While the pathophysiology of idiopathic hypersomnia is unknown, emerging science suggests that nighttime sleep dysfunction may contribute to daytime sleepiness in patients with idiopathic hypersomnia. A systematic review and meta-analysis that included 10 studies found that, on average, several sleep architecture hallmarks were different in patients with idiopathic hypersomnia relative to controls.

• Total sleep time and percent of REM sleep were increased in patients with idiopathic hypersomnia compared with controls.
• Sleep-onset latency and percent of slow-wave sleep were decreased in patients with idiopathic hypersomnia compared with controls.
• Sleep efficiency and REM latency were similar between patients with IH and controls.

In addition to nighttime sleep dysfunction, other physiological changes have been observed in some patients with idiopathic hypersomnia and theorized as possible contributors to its pathophysiology including:

• Dysfunction of the GABAergic system
• Autonomic system dysfunction
• Altered functional or regional connectivity in the brain
• Circadian system dysfunction
• Dysfunction of energy metabolism

This episode is produced by Sleep Review and is episode 5 of a 5-part series sponsored by Jazz Pharmaceuticals. Visit Jazzpharma.com and SleepCountsHCP.com for more information. In episode 5, listen as Sleep Review’s Sree Roy and neurologist-sleep specialist Isabelle Arnulf, MD, PhD, discuss:

• Science doesn’t fully understand the pathophysiology of idiopathic hypersomnia. Research has revealed potential clues, however. For example, idiopathic hypersomnia is associated with changes in sleep staging and architecture. What does emerging science suggest are differences in nighttime sleep?
• How might the arousal index differ in idiopathic hypersomnia versus in people without it, and why might that matter?
• In addition to nighttime sleep dysfunction, other physiological changes have been observed in some patients with idiopathic hypersomnia and theorized as possible contributors to its pathophysiology. What is the GABAergic system and its possible role?
• What are some emerging findings surrounding idiopathic hypersomnia and autonomic system dysfunction?
• What is the evidence that supports the idea of altered functional or regional connectivity in the brain in people with idiopathic hypersomnia?
• There were fascinating studies done on skin fibroblasts, suggesting that circadian period length may be different in people with idiopathic hypersomnia versus in people without it. What role might circadian rhythm dysfunction have in idiopathic hypersomnia?
• What has science discovered about the possible role of dysfunction of energy metabolism in idiopathic hypersomnia?
• What further research would you like to see conducted on the pathophysiology of idiopathic hypersomnia?

Listen to Episode 1: Symptoms of Idiopathic Hypersomnia

Listen to Episode 2: Diagnosis of Idiopathic Hypersomnia

Listen to Episode 3: Differential Diagnosis of Idiopathic Hypersomnia

Listen to Episode 4: Burden of Idiopathic Hypersomnia

People with idiopathic hypersomnia face a significant disease burden. Idiopathic hypersomnia is associated with challenges that impact daily living activities, such as limitations at school, work, interpersonal relationships, and social activities. Various impairments include

• • Impacts on attention and cognition, which can be characterized as “brain fog”
  • The burden of memory problems and a feeling of the mind going blank or making a mistake in a habitual activity

Public health and safety are also impacted, as more severe causes of sleepiness can be cause for accidents. Management strategies may not address the underlying sleep dysfunction associated, resulting in suboptimal symptom management. Patient survey and registry data suggest patients continue to experience symptoms of idiopathic hypersomnia and residual disease burden. This episode is produced by Sleep Review and is episode 4 of a 5-part series sponsored by Jazz Pharmaceuticals. Visit Jazzpharma.com and SleepCountsHCP.com for more information. In episode 4, listen as Sleep Review’s Sree Roy and pulmonologist-sleep specialist Richard K. Bogan, MD, discuss:

• • What are some limits that people with idiopathic hypersomnia can experience in their daily living activities?
  • How do people with idiopathic hypersomnia commonly describe "brain fog," and what are some of the real-life consequences it?
  • How does prolonged sleep inertia place a burden on the people with idiopathic hypersomnia who experience this symptom?
  • What do you see as the burden of idiopathic hypersomnia on public health and safety?
  • Beyond medications, how is idiopathic hypersomnia typically managed to control for symptoms as much as possible?
  • How do you determine when therapy for idiopathic hypersomnia has been optimized, and what symptoms may remain at this point?

This episode also provides valuable advice for sleep techs dealing with patients wanting to use mouth tape during in-lab sleep studies. DeNike underlines the importance of ensuring patients have a healthy nasal passageway and clarifies the role of mouth tape as a supportive accessory, not a standalone treatment. This episode is sure to provide you with a deeper understanding of mouth taping during sleep, armed with expert advice and valuable insights, whether you're a sleep professional or someone simply interested in optimizing your sleep health. In this episode, we answer the questions:

• What exactly is mouth taping during sleep?
• How has the practice of mouth taping during sleep evolved in popularity over the years?
• Is there any evidence that mouth taping is useful for healthy sleepers, that is, people without any sleep disorders?
• Is there any evidence that mouth taping is useful for people with any sleep disorders, perhaps as an add-on to a device such as an oral appliance for sleep apnea?
• What dangers are associated with mouth taping during sleep?
• What is your advice to sleep techs for how to handle the situation of an in-lab sleep study patient who wants to use mouth taping during an in-lab sleep study?
• What is your evidence to sleep medicine professionals if their patients confide in them that they using mouth tape, either with or without their prescribed device, to treat a sleep disorder?