Sleep in Human Narcolepsy Revisited with Special Reference to Prior Wakefulness Duration

Tafti, Mehdi; Villemin, Eric; Carlander, Bertrand; Besset, A; Billiard, Michel

doi:10.1093/sleep/15.4.344

Cited by 24 publications

(13 citation statements)

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“…The present results support previously reported findings concerning a clear disturbance of the nocturnal sleep pattern in patients with narcolepsy 5,7,11 . It is possible that the increased number of arousals and awakenings comprised the main causes of changes in light sleep, slow wave sleep, and REM sleep in narcolepsy, also including sleep onset latency and REM sleep latency.…”

Section: Discussionsupporting

confidence: 93%

“…For instance, an increase in SWS in patients with narcolepsy after sleep-deprivation periods (between 16 and 24 h) supports the homeostatic regulation theory of NREM sleep intensity 5 . Volk et al 21 reported an increase in nocturnal SWS after daytime sleep deprivation in patients with narcolepsy and concluded that homeostatic regulation of sleep also operates in patients with narcolepsy.…”

Section: Discussionmentioning

confidence: 67%

“…The sleep architecture (SA) of subjects with narcolepsy has been characterized by the following: (1) REM episodes at sleep onset; (2) long periods of wakefulness after sleep onset and, correspondingly, poor sleep efficiency, and (3) normal amounts of REM sleep 5 . Disturbed sleep is a significant feature in narcolepsy 6 .…”

mentioning

confidence: 99%

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

Jiménez‐Correa

Haro

González

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To determine the correlations between excessive daytime sleepiness (EDS), assessed by the Epworth sleepiness scale (ESS), and the multiple sleep latency test (MSLT) and nocturnal sleep architecture features, clinical symptoms of narcolepsy (CSN) and subjective sleep quality (SSQ) in patients with narcolepsy. Method: Twenty three untreated patients were studied and compared with a matched control group. Diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (PSG) record, and an MSLT. Results: Subjective number of awakenings was the SSQ indicator that best correlated with EDS (ESS and MSLT). Regarding clinical features, diurnal tiredness and sleep paralysis correlated with ESS values. Increase in ESS was related with decrease in total sleep time, SWS, and sleep onset latency. On the other hand, increase in MSLT was related with decrease in SWS. Conclusion: These data suggest that EDS in patients with narcolepsy could be impaired by disturbed nocturnal sleep.KEy WORDS: narcolepsy, clinical symptoms, subjective sleep quality, sleep architecture, Epworth sleepiness scale, multiple sleep latency test, excessive daytime sleepiness. Correlação entre as características objetivas e subjetivas do sono noturno e a hipersonolência diurna em pacientes narcolepticosResumo -Objetivo: Determinar as correlações entre hipersonolência, avaliada pela escala de sonolência Epworth (ESE) e o teste múltiplo de latência do sono (TMLS) com a arquitetura do sono (AS), sintomas e qualidade subjetiva do sono em pacientes narcolepticos. Método: Comparou-se um grupo de vinte e tres pacientes narcolepticos sem tratamento com grupo controle. O diagnóstico de narcolepsia foi realizado por uma entrevista clinica, polissonografia e o TMLS. Resultados: O número subjetivo de despertares foi o indicador com maior relação com a hipersonolência, o cansaço diurno e a paralisia do sono também foi correlacionados com a ESE.O aumento do índice na ESE foi correlacionado com uma diminuição do tempo total do sono, no sono de ondas lentas (SOL) e com a latência para o início do sono. O incremento na TMLS foi relacionado com diminuição do SOL. Conclusão: Os dados sugerem que a hipersonolência diurna em pacientes portadores de narcolepsia pode se correlacionar com as alterações da arquitetura do sono noturno. PALAVRAS-CHAVE: sintoma clínico de narcolepsia, qualidade subjetiva do sono, teste múltiplo de latência do sono, hipersonolência.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 67%

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

Jiménez‐Correa

Haro

González

et al. 2009

Arq. Neuro-Psiquiatr.

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“…One popular hypothesis is that individuals with narcolepsy may be more sensitive to homeostatic sleep drive as, after a period of sleep deprivation, they fall asleep faster than normal (Tafti et al, 1992a;Tafti et al, 1992b). Mice lacking orexins also tend to fall asleep very quickly after being deprived of sleep, but they recover the lost sleep at a normal rate and to the same extent as wild type mice (Mochizuki et al, 2004).…”

Section: Switches Gone Bad: the Example Of Narcolepsymentioning

confidence: 99%

Sleep State Switching

Saper

Fuller

Pedersen

et al. 2010

Neuron

1,185

1,064

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We take for granted the ability to fall asleep or to snap out of sleep into wakefulness, but these changes in behavioral state require specific switching mechanisms in the brain that allow well-defined state transitions. In this review, we examine the basic circuitry underlying the regulation of sleep and wakefulness, and discuss a theoretical framework wherein the interactions between reciprocal neuronal circuits enable relatively rapid and complete state transitions. We also review how homeostatic, circadian, and allostatic drives help regulate sleep state switching, and discuss how breakdown of the switching mechanism may contribute to sleep disorders such as narcolepsy.

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“…Narcoleptics often feel sleepy after just a few hours of wakefulness, and, after 24 hr of sleep deprivation, people with narcolepsy have shorter sleep latencies and more deep non-rapid eye movement (NREM) sleep than controls (Tafti et al, 1992a). Considered together, these observations suggest a heightened sensitivity to or a more rapid accumulation of sleep pressure in narcolepsy.…”

Section: Introductionmentioning

confidence: 99%

Behavioral State Instability in Orexin Knock-Out Mice

Mochizuki¹,

Crocker²,

Mccormack³

et al. 2004

J. Neurosci.

356

263

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Narcolepsy is caused by a lack of orexin (hypocretin), but the physiologic process that underlies the sleepiness of narcolepsy is unknown. Using orexin knock-out (KO) mice as a model of narcolepsy, we critically tested the three leading hypotheses: poor circadian control of sleep and wakefulness, inadequate activation of arousal regions, or abnormal sleep homeostasis. Compared with wild-type (WT) littermates, orexin KO mice had essentially normal amounts of sleep and wake, but wake and non-rapid eye movement (NREM) bouts were very brief, with many more transitions between all behavioral states. In constant darkness, orexin KO mice had normal amplitude and timing of sleep-wake rhythms, providing no evidence for disordered circadian control. When placed in a new, clean cage, both groups of mice remained awake for ϳ45 min, demonstrating that, even in the absence of orexin, fundamental arousal regions can be engaged to produce sustained wakefulness. After depriving mice of sleep for 2-8 hr, orexin KO mice recovered their NREM and rapid eye movement sleep deficits at comparable rates and to the same extent as WT mice, with similar increases in EEG delta power, suggesting that their homeostatic control of sleep is normal. These experiments demonstrate that the fragmented wakefulness of orexin deficiency is not a consequence of abnormal sleep homeostasis, poor circadian control, or defective fundamental arousal systems. Instead, the fragmented behavior of orexin KO mice may be best described as behavioral state instability, with apparently low thresholds to transition between states.

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Sleep in Human Narcolepsy Revisited with Special Reference to Prior Wakefulness Duration

Cited by 24 publications

References 0 publications

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

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

Sleep State Switching

Behavioral State Instability in Orexin Knock-Out Mice

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