Autonomic dysfunction in idiopathic hypersomnia: an overlooked association and potential management, 2021, Adra et al

Abstract

There is a small yet robust body of literature regarding autonomic dysfunction in Idiopathic hypersomnia (IH) as well as sleep disturbances in Postural Orthostatic Tachycardia Syndrome (POTS). This review aims at summarizing the current literature and highlighting gaps in the current knowledge. This article additionally presents the personal experience of one of the authors at the sleep center.

Full text available for download as pdf from:
https://jcsm.aasm.org/doi/10.5664/jcsm.9818

 

Way to confuse people (me) by using the acronym "EDS" without first noting they mean "Excessive Daytime Sleepiness" and not "Ehlers Danlos Syndrome", in relation to common POTS comorbidity!

Otherwise it seems to get it correct that whilst POTS patients share the excessive daytime sleepiness of idiopathic hypersomnia, they usually present very differently in sleep studies. Insomnia, excessive arousals, dawn phenomenon etc. with no primary sleep disorder. This was my n=1 case after PSG/MSLT too and it was later discovered the extreme daytime sleepiness I experienced was largely result of an overlapping digestion/endocrine problem.

Of interest is a further case study showing IVIG appearing to improve all symptoms in a patient with idiopathic hypersomnia, dysautonomia and small fibre neuropathy.