Characteristics of adults newly diagnosed with idiopathic hypersomnia in the United States

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.