Evaluation of sleep quality in patients with idiopathic intracranial hypertension

Year 2024, , 327 - 331, 30.10.2024

Aslı Yaman Kula , Duhan Kanmaz

https://doi.org/10.5472/marumj.1571896

Abstract

ABSTRACT
Objective: Idiopathic intracranial hypertension (IIH) is a condition that has no known cause and progresses with increased cerebrospinal
fluid (CSF) pressure. Sleep apnea or other sleep disorders may occur with increased intracranial pressure (ICP). This study aims to
determine the relationship between the signs and symptoms of IIH and sleep quality.
Patients and Methods: Three self-reported questionnaires, namely The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness
Scale (ESS), and the Beck Depression Inventory (BDI)) were administered to 31 IIH patients and the same number of controls and the
scores were compared. Scores were analyzed according to the presence of symptoms in the IIH group. The correlation of these scores
with ICP was evaluated.
Results: Between the two groups, the IIH group had significantly higher PSQI scores (p=0.009). Also, a significant relationship was
shown between papilledema and PSQI scores (p=0.017); patients with papilledema had lower PSQI scores than patients without
papilledema. BMI values were higher in patients without papilledema (p = 0.031). In the IIH group, PSQI and BDI scores had a positive
correlation (r = 0.638, p < 0.001).
Conclusion: Sleep quality is impaired in patients with IIH, and the effect of being overweight in this deterioration is more pronounced
than presence of papilledema.

Keywords

Idiopathic intracranial hypertension, Sleep quality, cerebrospinal fluid pressure, Papilledema

References

• Fargen KM, Coffman S, Torosian T, Brinjikji W, Nye BL, Hui F. ‘Idiopathic’ intracranial hypertension: An update from neurointerventional research for clinicians. Cephalalgia 2023; 43:333.102.4231161323. doi:10.1177/033.310.24231161323
• Kosmorsky GS. Idiopathic intracranial hypertension: pseudotumor cerebri. Headache 2014;54:389-93. doi:10.1111/ head.12284
• Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol 2016;15:78- 91. 10.1016/S1474-4422(15)00298-7
• Tokatly Latzer I, Tauman R, Senderowich N, et al.: Sleep disturbances in adolescents with ıdiopathic ıntracranial hypertension. Pediatr Neurol 2023;142:39-46. doi: 10.1016/j. pediatrneurol.2023.02.006
• Kornbluh AB, Thompson K, Mcmahen G, et al. Sleep disturbance in pediatric ıntracranial hypertension. J Clin Sleep Med 2020;16:1099-105. doi: 10.5664/jcsm.8436
• Wall M, Corbett JJ. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2014;83:198-9. doi:10.1212/01. wnl.000.045.2039.32455.3e
• Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193- 213. doi:10.1016/0165-1781(89)90047-4
• Gonçalves MT, Malafaia S, Moutinho Dos Santos J, Roth T, Marques DR. Epworth sleepiness scale: A meta-analytic study on the internal consistency. Sleep Med 2023;109:261-9. 10.1016/j.sleep.2023.07.008
• WHO Consultation on Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization Tech Rep Ser 2000;894:i–xii, 1-253.
• Marcus DM, Lynn J, Miller JJ, Chaudhary O, Thomas D, Chaudhary B. Sleep disorders: a risk factor for pseudotumor cerebri? J Neuroophthalmol 2001;21:121-3. doi:10.1097/00041.327.200106000-00014
• Rains JC, Poceta JS. Headache and sleep disorders: review and clinical implications for headache management. Headache 2006: 46:1344-63. doi:10.1111/j.1526-4610.2006.00578.x
• Dodick DW, Eross EJ, Parish JM, Silber M. Clinical, anatomical, and physiologic relationship between sleep and headache. Headache 2003:43:282-92. doi:10.1046/j.1526- 4610.2003.03055.x
• Raoof N, Hoffmann J. Diagnosis and treatment of idiopathic intracranial hypertension. Cephalalgia 2021;41:472-8. doi:10.1177/033.310.2421997093
• Wakerley BR, Tan MH, Ting EY. Idiopathic intracranial hypertension. Cephalalgia. 2015;35:248-61. doi:10.1177/033.310.2414534329
• Yokota A, Matsuoka S, Ishikawa T, Kohshi K, Kajiwara H. Overnight recordings of intracranial pressure and electroencephalography in neurosurgical patients. Part II: Changes in intracranial pressure during sleep. J UOEH 1989;11:383-91. doi:10.7888/juoeh.11.383
• Stephensen H, Tisell M, Wikkelsö C. Intracranial pressure during wakefulness and sleep in 55 adult patients with chronic hydrocephalus. Neurosurgery 2006;59:326-32; doi:10.1227/01. NEU.000.022.3513.89586.9A
• Alperin N, Ranganathan S, Bagci AM, et al. MRI evidence of impaired CSF homeostasis in obesity-associated idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2013;34:29-34. doi:10.3174/ajnr.A3171
• Bush AL, Armento MEA, Weiss BJ, et al. The Pittsburgh Sleep Quality Index in older primary care patients with generalized anxiety disorder: psychometrics and outcomes following cognitive behavioral therapy. Psychiatry Res 2012;199:24-30. doi:10.1016/j.psychres.2012.03.045
• Thurtell MJ, Trotti LM, Bixler EO, et al. Obstructive sleep apnea in idiopathic intracranial hypertension: comparison with matched population data. J Neurol 2013;260:1748-51. doi:10.1007/s00415.013.6858-6
• Sugita Y, Iijima S, Teshima Y, et al. Marked episodic elevation of cerebrospinal fluid pressure during nocturnal sleep in patients with sleep apnea hypersomnia syndrome. Electroencephalogr Clin Neurophysiol 1985;60:214-9. doi:10.1016/0013- 4694(85)90033-1
• Purvin VA, Kawasaki A, Yee RD. Papilledema and obstructive sleep apnea syndrome. Arch Ophthalmol 2000;118:1626-30. doi:10.1001/archopht.118.12.1626
• Szewka AJ, Bruce BB, Newman NJ, Biousse V. Idiopathic intracranial hypertension: relation between obesity and visual outcomes. J Neuroophthalmol 2013;33:4-8. doi:10.1097/ WNO.0b013e31823f852d
• Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med 2019;23:2324-32. doi:10.1111/ jcmm.14170
• Lewis BA, Gjerdingen D, Schuver K, Avery M, Marcus BH. The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health 2018;18:12. doi:10.1186/ s12905.017.0496-6