Clinical significance and correlates of behaviorally induced insufficient sleep syndrome

Background and purpose: The aim of this study was to investigate the demographic variables and clinical characteristics of behaviorally induced insufficient sleep syndrome (BIISS) and to compare it with the other major hypersomnia disorders.Patients and methods: One-thousand two-hundred forty-three consecutive patients referred to the outpatient clinic for complaint of excessive daytime sleepiness (EDS) were retrospectively investigated.Results: The rate of BIISS in patients with EDS was 7.1%, predominant in males. The mean age of initial visit was younger than that for obstructive sleep apnea syndrome (OSAS), while the mean age of onset of symptoms was older than that for idiopathic hypersomnia, narcolepsy, and circadian rhythm sleep disorders. The mean Epworth sleepiness scale (ESS) score before treatment was lower than that for narcolepsy but higher than that for both OSAS and circadian rhythm sleep disorders. Twenty-two percent of BIISS cases reported having accidents or near-miss accidents during the five-year period preceding the investigation, and this group showed higher ESS scores than the group without accidents.Conclusions: Our findings showed that an unignorably large number of people suffer from BIISS, and that people with severe cases of the disorder are at high risk for getting into an accident. Characteristics and demographic information could be helpful for making a differential diagnosis of BIISS. (c) 2007 Elsevier B.V. All rights reserved.

背景与目的：本研究旨在调查行为诱导性睡眠不足综合征（BIISS）的人口统计学变量和临床特征，并将其与其他主要的嗜睡障碍进行比较。 患者与方法：对1243例因日间过度嗜睡（EDS）主诉而转诊至门诊的连续患者进行回顾性研究。 结果：EDS患者中BIISS的发生率为7.1%，男性居多。首次就诊的平均年龄小于阻塞性睡眠呼吸暂停综合征（OSAS）患者，而症状发作的平均年龄大于特发性嗜睡症、发作性睡病和昼夜节律睡眠障碍患者。治疗前的平均爱泼沃斯嗜睡量表（ESS）评分低于发作性睡病患者，但高于OSAS和昼夜节律睡眠障碍患者。22%的BIISS患者报告在调查前的5年期间发生过事故或险些发生事故，且这组患者的ESS评分高于无事故组。 结论：我们的研究结果表明，有相当数量的人患有BIISS，病情严重的患者发生事故的风险较高。特征和人口统计学信息有助于对BIISS进行鉴别诊断。（c）2007爱思唯尔B.V.版权所有。