Disrupted Nighttime Sleep in Narcolepsy

Roth, Thomas; Dauvilliers, Yves; Mignot, Emmanuel; Montplaisir, Jacques; Paul, Josh; Swick, Todd J.; Zee, Phyllis

doi:10.5664/jcsm.3004

Cited by 172 publications

(97 citation statements)

References 45 publications

(99 reference statements)

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“…This indicates a decrease of slow-wave sleep and an increase of wakefulness and light sleep in our N1 group. Our results are in line with previous studies on disturbed nocturnal sleep in narcolepsy (Overeem et al 2001, Roth et al 2013, American Academy of Sleep Medicine 2014). The HPD group had normal, undisturbed nocturnal sleep, high sleep efficiency, normal NREM and REM sleep proportions in comparison to controls.…”

Section: The Night Sleep Parameterssupporting

confidence: 93%

“…In narcolepsy, PSG studies consistently show a disrupted night sleep with frequent brief awakenings, arousals and an increased amount of stage 1 sleep (Overeem et al 2001, Roth et al 2013, American Academy of Sleep Medicine 2014). The destabilization of hypothalamic control of sleep and wakefulness results in frequent, undesired sleep-wake state transitions (Saper et al 2001, Sorensen et al 2013).…”

Section: Introductionmentioning

confidence: 99%

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Narcolepsy type 1 and hypersomnia associated with a psychiatric disorder show different slow wave activity dynamics

Walacik-Ufnal¹,

Piotrowska²,

Wołyńczyk-Gmaj³

et al. 2017

Acta Neurobiologiae Experimentalis

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The aim of the study was to compare electrophysiological parameters of night sleep in narcolepsy type 1 and hypersomnia associated with a psychiatric disorder. Forty-four patients: 15 with narcolepsy type 1, 14 with hypersomnia associated with a psychiatric disorder and 15 age-and sex-matched controls participated in the study. The study subjects filled in the Athens Insomnia Scale (AIS) and the Beck Depression Inventory (BDI). The severity of daytime sleepiness was quantified subjectively using the Epworth Sleepiness Scale (ESS) and the Stanford Sleepiness Scale (SSS), and objectively using the Multiple Sleep Latency Test (MSLT). All subjects underwent polysomnography (PSG) on the two consecutive nights. The data from the second night was analysed. The slow wave activity (SWA, 1-4 Hz) was calculated for the three consecutive sleep cycles, and topographic delta power maps were plotted. In contrast to narcoleptics, psychiatric hypersomniacs had undisturbed nocturnal sleep, high sleep efficiency, normal non-rapid eye movement (NREM) and rapid eye movement (REM) sleep proportions, normal REM latency and sleep latencies on MSLT and PSG. The subjective and objective sleepiness was significantly higher in narcolepsy group than in psychiatric hypersomnia group. In all the study groups SWA was the most prominent in frontal areas, while the greatest between-group differences were found in the central areas. There were significant differences between the groups in SWA in the second NREM episode. The highest SWA was observed in the hypersomnia group, while the lowest in the narcolepsy group. Psychiatric hypersomniacs and controls did not differ in the SWA exponential decline over consecutive NREM episodes, whereas narcoleptics exhibited a steeper dissipation of sleep pressure from the first to the second NREM episode. In conclusion, narcolepsy type1 and hypersomnia associated with psychiatric disorder differ in the SWA dynamics.Narcoleptics presented with the altered dynamics of sleep homeostasis, whereas psychiatric hypersomniacs showed normal nocturnal sleep and normal sleep homeostasis.

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Section: The Night Sleep Parameterssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Narcolepsy type 1 and hypersomnia associated with a psychiatric disorder show different slow wave activity dynamics

Walacik-Ufnal¹,

Piotrowska²,

Wołyńczyk-Gmaj³

et al. 2017

Acta Neurobiologiae Experimentalis

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“…This sleep pattern is best characterized as frequent, brief nightly awakenings and associated poor sleep quality [45]. On polysomnography, these frequent awakening/arousals occur after sleep onset, more in stage 1 NREM sleep, and there are more frequent shifts to stage 1 NREM sleep or wake from deeper sleep stages [45]. This pattern of sleep fragmentation with high number of brief wakings has also been noted among children with narcolepsy and is a distinguishing feature from other hypersomnia conditions [46].…”

Section: Disrupted Nighttime Sleepmentioning

confidence: 95%

Section: Disrupted Nighttime Sleepmentioning

confidence: 99%

Beyond Daytime Sleepiness: Medical, Behavioral, Psychiatric, and Sleep Co-morbid Conditions Associated with Pediatric Narcolepsy

Maski

Heroux

2016

Curr Sleep Medicine Rep

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Pediatric narcolepsy can be challenging to diagnose and manage given a broad range of co-morbidities only recently described in the literature. These co-morbidities are broad in scope and span medical, psychiatric, and sleep disorders. Such associated conditions highlight potential novel effects of hypocretin deficiency on metabolic and neural functioning. Clinically, medication treatments for narcolepsy have the potential to alter co-morbid symptoms for better or worse and may guide individual treatment plans. Furthermore, sleep physicians may need to ally with other health care providers in endocrinology and psychiatry to optimize the care of pediatric patients with narcolepsy.

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“…1 It is clinically characterized by a symptom pentad that includes excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnopompic/hypnagogic hallucinations, and disrupted nighttime sleep. 2,3 The prevalence of narcolepsy with cataplexy (narcolepsy/cataplexy) is estimated to be 0.03% to 0.05% of the general population. [4][5][6] The onset of narcolepsy symptoms most often occurs in adolescence, although approximately one-third of patients experience initial symptoms in adulthood.…”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Measures of Narcolepsy: The Need for Better Assessment

Kallweit

Schmidt²,

Bassetti

2017

Journal of Clinical Sleep Medicine

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Study Objectives: Narcolepsy, a chronic disorder of the central nervous system, is clinically characterized by a symptom pentad that includes excessive daytime sleepiness, cataplexy, sleep paralysis, hypnopompic/hypnagogic hallucinations, and disrupted nighttime sleep. Ideally, screening and diagnosis instruments that assist physicians in evaluating a patient for type 1 or type 2 narcolepsy would be brief, easy for patients to understand and physicians to score, and would identify or rule out the need for electrophysiological testing. Methods: A search of the literature was conducted to review patient-reported measures used for the assessment of narcolepsy, mainly in clinical trials, with the goal of summarizing existing scales and identifying areas that may require additional screening questions and clinical practice scales. Results: Of the seven scales reviewed, the Epworth Sleepiness Scale continues to be an important outcome measure to screen adults for excessive daytime sleepiness, which may be associated with narcolepsy. Several narcolepsy-specific scales have demonstrated utility, such as the Ullanlinna Narcolepsy Scale, Swiss Narcolepsy Scale, and Narcolepsy Symptom Assessment Questionnaire, but further validation is required. Conclusions: Although the narcolepsy-specific scales currently in use may identify type 1 narcolepsy, there are no validated questionnaires to identify type 2 narcolepsy. Thus, there remains a need for short, easily understood, and well-validated instruments that can be readily used in clinical practice to distinguish narcolepsy subtypes, as well as other hypersomnias, and for assessing symptoms of these conditions during treatment. Keywords: cataplexy, narcolepsy, narcolepsy scales, patient-reported measures Citation: Kallweit U, Schmidt M, Bassetti CL. Patient-reported measures of narcolepsy: the need for better assessment.

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Disrupted Nighttime Sleep in Narcolepsy

Abstract: Among patients with narcolepsy, disrupted nighttime sleep (DNS) is a common complaint and frequent fi nding on polysomnographic (PSG) testing, and it is referred to in the contemporary literature as a disease-related symptom. Patients

Cited by 172 publications

References 45 publications

Narcolepsy type 1 and hypersomnia associated with a psychiatric disorder show different slow wave activity dynamics

Narcolepsy type 1 and hypersomnia associated with a psychiatric disorder show different slow wave activity dynamics

Beyond Daytime Sleepiness: Medical, Behavioral, Psychiatric, and Sleep Co-morbid Conditions Associated with Pediatric Narcolepsy

Patient-Reported Measures of Narcolepsy: The Need for Better Assessment

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