Diagnosis of central disorders of hypersomnolence: A reappraisal by European experts.

Lammers GJ; Bassetti CLA; Dolenc-Groselj L; Jennum PJ; Kallweit U; Khatami R; Lecendreux M; Manconi M; Mayer G; Partinen M; Plazzi G; Reading PJ; Santamaria J; Sonka K; Dauvilliers Y

doi:10.1016/j.smrv.2020.101306

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Journal article

Diagnosis of central disorders of hypersomnolence: A reappraisal by European experts.

Lammers GJ Sleep Wake Centre SEIN, Achterweg 5, Heemstede, the Netherlands; Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: g.j.lammers@lumc.nl.
Bassetti CLA Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Neurology, Sechenov First State Medical University, Moscow, Russia.
Dolenc-Groselj L Institute of Clinical Neurophysiology, University Medical Centre, University of Ljubljana, Ljubljana, Slovenia.
Jennum PJ Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.
Kallweit U Center for Narcolepsy and Hypersomnias, University Witten/Herdecke, Witten, Germany.
Khatami R Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Neurology, Sechenov First State Medical University, Moscow, Russia; Center for Sleep Medicine, Sleep Research and Epileptology, Klinik Barmelweid AG, Barmelweid, Switzerland.
Lecendreux M Pediatric Sleep Center, Hospital Robert-Debré, Paris, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (CNR Narcolepsie-hypersomnie), Paris, France.
Manconi M Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Neurology, Sechenov First State Medical University, Moscow, Russia; Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland.
Mayer G Department of Neurology, Hephata Klinik & Philipps Universität Marburg, Germany.
Partinen M Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland; Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland.
Plazzi G Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Reading PJ Department of Neurology, James Cook University Hospital, Middlesbrough, UK.
Santamaria J Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Universitat de Barcelona, Barcelona, Spain.
Sonka K Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
Dauvilliers Y Sleep-Wake Disorders Center, National Reference Network for Narcolepsy, Department of Neurology, Gui-de-Chauliac Hospital, INSERM, U1061, University of Montpellier, CHU Montpellier, France. Electronic address: ydauvilliers@yahoo.fr.

2020-04-21

Published in:

Sleep medicine reviews. - 2020

English The aim of this European initiative is to facilitate a structured discussion to improve the next edition of the International Classification of Sleep Disorders (ICSD), particularly the chapter on central disorders of hypersomnolence. The ultimate goal for a sleep disorders classification is to be based on the underlying neurobiological causes of the disorders with clear implication for treatment or, ideally, prevention and or healing. The current ICSD classification, published in 2014, inevitably has important shortcomings, largely reflecting the lack of knowledge about the precise neurobiological mechanisms underlying the majority of sleep disorders we currently delineate. Despite a clear rationale for the present structure, there remain important limitations that make it difficult to apply in routine clinical practice. Moreover, there are indications that the current structure may even prevent us from gaining relevant new knowledge to better understand certain sleep disorders and their neurobiological causes. We suggest the creation of a new consistent, complaint driven, hierarchical classification for central disorders of hypersomnolence; containing levels of certainty, and giving diagnostic tests, particularly the MSLT, a weighting based on its specificity and sensitivity in the diagnostic context. We propose and define three diagnostic categories (with levels of certainty): 1/"Narcolepsy" 2/"Idiopathic hypersomnia", 3/"Idiopathic excessive sleepiness" (with subtypes).

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