Purpose: We aimed to compare rapid eye movement sleep without atonia (RSWA), tonic RSWA, and phasic RSWA indices during polysomnography as a potential biomarker between narcolepsy type 1 and type 2.
Methods: Medical files, polysomnography, and multiple sleep latency tests of patients with narcolepsy were evaluated retrospectively. A total of three adolescents and 31 adult patients were included. We calculated the total number of rapid eye movement (REM) epochs with tonic and phasic activity in accordance with the American Academy of Sleep Medicine manual scoring rules, version 2.4. We defined tonic RSWA index as the ratio of total number of REM sleep stage epochs with only tonic activity to total REM sleep stage epochs, phasic RSWA index as the ratio of total number of REM sleep stage epochs with only phasic activity to total REM sleep stage epochs, and RSWA index as the ratio of total number of REM stage sleep epochs with RSWA to total REM sleep stage epochs on the polysomnography.
Results: Clinically and polysomnographically diagnosed 25 patients with narcolepsy type 1 and 9 patients with narcolepsy type 2 were included. The median age of the subjects was 30 (10, 61) and 36 (18, 64), respectively. Eleven narcolepsy type 1 patients (44%) and 4 narcolepsy type 2 patients (44.44%) were women. The RSWA index of ≥ 3% yielded a sensitivity of 76% and specificity of 88.9% (AUC = 0.77 (0.09), 95% confidence interval = 0.58 to 0.97, p = 0.01), and the tonic RSWA index of ≥ 2.2% yielded a sensitivity of 72% and specificity of 77.8% (area under the curve = 0.74 (0.1), 95% confidence interval = 0.54-0.94, p = 0.03).
Conclusions: As an electrophysiological biomarker, RSWA and tonic RSWA indices can be sensitive and specific polysomnography parameters in distinguishing narcolepsy type 1 from narcolepsy type 2.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/WNP.0000000000000688 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Very late onset narcolepsy type 1: a case report and review of the literature.
J Clin Sleep Med
December 2024
Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium.
Narcolepsy type 1 (NT1) is a clinical syndrome defined by recurrent episodes of excessive daytime sleepiness (EDS), episodes of cataplexy, hypnagogic hallucinations, and sleep paralysis. Symptoms typically manifest in the second or third decade with another small peak in the fourth decade. In this report we describe the case of a 64-year-old woman presenting with new-onset visual hallucinations as the main complaint.
View Article and Find Full Text PDFZ hypnotics in the management of narcolepsy: a case series.
J Clin Sleep Med
December 2024
Sleep Disorders & Research Center, Department of Sleep Medicine, Henry Ford Health System, Detroit, MI.
Study Objectives: Here we report our experience treating patients with narcolepsy using benzodiazepine receptor agonists (BzRA), zolpidem (Zol) or eszopiclone (Esz) taken at bedtime for both excessive daytime sleepiness (EDS) and cataplexy.
Methods: We reviewed the medical records of 53 patients diagnosed with narcolepsy, between 2002 and 2023. Twenty-three patients, 8 with type1 (NT1), 13 with type 2 (NT2) and 2 with secondary narcolepsy, were treated with BzRA's (20 Zol and 3 Esz).
Variability of excessive daytime sleepiness and cataplexy according to seasonality: A study in central disorders of hypersomnolence.
J Sleep Res
January 2025
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Seasonality of excessive daytime sleepiness has been proposed, yet no research has specifically investigated its impact on daytime sleepiness and cataplexy in central disorders of hypersomnolence. This study examined seasonal variations in daytime sleepiness and cataplexy in narcolepsy type 1, narcolepsy type 2 and idiopathic hypersomnia. Patients included in the study were on stable pharmacological treatment, and participated in sleep medicine interviews to assess diurnal sleepiness and daytime napping and completed the Epworth Sleepiness Scale to assess excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10).
View Article and Find Full Text PDFEpidemiology, patient characteristics, and treatment patterns of patients with narcolepsy in Sweden: a non-interventional study using secondary data.
Sleep Adv
December 2024
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Study Objectives: To estimate the prevalence and incidence and evaluate the treatment patterns of patients diagnosed with narcolepsy in specialist care in Sweden.
Methods: This non-interventional retrospective longitudinal study used Swedish register data from 2010 to 2020 and included patients diagnosed with narcolepsy (either type 1 or type 2), recorded in specialist outpatient and inpatient care from January 2015 to December 2019. All patients received an index date corresponding to the date of the first narcolepsy diagnosis.
Armodafinil as Monotherapy in Treating Narcolepsy with Cataplexy.
Cureus
December 2024
Internal Medicine, Guthrie Lourdes Hospital, Binghamton, USA.
In narcolepsy with cataplexy, sodium oxybate and the recently FDA-approved drug pitolisant are preferred medications. Armodafinil, a longer-acting, non-amphetamine stimulant, is often used in patients who have narcolepsy without cataplexy. It enhances alertness by increasing presynaptic dopamine transmission presynaptically, amplifying serotonin in the cerebral cortex, activating glutamatergic circuits, which may contribute to its vigilance-enhancing properties, and stimulating orexin activity.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!