Night‐time sleep and daytime sleepiness in narcolepsy

Abstract

This report describes night‐time sleep and daytime sleepiness in a large (N=530) sample of patients meeting the International Classification of Sleep Disorders criteria for diagnosis of narcolepsy. Sleep data were obtained from polysomnographic recordings on two consecutive nights. Sleepiness was assessed using the Multiple Sleep Latency Test, the Maintenance of Wakefulness Test and the Epworth Sleepiness Scale. Analysis revealed that sleep was mild to moderately disturbed on both recording nights. A first‐night effect was suggested by decreased REM latency and increased percentage REM and slow‐wave sleep on the second night. Sleepiness and sleep disturbance varied across patient subgroups created based on patient ethnicity and on the presence/absence of cataplexy, sleep apnoea, and periodic limb movements. Covariation of sleep and sleepiness measures across patients was significant but weak. Strong association was found between subgroup means of sleep and sleep disturbance measures. The findings reported here show that sleepiness and sleep disturbance vary across patient subgroups and that sleep disturbance is related to, although unable to account, for the pathological sleepiness of narcolepsy.

Correlations between subjective and objective features of nocturnal sleep and excessive diurnal sleepiness in patients with narcolepsy

“…Concerning the relation between SA and EDS, our results are similar to those in previous reports 6 , indicating that EDS severity is related with nocturnal sleep-disturbance severity in patients with narcolepsy. We found moderate correlations suggesting that increase of subjective sleepiness is related with an expected rise in nocturnal wake time and number of awakenings, and a decrease in total sleep time, sleep efficiency, and SWS, as well as in sleep onset latency.…”

“…Disturbed sleep is a significant feature in narcolepsy 6 . Nocturnal sleep disruption can be found in approximately 50% of patients with narcolepsy; most typically, the sleep maintenance insomnia symptom, an increase in the amount of sleep stage 1, and awakenings are observed.…”

“…In particular, REM latency at night was highly predictive of the magnitude of hypersomnia for patients with narcolepsy. Harsh et al 6 reported that abnormal sleep structure and sleep fragmentation are related with the EDS of patients with narcolepsy.…”

The Natural History of Health and Symptoms in Narcolepsy: A to-year Longitudinal Study

“…The low reported frequencies of both mental illness and other sleep disorders is surprising and at variance with reports in the literature, where higher rates of mental illness and other sleep disorders among people with narcolepsy are documented [14,18,19,20]. Perhaps the open-ended nature of the responses in this section on illnesses led to some under reporting.…”

“…There are reports of people with narcolepsy being more prone to also having other physical illnesses, in particular diabetes mellitus [13] and other sleep disorders [14] and it is expected that the incidence of concomitant illnesses would increase with advancing age. There are numerous reports of a higher incidence of depressed mood and depressive symptomatology in people with narcolepsy [15,16,17] but the degree of association with major clinical depression is controversial, as is the association between narcolepsy and psychiatric disorders [18,19,20].…”