Socio-professional handicap and accidental risk in patients with hypersomnias of central origin
Sleep Medicine Reviews. 2009-12-01; 13(6): 421-426
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1. Sleep Med Rev. 2009 Dec;13(6):421-6. doi: 10.1016/j.smrv.2009.02.001. Epub 2009
Socio-professional handicap and accidental risk in patients with hypersomnias of
Bayon V(1), Léger D, Philip P.
(1)Université Paris Descartes- Faculté de Medecine, APHP – Hôtel Dieu- Centre du
Sommeil et de la Vigilance, Paris, France.
Narcolepsy and idiopathic hypersomnia profoundly affect quality of life,
education and work. Young patients are very handicapped by unexpected sleep
episodes during lessons. Professionals frequently complain about sleepiness at
work. Motor discomfort (i.e., cataplectic attacks) surprisingly is less
handicapping in narcoleptics than sleepiness but only a few studies clearly
assess the problem. Quality of life is also largely impaired in its physical and
emotional dimensions. Sleepiness is the major factor explaining a decrease of
quality of life and unexpectedly cataplectic attacks have little impact on
patients. Another potential problem for these patients is the risk of accidents
at work or when driving. Narcoleptic and hypersomniac patients have a higher risk
of accidents than apneic or insomniac subjects. But, confounding factors such as
duration of driving, number of cataplectic attacks or even objective level of
alertness are not always entered in the analytic models mainly because of small
samples of patients. Unlike in apneic patients, the effect of treatment on
accidental risk has not been studied in narcoleptics or in hypersomniacs.
Epidemiological data are needed to improve knowledge concerning these areas.
Clinical trials assessing the impact of treatment on driving and work are also
urgently needed. Finally, medical treatment does not seem to be completely
efficient and physicians should pay more attention to the education, work, life
and social environment of their patients.
PMID: 19493688 [Indexed for MEDLINE]