Survey Reveals Decrease in Symptoms of Central Hypersomnias During Pandemic Lockdowns

A survey measuring the impact of COVID-19–related lockdowns and similar restrictions on patients with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) found that relaxed social and professional constraints led to decreased symptoms of the respective conditions.

The research was reported in the Journal of Clinical Sleep Medicine.

Patients with NT1, NT2, and IH have different sleep needs, including frequent naps or more total sleep time, that often conflict with typical daytime obligations such as work or school. Conflicts can lead to adverse effects if sleep needs are not met, such as excessive daytime sleepiness or a decrease in quality of life. Because COVID-19 lockdown measures loosened daily constraints that typically interfered with sleep needs, investigators questioned what the effects would be on the sleep-wake habits of patients with central hypersomnias.

Participants with either NT1, NT2, or IH who were followed at a university hospital in France answered a 78-question online survey regarding demographic, clinical, and occupational features, and answers from 291 patients were included in the final analysis. The survey focused on changes to the features that occurred during the first COVID-related lockdown.

Findings showed:

• Of 851 respondents, 219 (25.7%) reported a mean (SD) increase of 1.2 (1.9) hours (P < .001) in night sleep time, and a mean decrease of 1.0 (3.4) points (P < .001) on the Epworth sleepiness scale.
• Bedtime and wake-up time were delayed by 46.1% and 59.6% of participants, respectively, and driven by participants with IH.
• Teleworkers reported a mean increase of 0.9 (1.2) hours in night sleep (P < .001) and a mean decrease in sleepiness score of 1.6 (3.1) (P < .001).
• Cataplexy improvement was reported among 54.1% of participants with NT1.
• Sleepiness correlated with psychological wellness (R = 0.3; P < .001).
• While 42.5% of participants reported enjoying the lockdown due to factors such as extended sleep time, extended time to devote to hobbies and family, and a freer napping schedule, 13.2% reported disliking the lockdown because of isolation and psychological distress.
• About one-third of participants reported decreased fatigue and better concentration.
• Sleep-related hallucinations decreased in 35.0% of participants with NT1.

The results of the survey suggest that during lockdown, patients with N1, N2, and IH were more easily able to accommodate for their sleep schedule in accordance with the specific needs of their central hypersomnias.

Factors such as extended sleep time allowed by COVID-19–related lockdowns, circadian delay in patients with IH, and telework in lieu of in-person work contributed to decreased symptoms in patients with N1, N2, and IH, the authors wrote. Although patients were susceptible to sleep-disruptive factors associated with the pandemic, such as stress, anxiety, and increased screen time, for many participants, the advantages associated with a relaxed schedule outweighed the disadvantages.

Patients’ sleep-wake habits may benefit from a continued decrease in professional and social constraints like those observed during lockdowns, as well as workplace schedule accommodations for the affected population, the authors concluded.

Reference

Nigam M, Hippolyte A, Dodet P, et al. Sleeping through a pandemic: impact of COVID-19 related restrictions on narcolepsy and idiopathic hypersomnia. J. Clin. Sleep Med. Published online July 27, 2021. doi:10.5664/jcsm.9556