OBJECTIVES: To compare cardiovascular comorbidities of patients diagnosed with idiopathic hypersomnia (IH) versus matched non-IH controls.

METHODS: MarketScan^® administrative claims between December 2013 and February 2020 were analyzed. Eligible patients were aged ≥18 years upon cohort entry and had 365 days of continuous medical coverage (gaps ≤30 days allowed) before and after cohort entry. IH cases entered the cohort upon their earliest medical claim containing an IH diagnosis code in any position and had no history of cataplexy. Non-IH controls were matched 5:1 to patients with IH on age, sex, region, payer type, and cohort entry date. Prevalence estimates of cardiovascular conditions during the 2-year analysis period were compared between cohorts using logistic regression. Differences were reported as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Final cohorts included 11,428 and 57,138 patients with IH and non-IH controls, respectively. Approximately two-thirds of the sample was female (65.0%), the majority was commercially insured (75.0%), and the median age was 45 years. Compared with non-IH controls, patients with IH experienced significantly higher prevalence of cardiovascular disease (OR: 2.24 [CI: 2.12-2.36]), stroke (OR: 2.18 [CI: 1.97-2.42]), major adverse cardiovascular event (OR: 2.15 [CI: 1.95-2.37]), hypertension diagnosis or use of antihypertensives (OR: 2.04 [CI: 1.95-2.13]), heart failure (OR: 2.02 [CI: 1.80-2.26]), atrial fibrillation (OR: 1.95 [CI: 1.70-2.25]), myocardial infarction (OR: 1.76 [CI: 1.44-2.14]), cardiac arrest (OR: 1.59 [CI: 1.00-2.45]), and coronary revascularization (OR: 1.40 [CI: 1.00-1.93]).

CONCLUSIONS: As evidenced by these results, patients diagnosed with IH experience a significantly greater burden of a spectrum of cardiovascular illnesses, including chronic and acute cardiovascular events. These findings are consistent with observational studies on patients diagnosed with other central hypersomnolence disorders. Clinicians should carefully monitor the cardiovascular health of their patients with IH and consider therapies that effectively treat IH symptoms while avoiding further cardiovascular risk.