Narcolepsy/cataplexy. IV: Diagnostic value of daytime nap recordings

Abstract

Sleep and wakefulness patterns in daytime naps of 50 patients with narcolepsy/cataplexy were compared with those of 50 controls. Each subject was monitored polygraphically during 2 one-hour nap periods. A sleep-onset REM period in either of the 2 daytime naps was observed to have a higher diagnostic sensitivity (78%) than an abnormally shortened sleep latency (68%). However, the specificities of a sleep-onset REM period (88%) or abnormally shortened sleep latency (90%) were quite similar. When the occurrence of either a sleep-onset REM period or a shortened sleep latency was evaluated in either of the two naps, the overall sensitivity was increased to 84% while the specificity was decreased only to 80%. The limitations of and indications for the use of testing for sleep and REM latencies in the diagnosis of narcolepsy in clinical practice are discussed.

Episodic Cluster Headache and Narcolepsy: A Case Report

“…Polysomnography and multiple sleep latency tests serve to discard other sleep alterations and confirm the diagnosis of the disease. Short latency sleep (SLS) and sleep onset REM (SOREM) are typically seen during both nocturnal and diurnal sleep in narcoleptics and narcolepsy is considered a REM sleep disorder (1,2,6,7).…”

Episodic Cluster Headache and Narcolepsy: A Case Report

“…Polysomnography and multiple sleep latency tests serve to discard other sleep alterations and confirm the diagnosis of the disease. Short latency sleep (SLS) and sleep onset REM (SOREM) are typically seen during both nocturnal and diurnal sleep in narcoleptics and narcolepsy is considered a REM sleep disorder (1,2,6,7).…”

Chronic fatigue syndrome and fibromyalgia in diagnosed sleep disorders: a further test of the ‘unitary’ hypothesis

“…The next morning, subjects were evaluated by the sleep specialists of the Sleep Research and Treatment Center and were diagnosed with primary sleep disorder`(s) if they met International Classification of Sleep Disorders criteria [ 25 ]. Then, patients, who by history and/or PSG had evidence of having hypersomnias of central origin (either idiopathic hypersomnia or narcolepsy), underwent two 60 min daytime naps at approximately 9:00 AM and 12:30 PM [ 26 ]; this protocol provides a quantitative assessment of pathological diurnal sleepiness and has been suggested as an alternative to the Multiple Sleep Latency Test in the evaluation of patients with these disorders [ 27 ].…”

Evaluation and Diagnosis of Sleep Disorders Patients

“…Multiple daytime nap recordings may be a useful diagnostic adjunct by detecting the sleep-onset REM periods and/or extremely short sleep latencies found in n a r c o l e p t i c~.~~,~~ A sleep latency of less than 5 minutes on at least two of five 20-minute opportunities to sleep between 10:OO a.m. and 6:00 p.m. has been proposed as a diagnostic indicator of narc o l e p~~.~~ An abnormally short sleep latency or a REM onset of less than 10 minutes on either of two 1-hour daytime naps was shown recently to have a diagnostic sensitivity of 84% and a specificity of 80 % . 49 It is important and relatively easy to differentiate between narcolepsy and hypersomnia secondary to depression.' This type of hypersomnia is characterized by daytime sleep episodes of relatively long duration without auxiliary symptoms, prolonged nocturnal sleep, and depressive symptoms.…”

Episodic Cluster Headache and Narcolepsy: A Case Report

“…Polysomnography and multiple sleep latency tests serve to discard other sleep alterations and confirm the diagnosis of the disease. Short latency sleep (SLS) and sleep onset REM (SOREM) are typically seen during both nocturnal and diurnal sleep in narcoleptics and narcolepsy is considered a REM sleep disorder (1,2,6,7).…”

Chronic fatigue syndrome and fibromyalgia in diagnosed sleep disorders: a further test of the ‘unitary’ hypothesis

“…The next morning, subjects were evaluated by the sleep specialists of the Sleep Research and Treatment Center and were diagnosed with primary sleep disorder`(s) if they met International Classification of Sleep Disorders criteria [ 25 ]. Then, patients, who by history and/or PSG had evidence of having hypersomnias of central origin (either idiopathic hypersomnia or narcolepsy), underwent two 60 min daytime naps at approximately 9:00 AM and 12:30 PM [ 26 ]; this protocol provides a quantitative assessment of pathological diurnal sleepiness and has been suggested as an alternative to the Multiple Sleep Latency Test in the evaluation of patients with these disorders [ 27 ].…”

Evaluation and Diagnosis of Sleep Disorders Patients

“…Multiple daytime nap recordings may be a useful diagnostic adjunct by detecting the sleep-onset REM periods and/or extremely short sleep latencies found in n a r c o l e p t i c~.~~,~~ A sleep latency of less than 5 minutes on at least two of five 20-minute opportunities to sleep between 10:OO a.m. and 6:00 p.m. has been proposed as a diagnostic indicator of narc o l e p~~.~~ An abnormally short sleep latency or a REM onset of less than 10 minutes on either of two 1-hour daytime naps was shown recently to have a diagnostic sensitivity of 84% and a specificity of 80 % . 49 It is important and relatively easy to differentiate between narcolepsy and hypersomnia secondary to depression.' This type of hypersomnia is characterized by daytime sleep episodes of relatively long duration without auxiliary symptoms, prolonged nocturnal sleep, and depressive symptoms.…”

Episodic Cluster Headache and Narcolepsy: A Case Report

“…Polysomnography and multiple sleep latency tests serve to discard other sleep alterations and confirm the diagnosis of the disease. Short latency sleep (SLS) and sleep onset REM (SOREM) are typically seen during both nocturnal and diurnal sleep in narcoleptics and narcolepsy is considered a REM sleep disorder (1,2,6,7).…”

Chronic fatigue syndrome and fibromyalgia in diagnosed sleep disorders: a further test of the ‘unitary’ hypothesis

“…The next morning, subjects were evaluated by the sleep specialists of the Sleep Research and Treatment Center and were diagnosed with primary sleep disorder`(s) if they met International Classification of Sleep Disorders criteria [ 25 ]. Then, patients, who by history and/or PSG had evidence of having hypersomnias of central origin (either idiopathic hypersomnia or narcolepsy), underwent two 60 min daytime naps at approximately 9:00 AM and 12:30 PM [ 26 ]; this protocol provides a quantitative assessment of pathological diurnal sleepiness and has been suggested as an alternative to the Multiple Sleep Latency Test in the evaluation of patients with these disorders [ 27 ].…”

Evaluation and Diagnosis of Sleep Disorders Patients

“…Multiple daytime nap recordings may be a useful diagnostic adjunct by detecting the sleep-onset REM periods and/or extremely short sleep latencies found in n a r c o l e p t i c~.~~,~~ A sleep latency of less than 5 minutes on at least two of five 20-minute opportunities to sleep between 10:OO a.m. and 6:00 p.m. has been proposed as a diagnostic indicator of narc o l e p~~.~~ An abnormally short sleep latency or a REM onset of less than 10 minutes on either of two 1-hour daytime naps was shown recently to have a diagnostic sensitivity of 84% and a specificity of 80 % . 49 It is important and relatively easy to differentiate between narcolepsy and hypersomnia secondary to depression.' This type of hypersomnia is characterized by daytime sleep episodes of relatively long duration without auxiliary symptoms, prolonged nocturnal sleep, and depressive symptoms.…”