• Takamasa Asaga, Kenichi Hashimoto, Yusuke Kawamura, Naoya Fujita, Motohiro Kimata, Akinori Sekizawa, Yosuke Ono, Yasuhiro Obuchi, Nanase Kobayashi, Hideto Hirasawa, Takashi Kanbayashi, and Yuji Tanaka.
• Department of General Medicine National Defense Medical College, Saitama, Japan.
• Medicine (Baltimore). 2024 Feb 16; 103 (7): e36782e36782.

RationaleAlthough patients with central disorders of hypersomnolence (CDH) exhibit characteristic symptoms of hypersomnia frequently, it takes 5 to 15 years from the onset for its diagnosis due to the lack of symptom recognition. Here, we present a case of idiopathic hypersomnia (IH), a CDH, wherein early diagnosis was aided by a video footage of a spontaneous sleep attack.Patient ConcernsA 21-year-old man lost consciousness while driving and experienced an accident. He had complained of excessive daytime sleepiness (EDS) over half a year. During his hospitalization for close monitoring of the loss of consciousness, an in-room surveillance camera captured a 14-minutes long spontaneous sleep attack, during which he experienced general muscle weakness and loss of consciousness without warnings or convulsions leading to a fall from the bed. There were no abnormalities in vital signs.DiagnosesThere was no significant cataplexy and less than 2 sleep-onset rapid eye movements (SOREM) in 2 sleep latency tests, with a mean sleep latency of 2.1 and 4.6 minutes. Other sleep deprivation syndromes were excluded from differential diagnosis and finally, a diagnosis of IH was confirmed according to the criteria of the Third Edition of the International Classification of Sleep Disorders. During the course of the disease, attention-deficit/hyperactive disorder (ADHD) and a gaming disorder also diagnosed.InterventionsPharmacological treatment with modafinil was administered for IH and methylphenidate for ADHD. Cognitive behavioral therapy was performed for the gaming disorder.OutcomesThe EDS improved, and sleep attacks were no longer observed. The disruption of daily life caused by the gaming disorder was also reduced.LessonsVideo recordings of sleep attacks are beneficial for identifying the cause of loss of consciousness. Home video recordings may be helpful in the early diagnosis of IH.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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