Polysomnographic findings in men over 55 years of age with narcolepsy type 1
Authors:
P. Kovalská; J. Nepožitek; D. Kemlink; S. Dostálová; P. Peřinová; K. Šonka
Authors‘ workplace:
Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze
Published in:
Cesk Slov Neurol N 2023; 86(6): 397-402
Category:
Original Paper
doi:
https://doi.org/10.48095/cccsnn2023397
Overview
Aim: The aim of this study was to compare polysomnographic parameters of nocturnal sleep in male patients with narcolepsy type 1 aged over 55 years with age-matched controls. Patients and methods: The cohort consisted of 17 men (mean age 66.1 ± 8.3 years) with narcolepsy type 1 whose previously obtained polysomnographic records were compared in terms of basic parameters of sleep macrostructure and its basic disorders with polysomnographic records of age-paired men (mean 65.0 ± 6.6 years). Results: Compared to controls, males with narcolepsy type 1 had a significantly lower percentage of NREM 3 (8 vs. 26%; P = 0.003) and REM sleep stages (12 vs. 19%; P = 0.01) and a higher presentation of NREM 1 stages (17 vs. 10%; P = 0.01). The representation of wakefulness (29 vs. 26%) and NREM 2 stages (33 vs. 30%), mean sleep latency, REM sleep latency, sleep duration, and sleep efficiency (67 ± 14 vs. 72 ± 17%) did not differ between groups. The incidence of obstructive sleep apneas was comparable (apnea-hypopnea index 25 ± 26 vs. 23 ± 18). The index of periodic limb movements during sleep was significantly higher (46 ± 31 vs. 16 ± 22; P = 0.02) and the presence of REM sleep without atonia (47 vs. 8%; P = 0.02) was more frequent in the narcoleptic group. Conclusion: Men with narcolepsy type 1 have significantly less NREM 3 and REM stages and more NREM 1 stages.
Keywords:
obstructive sleep apnea – polysomnography – sleep disorders – narcolepsy with cataplexy – sleep macrostructure
Sources
1. Sateria MJ. International classification of sleep disorders – third edition: highlights and modifications. Chest 2014; 146 (5): 1387–1394. doi: 10.1378/chest.14-0970.
2. Bassetti CLA, Adamantidis A, Burdakov D et al. Narcolepsy – clinical spectrum, aetiopathophysiology, diagnosis and treatment. Nat Rev Neurol 2019; 15 (9): 519–539. doi: 10.1038/s41582-019-0226-9.
3. Yoss RE, Daly DD. Narcolepsy. Med Clin North Am 1960; 44: 953–968. doi: 10.1016/s0025-7125 (16) 33982-7.
4. Roth B. Narcolepsy and hypersomnia: review and classification of 642 personally observed cases. Schweiz Arch Neurol Neurochir Psychiatr 1976; 119 (1): 31–41.
5. Luca G, Haba-Rubio J, Dauvilliers Y et al. Clinical, polysomnographic and genome-wide association analyses of narcolepsy with cataplexy: a European Narcolepsy Network study. J Sleep Res 2013; 22 (5): 482–495. doi: 10.1111/jsr.12044.
6. Andlauer O, Moore H, Jouhier L et al. Nocturnal rapid eye movement sleep latency for identifying patients with narcolepsy/hypocretin deficiency. JAMA Neurol 2013; 70 (7): 891–902. doi: 10.1001/jamaneurol.2013.1589.
7. Mukai J, Uchida S, Miyazaki S et al. Spectral analysis of all-night human sleep EEG in narcoleptic patients and normal subjects. J Sleep Res 2003; 12 (1): 63–71. doi: 10.1046/j.1365-2869.2003.00331.x.
8. Dauvilliers Y, Rompre S, Gagnon JF et al. REM sleep characteristics in narcolepsy and REM sleep behavior disorder. Sleep 2007; 30 (7): 844–849. doi: 10.1093/sleep/30.7.844.
9. Khatami R, Landolt HP, Achermann P et al. Insufficient non-REM sleep intensity in narcolepsy-cataplexy. Sleep 2007; 30 (8): 980–989. doi: 10.1093/sleep/30.8.980.
10. Khatami R, Landolt HP, Achermann P et al. Challenging sleep homeostasis in narcolepsy-cataplexy: implications for non-REM and REM sleep regulation. Sleep 2008; 31 (6): 859–867. doi: 10.1093/sleep/31.6.859.
11. Pizza F, Vandi S, Iloti M et al. Nocturnal sleep dynamics identify narcolepsy type 1. Sleep 2015; 38 (8): 1277–1284. doi: 10.5665/sleep.4908.
12. Walacik-Ufnal E, Piotrowska AJ, Wolynczyk-Gmaj D et al. Narcolepsy type 1 and hypersomnia associated with a psychiatric disorder show different slow wave activity dynamics. Acta Neurobiol Exp (Wars) 2017; 77 (2): 147–156. doi: 10.21307/ane-2017-047.
13. Pataka AD, Frangulyan RR, Mackay TW et al. Narcolepsy and sleep-disordered breathing. Eur J Neurol 2012; 19 (5): 696–702. doi: 10.1111/j.1468-1331.2011.03610.x.
14. Dauvilliers Y, Pennestri MH, Petit D et al. Periodic leg movements during sleep and wakefulness in narcolepsy. J Sleep Res 2007; 16 (3): 333–339. doi: 10.1111/j.1365-2869.2007.00601.x.
15. Berry RB, Brooks R, Gamaldo CE et al. The AASM manual for the scoring of sleep and associated events. [online]. Available from: https: //aasm.org/resources/pdf/scoring-manual-preface.pdf.
16. Antelmi E, Pizza F, Franceschini C et al. REM sleep behavior disorder in narcolepsy: a secondary form or an intrinsic feature? Sleep Med Rev 2020; 50: 101254. doi: 10.1016/j.smrv.2019.101254.
17. Luca G, Haba Rubio J, Andries D et al. Age and gender variations of sleep in subjects without sleep disorders. Ann Med 2015; 47 (6): 482–491. doi: 10.3109/07853890. 2015.1074271.
18. Ohayon MM, Carskadon MA, Guilleminault C et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004; 27 (7): 1255–1273. doi: 10.1093/sleep/27.7.1255.
19. Punjabi NM, Newman AB, Young TB et al. Sleep-disordered breathing and cardiovascular disease: an outcome-based definition of hypopneas. Am J Respir Crit Care Med 2008; 177 (10): 1150–1155. doi: 10.1164/rccm.200712-1884OC.
20. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165 (9): 1217–1239. doi: 10.1164/rccm.2109080.
21. Duran J, Esnaola S, Rubio R et al. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 2001; 163 (3 Pt 1): 685–689. doi: 10.1164/ajrccm.163.3.2005065.
22. Haba-Rubio J, Frauscher B, Marques-Vidal P et al. Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population. Sleep 2018; 41 (2): zsx197. doi: 10.1093/sleep/zsx197.
23. Lividini A, Pizza F, Filardi M et al. Narcolepsy type 1 features across the life span: age impact on clinical and polysomnographic phenotype. J Clin Sleep Med 2021; 17 (7): 1363–1370. doi: 10.5664/jcsm.9198.
24. Kryger MH, Roth T, Dement WC. Principles and practice of sleep medicine. Philadelphia: Elsevier 2017.
25. Sasai-Sakuma T, Kinoshita A, Inoue Y. Polysomnographic assessment of sleep comorbidities in drug-naive narcolepsy-spectrum disorders – a Japanese cross-sectional study. PLoS One 2015; 10 (8): e0136988. doi: 10.1371/journal.pone.0136988.
26. Pizza F, Tartarotti S, Poryazova R et al. Sleep-disordered breathing and periodic limb movements in narcolepsy with cataplexy: a systematic analysis of 35 consecutive patients. Eur Neurol 2013; 70 (1–2): 22–26. doi: 10.1159/000348719.
27. Wang Z, Wu H, Stone WS et al. Body weight and basal metabolic rate in childhood narcolepsy: a longitudinal study. Sleep Med 2016; 25: 139–144. doi: 10.1016/ j.sleep.2016.06.019.
28. Kovalska P, Kemlink D, Topinkova E et al. Higher body mass index in narcolepsy with cataplexy: life-long experience. Sleep Med 2017; 32: 277. doi: 10.1016/ j.sleep.2016.11.010.
29. Zhang Y, Ren R, Yang L et al. Polysomnographic nighttime features of narcolepsy: a systematic review and meta-analysis. Sleep Med Rev 2021; 58: 101488. doi: 10.1016/j.smrv.2021.101488.
30. Vaz Fragoso CA, Van Ness PH, Araujo KL et al. Age-related differences in sleep-wake symptoms of adults undergoing polysomnography. J Am Geriatr Soc 2015; 63 (9): 1845–1851. doi: 10.1111/jgs.13632.
31. Nevsimalova S, Pisko J, Buskova J et al. Narcolepsy: clinical differences and association with other sleep disorders in different age groups. J Neurol 2013; 260 (3): 767–775. doi: 10.1007/s00415-012-6702-4.
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Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
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