Is Idiopathic Hypersomnia a Circadian Rhythm Disorder?

  • David Landzberg
  • Lynn Marie TrottiEmail author
Hypersomnia Disorders (D Plante, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypersomnia Disorders


Purpose of Review

The pathophysiology of idiopathic hypersomnia remains unclear, but some of its clinical features suggest the possibility of circadian dysfunction. This review will provide an overview of recent studies of circadian biology that have begun to elucidate the potential role of circadian rhythm dysfunction in idiopathic hypersomnia.

Recent Findings

Clinically, people with idiopathic hypersomnia tend to have both a late chronotype and prominent sleep inertia or sleep drunkenness. Melatonin and cortisol profiles in people with IH confirm this tendency toward phase delay. More recently, it has been suggested that the night phase as defined by melatonin profile or period length as defined by BMA1 in dermal fibroblasts may also be prolonged in people with IH. Additionally, amplitude of melatonin rhythm and circadian gene expression, particularly BMAL1, PER1, and PER2, may be impaired in this disease.


Clinical features, melatonin profiles, and circadian gene expression all suggest that abnormalities of the circadian system may be a contributor to the pathogenesis of IH.


Idiopathic hypersomnia Circadian rhythm sleep-wake disorders Delayed sleep phase syndrome Circadian rhythm genetics Sleep inertia Sleep drunkenness 


Funding Information

This was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under Award Number K23 NS083748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of Interest

Dr. Trotti reports fees to her institution from Jazz Pharmaceuticals, Balance Therapeutics, and Harmony Biosciences, outside this work. There are no financial or other conflicts of interest related to this article.

Human and Animal Rights Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Emory Sleep Center and Department of NeurologyEmory University School of MedicineAtlantaUSA

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