Sleep and Biological Rhythms

, Volume 16, Issue 2, pp 205–210 | Cite as

Hypersomnia with ADHD: a possible subtype of narcolepsy type 2

  • Wakako Ito
  • Makoto Honda
  • Taro Ueno
  • Nobumasa Kato
Original Article


Patients with attention deficit/hyperactivity disorder (ADHD) suffer from hypersomnia; indeed, we have often encountered ADHD patients that fulfill the diagnostic criteria for narcolepsy type 2 (NA 2). Because not all patients with NA 2 carry the HLA-DQB1*06:02 allele, which is closely associated with narcolepsy type 1 (NA 1), NA 2 is believed to be heterogeneous. To reveal the contribution of ADHD in hypersomnia, we studied the characteristics of hypersomnia patients with ADHD, especially those diagnosed with NA 2. Participants were 77 of 185 consecutive outpatients who were diagnosed with NA 2 or idiopathic hypersomnia. We investigated sleep variables in (a) participants with hypersomnia with/without ADHD and (b) patients with NA 2 with/without ADHD and those with/without the DQB1*06:02 allele. The proportion of those diagnosed with NA 2 was higher in hypersomnia patients with ADHD compared to those without ADHD. None of the NA 2 patients with ADHD carried the narcolepsy-specific DQB1*06:02 allele. These patients with NA 2 with ADHD exhibited short REM latencies on the MSLT (similarly to DQB1*06:02-positive patients with NA 2 without ADHD), but less REM-related phenomena than patients with NA 2 without ADHD. Hypersomnia patients with ADHD tended to show short REM latencies, and fulfilled NA 2 diagnostic criteria in the absence of the DQB1*06:02 allele, suggesting a different etiology from NA 1. These findings support the hypotheses of noradrenergic dysregulation and delayed brain maturation that have been proposed for the pathophysiology of ADHD.


Attention deficit/hyperactivity disorder (ADHD) Sleep onset REM periods (SOREMPs) Excessive daytime sleepiness Narcolepsy type 2 HLA-DQB1*06:02 



The authors wish to thank Ms. Kaori Sasaki and Mr. Shinya Kimura for their help to analyze PSG and MSLT data.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest regarding this paper.

Ethical committee permission

The Ethics Committee of Institute of Neuropsychiatry, Permission Number 119.

Informed consent

All study participants provided informed consent.


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Copyright information

© Japanese Society of Sleep Research 2017

Authors and Affiliations

  • Wakako Ito
    • 1
  • Makoto Honda
    • 1
    • 2
  • Taro Ueno
    • 1
    • 3
  • Nobumasa Kato
    • 1
    • 4
  1. 1.Seiwa Hospital, Institute of NeuropsychiatryTokyoJapan
  2. 2.Sleep Disorders Project, Department of Psychiatry and Behavioral ScienceTokyo Metropolitan Institute of Medical ScienceTokyoJapan
  3. 3.Department of Biomolecular Science, Faculty of ScienceToho UniversityChibaJapan
  4. 4.Medical Institute of Developmental Disabilities ResearchShowa UniversityTokyoJapan

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