder related to another mental disorder’ and ‘ sleep disorder due to a general medical condition,’ in favor of ‘hypersomnia disorder’ with concurrent specification
sleep disorder 12993 treatment management. As the primary users of DSM are mental health and general medical clinicians, not sleep disorder specialists, new DSM5 sleep-wake disorders criteria also included aggregation of hypersomnia disorder
sleep disorder 24127 DSM-IV-TR are common features of hypersomnia disorders.Narcolepsy with cataplexyNarcolepsy is an orphan sleep disorder (0.026% of the general population) characterized by a clinical history of EDS and abnormal manifestations
sleep paralysis 24391 (that is, sudden loss of muscle tone triggered by strong emotions), hypnagogic hallucinations, and sleep paralysis [[59]]. Narcolepsy typically starts during adolescence, a critical period of normal development and
sleep paralysis 27751 well as the presence of REM sleep manifestations, such as cataplexy, hypnagogic hallucinations and sleep paralysis [[76]]. Although depressed patients generally tend to overscore on any scale, these data reinforced
sleep paralysis 27949 these data reinforced reported associations between depressive symptoms, hypnagogic hallucinations, and sleep paralysis in a population-based study [[79]]. A similar frequency of depressive symptoms was found in other narcoleptic

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