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SLEEP 2026 | The alignment between subjective and objective measures in hypersomnolence disorders
Lucie Barateau, MD, PhD, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France, discusses the importance of integrating both subjective and objective assessments when diagnosing and managing central disorders of hypersomnolence. She reviews current tools used to evaluate symptoms such as excessive daytime sleepiness and sleep inertia, emphasizes the value of patient-reported outcomes, and explains how a comprehensive approach can improve disease characterization and treatment selection. This interview took place at the 40th annual meeting of the Associated Professional Sleep Societies (APSS) in Baltimore, MD.
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Transcript
So we tried to make a review of the literature to list all the symptoms and all the tools that can be evaluated in central disorders of hypersomnolence, and also the perception of the patients. So we know a lot about disruption of nocturnal sleep, especially in narcolepsy type 1, also about sleepiness, and not so much about sleep inertia, for example, in idiopathic hypersomnia. But what we have overall is that we can summarize by saying that both subjective and objective measures are of major importance...
So we tried to make a review of the literature to list all the symptoms and all the tools that can be evaluated in central disorders of hypersomnolence, and also the perception of the patients. So we know a lot about disruption of nocturnal sleep, especially in narcolepsy type 1, also about sleepiness, and not so much about sleep inertia, for example, in idiopathic hypersomnia. But what we have overall is that we can summarize by saying that both subjective and objective measures are of major importance. Sometimes they are not aligned. But it does not mean one is better than the other. It just means that we have to keep in mind everything to make a proper diagnosis, to assess the severity of the patient, and then to propose the correct treatment, because, for example, if you have MSLT with a very short sleep latency, this is objective sleepiness. If you have the Epworth Sleepiness Scale or Narcolepsy Severity Scale with a minor score or moderate or severe score, all of this information is important to take care of the patients. So yes, we have discrepancies, but it does not mean the tests are not correct. It does not mean patients have complaints that are impossible to assess. It just means that we have a huge, a big picture of the severity of the patients, and we need to consider everything to make a proper diagnosis and treatment. And this was very well done, for example, in the Phase III results of the oveporexton study, where they assessed both objective and subjective measures and symptoms in the patients, and they could prove that the treatment was effective on all these measures. So this is how we should manage and diagnose our patients now, and this is also what has been said by the patients. So the patient’s voice is very important, and we have a lot of publications in that domain with all these symptoms reported by patients and all these prompts and all this information that we have to get from the patients.
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