Workplace Implications of Idiopathic Hypersomnia in the Setting of Occupational Sleep Medicine: A Case Report and Literature Review

Idiopathic hypersomnia (IH) manifests with excessive daytime sleepiness (EDS), cognitive and autonomic symptoms, debilitating sleep inertia, difficulty awakening, prolonged sleep duration, and non-restorative sleep. Here, we present a case with IH who was a shift worker in an automobile factory. Workplace implications and fitness for work in safety-sensitive jobs are especially important for patients with hypersomnolence, because rates of accidents increase in these situations.

The patient was a 34-year-old man referred to Baharloo Sleep Clinic, Tehran, Iran, because of EDS. He was a shift worker in an automobile factory. The subject underwent multiple sleep latency test (MSLT) after overnight polysomnography (PSG). He had no sleep onset rapid eye movement (REM) periods in MSLT and the mean sleep latency (MSL) was 5.75 minutes. According to PSG and MSLT report, the diagnosis of narcolepsy was ruled out. According to his sleep log, the patient slept more than 11 hours per 24 hours and had MSL lower than eight minutes. Our patient used modafinil for improvement of his symptoms and he was unfit for working in night shifts.

Here, we reported a case of IH. Attention to past medical history, occupational history, sleep log or actigraphy, PSG, and MSLT findings is very helpful for diagnosis and confirmation of IH. Pre-employment and periodic evaluation of sleepiness, accident analysis, and tracking in an integrative sleepiness or fatigue management system would be very useful.