# Development and Validation of a Nocturnal Sleep Signature for the Diagnosis of Idiopathic Hypersomnia

> **NIH NIH R61** · BOSTON CHILDREN'S HOSPITAL · 2024 · $785,153

## Abstract

Abstract
Idiopathic hypersomnia (IH) is a chronic, disabling central nervous system disorder of hypersomnolence that
typically begins in adolescence. Progress in understanding IH pathophysiology and identifying effective
treatments is stymied by the commonly used diagnostic test, the multiple sleep latency testing (MSLT). This
test is very reliable in classic narcolepsy but has poor validity and reliability in people with IH. In addition to this
poor clinical performance, the current diagnostic use of the MSLT also hinders clinical trials by enrollment of
clinically heterogeneous IH cohorts with more variable outcomes. Thus, there is a critical need to develop and
validate an objective IH biomarker signature to improve diagnostic accuracy. The most striking IH features
occur in the nocturnal sleep period. Most IH patients report non-restorative sleep and profound difficulty waking
from sleep in the morning despite normal to long sleep durations. In our prior work, we showed IH is
characterized by shorter (less stable) bouts of NREM 3 (N3) sleep (the most restorative sleep stage), longer
bouts of less refreshing NREM 2 (N2) sleep, long sleep times, and high sleep efficiency. These findings may
reflect proposed mechanisms of IH including heightened GABA receptor potentiation or prolonged circadian
period. As a multi-disciplinary team with expertise in modeling neurophysiological processes, biomarker
discovery, statistics, and hypersomnia disorders, we hypothesize that measures of nocturnal sleep
stability will define the IH signature and more accurately identify IH than the current MSLT method. In
the R61 grant, our objectives are to: (Aim 1) identify nocturnal sleep features of hypersomnia patients using
polysomnograms retained in the National Sleep Research Resource; (Aim 2) develop and test a sleep
biomarker signature from polysomnogram signals (IH signature) for IH diagnosis in a clinical population across
5 sites using current diagnostic criteria and cutoff scores on validated IH symptom scales as the “gold
standard” IH classification. In meeting our robust “go criteria” showing high sensitivity and specificity of our IH
signature for IH diagnosis, we will proceed with the R33 phase. In this next grant phase, we will validate the IH
signature in a separate and new clinical cohort of patients (Aim 3) and test the reliability of the IH signature
(Aim 4). Through this work, we will identify an accurate and stable biomarker signature that will provide more
accurate diagnosis of IH using nocturnal PSG testing. This will improve diagnostic certainty in the clinic and
reduce clinical heterogeneity for research, enabling study of underlying causal mechanisms and future drug
development.

## Key facts

- **NIH application ID:** 10794044
- **Project number:** 1R61NS130215-01A1
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Kiran Prasad Maski
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $785,153
- **Award type:** 1
- **Project period:** 2024-06-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10794044

## Citation

> US National Institutes of Health, RePORTER application 10794044, Development and Validation of a Nocturnal Sleep Signature for the Diagnosis of Idiopathic Hypersomnia (1R61NS130215-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10794044. Licensed CC0.

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