Workplace Implications of Idiopathic Hypersomnia in the Setting of Occupational Sleep Medicine: A Case Report and Literature Review
Abstract
Background and Objective: Idiopathic hypersomnia (IH) manifests with excessive daytime sleepiness (EDS), cogni-tive and autonomic symptoms, debilitating sleep inertia, difficulty awakening, prolonged sleep duration, and non-restorative sleep. Here, we present a case with IH who was a shift worker in an automobile factory. Workplace implications and fitness for work in safety-sensitive jobs are especially important for patients with hypersomnolence, be cause rates of accidents increase in these situations.
Case Report: The patient was a 34-year-old man referred to Baharloo Sleep Clinic, Tehran, Iran, because of EDS. He was a shift worker in an automobile factory. The subject underwent multiple sleep latency test (MSLT) after overnight polysomnography (PSG). He had no sleep onset rapid eye movement (REM) periods in MSLT and the mean sleep la-tency (MSL) was 5.75 minutes. According to PSG and MSLT report, the diagnosis of narcolepsy was ruled out. According to his sleep log, the patient slept more than 11 hours per 24 hours and had MSL lower than eight minutes. Our patient used modafinil for improvement of his symptoms and he was unfit for working in night shifts.
Conclusion: Here, we reported a case of IH. Attention to past medical history, occupational history, sleep log or actigraphy, PSG, and MSLT findings is very helpful for diagnosis and confirmation of IH. Pre-employment and periodic evaluation of sleepiness, accident analysis, and tracking in an integrative sleepiness or fatigue management system would be very useful.
2. Trotti LM. Idiopathic hypersomnia. Sleep Med Clin 2017; 12: 331-44.
3. Anderson KN, Pilsworth S, Sharples LD, et al. Idiopathic hypersomnia: A study of 77 cases. Sleep 2007; 30: 1274-81.
4. Rye DB, Bliwise DL, Parker K, et al. Modulation of vigilance in the primary hypersomnias by endogenous enhancement of GABAA receptors. Sci Transl Med 2012; 4: 161ra151.
5. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
6. Najafi A, Sadeghniiat-Haghighi K, Khajeh-Mehrizi A, et al. Motor vehicle accidents in patients with excessive daytime sleepiness. J Sleep Sci 2019; 3: 21-4.
7. Sadeghniiat HK, Montazeri A, Khajeh MA, et al. The Epworth Sleepiness Scale: Translation and validation study of the Iranian version. Sleep Breath 2013; 17: 419-26.
8. Arnau RC, Meagher MW, Norris MP, et al. Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. Health Psychol 2001; 20: 112-9.
9. Yazdi Z, Sadeghniiat-Haghighi K, Zohal MA, et al. Validity and reliability of the Iranian version of the insomnia severity index. Malays J Med Sci 2012; 19: 31-6.
10. Sadeghniiat-Haghighi K, Montazeri A, Khajeh-Mehrizi A, et al. The STOP-BANG questionnaire: Reliability and validity of the Persian version in sleep clinic population. Qual Life Res 2015; 24: 2025-30.
11. Benbadis SR, Perry MC, Wolgamuth BR, et al. The multiple sleep latency test: Comparison of sleep onset criteria. Sleep 1996; 19: 632-6.
12. Coelho FM, Pradella-Hallinan M, Predazzoli NM, et al. Prevalence of the HLA-DQB1*0602 allele in narcolepsy and idiopathic hypersomnia patients seen at a sleep disorders outpatient unit in Sao Paulo. Braz J Psychiatry 2009; 31: 10-4.
13. Drake CL, Wright KP. Shift work, shift-work disorder, and jet lag. In: Kryger M, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 6th ed. Philadelphia, PA: Elsevier; 2017. p. 714-25.
14. Rajaratnam SM. Legal issues in accidents caused by sleepiness. J Hum Ergol (Tokyo) 2001; 30: 107-11.
15. Slanger TE, Gross JV, Pinger A, et al. Person directed, non-pharmacological interventions for sleepiness at work and sleep disturbances caused by shift work. Cochrane Database Syst Rev 2016; 8: CD010641.
16. Schinkelshoek MS, Fronczek R, Lammers GJ. Up-date on the treatment of idiopathic hypersomnia. Curr Sleep Med Rep 2019; 5: 207-14.
17. Gander PH, Wu LJ, van den Berg M, et al. Fatigue
risk management systems. In: Kryger M, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 6th ed. Philadelphia, PA: Elsevier; 2017. p. 697-707.
18. Kecklund G, Sallinen M, Axelsson J. Optimizing shift scheduling. In: Kryger M, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 6th ed. Philadelphia, PA: Elsevier; 2017. p. 742-9.
19. Materna L, Halfter H, Heidbreder A, et al. Idiopathic hypersomnia patients revealed longer circadian period length in peripheral skin fibroblasts. Front Neurol 2018; 9: 424.
20. Dauvilliers Y, Bassetti CL. Idiopathic hypersomnia. In: Kryger M, Roth T, Dement WC, editors. Principles and practice of sleep medicine.6th ed. Philadelphia, PA: Elsevier; 2017. p. 883-91.
21. DeArmond S, Chen PY. Occupational safety: The role of workplace sleepiness. Accid Anal Prev 2009; 41: 976-84.
| Files | ||
| Issue | Vol 4 No 3-4 (2019): Summer-Autumn | |
| Section | Case Report(s) | |
| Keywords | ||
| Idiopathic hypersomnia; Sleepiness; Workplace | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
