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Diagnosis of central disorders of hypersomnolence: A reappraisal by European experts.
Sleep Medicine Reviews ( IF 11.2 ) Pub Date : 2020-03-23 , DOI: 10.1016/j.smrv.2020.101306
Gert Jan Lammers 1 , Claudio L A Bassetti 2 , Leja Dolenc-Groselj 3 , Poul J Jennum 4 , Ulf Kallweit 5 , Ramin Khatami 6 , Michel Lecendreux 7 , Mauro Manconi 8 , Geert Mayer 9 , Markku Partinen 10 , Giuseppe Plazzi 11 , Paul J Reading 12 , Joan Santamaria 13 , Karel Sonka 14 , Yves Dauvilliers 15
Affiliation  

The aim of this European initiative is to facilitate a structured discussion to improve the next edition of the International Classification of Sleep Disorders (ICSD), particularly the chapter on central disorders of hypersomnolence.

The ultimate goal for a sleep disorders classification is to be based on the underlying neurobiological causes of the disorders with clear implication for treatment or, ideally, prevention and or healing. The current ICSD classification, published in 2014, inevitably has important shortcomings, largely reflecting the lack of knowledge about the precise neurobiological mechanisms underlying the majority of sleep disorders we currently delineate. Despite a clear rationale for the present structure, there remain important limitations that make it difficult to apply in routine clinical practice. Moreover, there are indications that the current structure may even prevent us from gaining relevant new knowledge to better understand certain sleep disorders and their neurobiological causes.

We suggest the creation of a new consistent, complaint driven, hierarchical classification for central disorders of hypersomnolence; containing levels of certainty, and giving diagnostic tests, particularly the MSLT, a weighting based on its specificity and sensitivity in the diagnostic context.

We propose and define three diagnostic categories (with levels of certainty):

1/“Narcolepsy” 2/“Idiopathic hypersomnia”, 3/“Idiopathic excessive sleepiness” (with subtypes).



中文翻译:

中枢性高嗜睡症的诊断:欧洲专家的重新评估。

这项欧洲计划的目的是促进有组织的讨论,以改善下一版《国际睡眠障碍分类》(ICSD),特别是有关高嗜睡症中枢性疾病的章节。

睡眠障碍分类的最终目标是基于引起疾病的潜在神经生物学原因,对治疗或理想情况下的预防和/或治愈具有明确的含义。当前的ICSD分类于2014年发布,不可避免地存在重大缺陷,主要反映出我们对目前描述的大多数睡眠障碍背后的确切神经生物学机制缺乏了解。尽管对当前结构有明确的理由,但仍然存在重要的局限性,使其难以应用于常规临床实践。而且,有迹象表明,当前的结构甚至可能阻止我们获得相关的新知识,以更好地理解某些睡眠障碍及其神经生物学原因。

我们建议创建一种新的一致的,由投诉驱动的,分级的针对高睡眠感性中枢性疾病的分类;包含确定性水平,并给予诊断测试,尤其是MSLT,基于其在诊断环境中的特异性和敏感性进行加权。

我们提出并定义了三个诊断类别(具有一定的确定性):

1 /“嗜睡症” 2 /“特发性失眠”,3 /“特发性过度嗜睡”(亚型)。

更新日期:2020-03-23
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