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Is Idiopathic Hypersomnia a Circadian Rhythm Disorder?

  • Hypersomnia Disorders (D Plante, Section Editor)
  • Published:
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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.

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

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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.

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Correspondence to Lynn Marie Trotti.

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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.

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This article is part of the Topical Collection on Hypersomnia Disorders

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Landzberg, D., Trotti, L.M. Is Idiopathic Hypersomnia a Circadian Rhythm Disorder?. Curr Sleep Medicine Rep 5, 201–206 (2019).

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