Volume 34, Issue 4 e14451
RESEARCH ARTICLE

Variability of excessive daytime sleepiness and cataplexy according to seasonality: A study in central disorders of hypersomnolence

Flavia Cirillo

Flavia Cirillo

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

Contribution: Writing - original draft, ​Investigation

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Mariana Fernandes

Mariana Fernandes

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

Contribution: Writing - original draft, Formal analysis, Writing - review & editing

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Fabio Placidi

Fabio Placidi

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy

Contribution: ​Investigation

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Francesca Izzi

Francesca Izzi

Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy

Contribution: ​Investigation

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Nicola Biagio Mercuri

Nicola Biagio Mercuri

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy

Contribution: Supervision, Writing - review & editing

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Claudio Liguori

Corresponding Author

Claudio Liguori

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy

Correspondence

Claudio Liguori, Sleep Medicine Centre, Department of Systems Medicine, University of Rome, "Tor Vergata" Viale Oxford 81 00133, Rome, Italy.

Email: [email protected]

Contribution: Writing - review & editing, Conceptualization

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First published: 01 January 2025

Summary

Seasonality of excessive daytime sleepiness has been proposed, yet no research has specifically investigated its impact on daytime sleepiness and cataplexy in central disorders of hypersomnolence. This study examined seasonal variations in daytime sleepiness and cataplexy in narcolepsy type 1, narcolepsy type 2 and idiopathic hypersomnia. Patients included in the study were on stable pharmacological treatment, and participated in sleep medicine interviews to assess diurnal sleepiness and daytime napping and completed the Epworth Sleepiness Scale to assess excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10). Patients with narcolepsy type 1 also maintained a cataplexy diary. Evaluations were conducted in autumn, winter, spring and summer. The study included 29 patients with narcolepsy type 1, 16 patients with narcolepsy type 2 and 10 patients with idiopathic hypersomnia. Patients with narcolepsy type 1 and narcolepsy type 2 showed higher Epworth Sleepiness Scale scores in summer compared with other seasons, while patients with idiopathic hypersomnia showed no changes in excessive daytime sleepiness across the four seasons. Epworth Sleepiness Scale scores were higher in idiopathic hypersomnia patients compared to narcolepsy type 1 and narcolepsy type 2 patients in spring, autumn, and winter; conversely, in summer there were no differences in Epworth Sleepiness Scale scores among the three groups. No significant differences in Epworth Sleepiness Scale scores were noted between patients with narcolepsy type 1 and narcolepsy type 2 throughout the year. Furthermore, no seasonal effect on cataplexy frequency was found in patients with narcolepsy type 1. This study demonstrates that seasonality may influence daytime sleepiness in patients with narcolepsy type 1 and narcolepsy type 2 but not in patients with idiopathic hypersomnia, while cataplexy symptoms remain unaffected by seasonal changes. The underlying mechanisms linking excessive daytime sleepiness to seasonality have yet to be explored, though social factors and vacation time may contribute to increased excessive daytime sleepiness in narcolepsy.

CONFLICT OF INTEREST STATEMENT

All authors declare that they have no conflict of interest to declare.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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