Sleep Epidemiology (Dec 2023)
Characteristics of adults newly diagnosed with idiopathic hypersomnia in the United States
Abstract
Background: Idiopathic hypersomnia is a debilitating sleep disorder; however, little is known about the clinical presentation of patients receiving this diagnosis. Methods: A retrospective cohort study of IBM® MarketScan® claims (January 2014 to September 2019) was conducted. Analysis cohorts included adults ≥18 years of age from the MarketScan population and a subset newly diagnosed with idiopathic hypersomnia. Diagnosis required ≥2 idiopathic hypersomnia claims separated by ≥1 and ≤180 days, and continuous enrollment ≥12 months before the diagnosis date. Descriptive statistics were reported for diagnosing medical specialties, objective sleep laboratory testing utilization, and comorbidities in the 12 months prior to diagnosis. Results: From the general MarketScan cohort (N = 32,948,986), 4980 patients (0.015%) were newly diagnosed with idiopathic hypersomnia (mean age, 42.7 years; 66.9% female). The most common diagnosing medical specialties were pulmonary medicine (23.3%), neurology (14.4%), and internal medicine (11.4%). Only 44.4% of patients received objective sleep laboratory testing during the 12 months prior to diagnosis. The most common comorbidities were sleep apnea (49.5%), mood disorders (32.1%), depressive and anxiety disorders (31.0%, 30.7%, respectively), hyperlipidemia (30.1%), headache/migraine (23.9%), diabetes or use of diabetes/obesity medication (19.8%), hypertension (15.0%), and history of cardiovascular disease (14.3%). Conclusions: These results suggest that idiopathic hypersomnia is diagnosed by multiple medical specialists, and less than half of clinicians utilize proximate sleep laboratory testing prior to patient diagnosis in real-world settings. Furthermore, patients commonly have cardiovascular, metabolic, and psychiatric comorbidities. Healthcare providers should consider these comorbidities and cardiometabolic risks when evaluating treatment options for idiopathic hypersomnia.
