Sleep-stage transitions during polysomnographic recordings as diagnostic features of type 1 narcolepsy

Abstract

Increased sleep-stage transitions notably from ≥2.5 min of W/N1 into REM are specifically diagnostic for narcolepsy independent of a nocturnal SOREMP.

Effect of sodium oxybate on disrupted nighttime sleep in patients with narcolepsy

“…in a clinical trial. Results showed that positive effects of SXB on DNS are manifested by increases in sleep consolidation and reported nocturnal sleep quality, providing support for other studies that have used different approaches for evaluating transitional rates and determining their potential utility as diagnostic features and for assessing treatment effects (Christensen et al, 2015;Pizza et al, 2015;Sorensen et al, 2013). The original trial reports characterized dose-dependent increases in the time spent in sleep Stages N2 and N3 as well as reductions in the number of nocturnal awakenings that were significant relative to placebo for the 6-and 9-g doses (Black et al, 2010).…”

“…This analysis reports on the treatment effects of SXB on both fragmented sleep and narcolepsy symptoms including nocturnal sleep quality among patients with narcolepsy with evaluable sleep stage data at baseline and during follow‐up in a clinical trial. Results showed that positive effects of SXB on DNS are manifested by increases in sleep consolidation and reported nocturnal sleep quality, providing support for other studies that have used different approaches for evaluating transitional rates and determining their potential utility as diagnostic features and for assessing treatment effects (Christensen et al ., ; Pizza et al ., ; Sorensen et al ., ).…”

Diagnostic value of sleep stage dissociation as visualized on a 2-dimensional sleep state space in human narcolepsy

“…In this study, we explored whether sleep-wake state dissociations could be used to diagnose narcolepsy using a night time PSG study alone, extending on studies of other PSG biomarkers such as SOREMS [1], sleep stage transitions [6] and power spectrum ratios [17] in the disorder. Using a combination of EEG, EOG and EMG features, we created a sleep state space that can be used to distinguish sleep stages in a 2 D-plan.…”

“…Other work [6] suggests that antidepressants and other central acting stimuli can have an effect on the results of classification. Therefore, an analysis was done on Dataset E that contained controls versus the narcoleptics receiving antidepressants and other central acting stimuli.…”

“…Because a nSOREMP is highly specific (≈ 99%) for narcolepsy but has only modest sensitivity (≈ 40 − 50%), it has been proposed that other diagnostic biomarkers should be sought within the PSG to add sensitivity, so that a nocturnal PSG alone could be used to diagnose narcolepsy without the need for a subsequent MSLT. Following on this hypothesis, sleep onset REM periods during nocturnal sleep, long periods of wakefulness within sleep, or the presence of specific EEG spectra abnormalities have been found to differentiate narcolepsy versus controls [6] [7]. Unfortunately, however, none of these new biomarkers were sufficiently predictive alone, although combining them may be helpful and has not yet been systematically tested.…”