The Swiss Primary Hypersomnolence and Narcolepsy Cohort study (SPHYNCS): Study protocol for a prospective, multicentre cohort observational study.

Abstract

Narcolepsy type 1 (NT1) is a disorder with well-established markers and a suspected autoimmune aetiology. Conversely, the narcoleptic borderland (NBL) disorders, including narcolepsy type 2, idiopathic hypersomnia, insufficient sleep syndrome and hypersomnia associated with a psychiatric disorder, lack well-defined markers and remain controversial in terms of aetiology, diagnosis and management. The Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (SPHYNCS) is a comprehensive multicentre cohort study, which will investigate the clinical picture, pathophysiology and long-term course of NT1 and the NBL. The primary aim is to validate new and reappraise well-known markers for the characterization of the NBL, facilitating the diagnostic process. Seven Swiss sleep centres, belonging to the Swiss Narcolepsy Network (SNaNe), joined the study and will prospectively enrol over 500 patients with recent onset of excessive daytime sleepiness (EDS), hypersomnia or a suspected central disorder of hypersomnolence (CDH) during a 3-year recruitment phase. Healthy controls and patients with EDS due to severe sleep-disordered breathing, improving after therapy, will represent two control groups of over 50 patients each. Clinical and electrophysiological (polysomnography, multiple sleep latency test, maintenance of wakefulness test) information, and information on psychomotor vigilance and a sustained attention to response task, actigraphy and wearable devices (long-term monitoring), and responses to questionnaires will be collected at baseline and after 6, 12, 24 and 36 months. Potential disease markers will be searched for in blood, cerebrospinal fluid and stool. Analyses will include quantitative hypocretin measurements, proteomics/peptidomics, and immunological, genetic and microbiota studies. SPHYNCS will increase our understanding of CDH and the relationship between NT1 and the NBL. The identification of new disease markers is expected to lead to better and earlier diagnosis, better prognosis and personalized management of CDH.

• Authors: Anelia Dietmann, Elena Wenz, Julia van der Meer, Maya Ringli, Jan D Warncke, Ellen Edwards, Markus H Schmidt, Corrado A Bernasconi, Arto Nirkko, Mathias Strub, Silvia Miano, Mauro Manconi, Jens Acker, Sigrid von Manitius, Christian R Baumann, Philip O Valko, Bahtiyar Yilmaz, Andreas-David Brunner, Athina Tzovara, Zhongxing Zhang, Carlo R Largiadèr, Mehdi Tafti, Daniela Latorre, Federica Sallusto, Ramin Khatami, Claudio L A Bassetti
• Journal: Journal of sleep research (J Sleep Res) Vol. 30 Issue 5 Pg. e13296 (10 2021) ISSN: 1365-2869 [Electronic] England
• PMID: 33813771 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

Topics

• Cohort Studies
• Disorders of Excessive Somnolence (diagnosis, etiology, therapy)
• Humans
• Multicenter Studies as Topic
• Narcolepsy (diagnosis, therapy)
• Observational Studies as Topic
• Prospective Studies
• Switzerland