Emerging Trends in Sleep: Treating Central Disorders of Hypersomnolence, Breath Biomarkers in OSA, and More

AASM Updates Guidance on Treatment of Central Disorders of Hypersomnolence

As reported by NeurologyLive^®, the American Academy of Sleep Medicine issued new guidance for the treatment of central disorders of hypersomnolence, marking the first update since 2007 for these conditions.

Published in the Journal of Clinical Sleep Medicine, the guidelines provide 20 recommendations for the use of medications in adults and 2 additional recommendations specific to pediatric patients with narcolepsy, in which recent FDA-approved medications in the treatment of narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome are now included.

Following an evaluation of Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, strong recommendations included the use of modafinil, pitolisant, sodium oxybate, and solriamfetol for the treatment of narcolepsy, as well as modafinil for idiopathic hypersomnia (IH). As the guidelines were released prior to recently published data on lower sodium oxybate for narcolepsy and the FDA approval of Xywav for IH, both therapies were not included.

Study Validates Use of Breath Biomarkers in Obstructive Sleep Apnea

According to findings of an observational study assessing secondary electrospray ionization high-resolution mass spectrometry (SESI-HRMS) in the evaluation of patients with obstructive sleep apnea (OSA), patients with the condition were shown to exhibit significant differences in breath biomarkers compared with the control group, with biomarker levels also shown to correlate with OSA severity.

Reported by NeurologyLive^®, 33 metabolites/breath biomarkers previously identified by SESI-HRMS in a pilot study were assessed, of which 19 features showed significant differences (P ≤ .05) and 21 features had a significant correlation between breath levels and oxygen saturation index (P ≤ .05).

Speaking on their findings, researchers said there is unlikely to be only 1 biomarker for OSA diagnosis, with a pattern of several biomarkers instead more likely to be disease specific. A combination of SESI-HRMS measurements and OSA screening questionnaires was noted to be a potential diagnostic approach for patients with OSA in the future.

Assessing State of Sleep Research, Progress in Unmet Needs

As reported by HCPLive^®, patients with vitiligo may be at significantly increased risk of insomnia, with the skin condition serving as a potential contributor to adverse sleep health.

With vitiligo commonly associated with impaired social functioning and physiological conditions, including insomnia, researchers from China sought to evaluate the prevalence, severity, and risk factors of the sleep condition in these patient populations. In findings from their case-control study, approximately half of the 409 surveyed adult patients with vitiligo reported in an online questionnaire that they suffer from insomnia.

Notably, patients with vitligo and insomnia were more likely to be female (62.8%; P = .006), work in urban areas (77.0%; P = .017), experience vitiligo in their face and neck (67.2%; P <.001), and be treated with oral corticosteroids (25.0%; P = .036). More than two-thirds of those with both comorbid conditions also reported development, aggravation, or recurrence of vitiligo as the first reason for their insomnia.