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Polysomnographic Assessment of Sleep Comorbidities in Drug-Naïve Narcolepsy-Spectrum Disorders--A Japanese Cross-Sectional Study.

Sasai-Sakuma T, Kinoshita A, Inoue Y - PLoS ONE (2015)

Bottom Line: A total of 158 consecutive drug naïve patients with narcolepsy with cataplexy, 295 patients with narcolepsy without cataplexy and 395 patients with idiopathic hypersomnia without long sleep time were enrolled.They had more severe periodic limb movements during sleep especially during rapid eye movement sleep and higher percentages of rapid eye movement sleep without atonia than the other two patient groups.In the present large sample study, Japanese drug naïve patients with narcolepsy with cataplexy showed the highest comorbidity rates of periodic limb movements during sleep, polysomnographically diagnosable rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia among those with the other narcolepsy-spectrum disorders; the rates were lower than those for Western patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan; Department of Life Sciences and Bio-informatics, Division of Biomedical Laboratory Sciences, Graduate School of Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

ABSTRACT
This is a large cross-sectional study which aimed to investigate comorbidity rate, degree of sleep-related breathing disorder, polysomnigraphically diagnosible rapid eye movement sleep behavior disorder/rapid eye movement sleep without atonia and periodic limb movements during sleep in Japanese drug-naïve patients with narcolepsy-spectrum disorders. A total of 158 consecutive drug naïve patients with narcolepsy with cataplexy, 295 patients with narcolepsy without cataplexy and 395 patients with idiopathic hypersomnia without long sleep time were enrolled. From retrospectively analyzed data of nocturnal polysomnography and multiple sleep latency test, higher rates of periodic limb movements during sleep (> = 15 h(-1)) (10.2%) and polysomnographically diagnosable rapid eye movement sleep behavior disorder (1.9%) were found in patients with narcolepsy with cataplexy. They had more severe periodic limb movements during sleep especially during rapid eye movement sleep and higher percentages of rapid eye movement sleep without atonia than the other two patient groups. In the present large sample study, Japanese drug naïve patients with narcolepsy with cataplexy showed the highest comorbidity rates of periodic limb movements during sleep, polysomnographically diagnosable rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia among those with the other narcolepsy-spectrum disorders; the rates were lower than those for Western patients.

No MeSH data available.


Related in: MedlinePlus

Comparisons of AHI, PLMS index and amount of RWA among the three patient groups.AHI, apnea hypopnea index; PLMS, periodic limb movements during sleep; RWA, rapid eye movement (REM) sleep without atonia; NA, narcolepsy; CA, cataplexy; IHS w/o LST, idiopathic hypersomnia without long sleep time; NREM, non-REM; EMG, electromyogram.
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pone.0136988.g001: Comparisons of AHI, PLMS index and amount of RWA among the three patient groups.AHI, apnea hypopnea index; PLMS, periodic limb movements during sleep; RWA, rapid eye movement (REM) sleep without atonia; NA, narcolepsy; CA, cataplexy; IHS w/o LST, idiopathic hypersomnia without long sleep time; NREM, non-REM; EMG, electromyogram.

Mentions: Fig 1a–1f presents the apnea–hypopnea index (AHI), PLMS index and percentages of phasic and tonic EMG activity in NA-CA, NA w/o CA, and IHS w/o LST. No differences were found in the apnea–hypopnea index among the three patient groups (mean±standard deviation was 3.3±4.5 h-1 in NA-CA, 2.7±3.5 h-1 in NA w/o CA and 3.8±7.2 h-1 in IHS w/o LST). Patients with NA-CA had higher PLMS index during total sleep than those with NA w/o CA and IHS w/o LST (χ2 = 19.692, df = 2, P <.001; 5.6±14.4 h-1 in NA-CA, 2.0±6.4 h-1 in NA w/o CA and 3.0±6.4 h-1 in IHS w/o LST). They also had higher PLMS index during REM sleep than those with IHS w/o LST (χ2 = 16.489, df = 2, P <.001; 7.0±14.5 h-1 in NA-CA, 4.5±9.3 h-1 in NA w/o CA and 2.7±6.9 h-1 in IHS w/o LST). In contrast, no differences were found in the PLMS index during NREM sleep among the three patient groups (14.2±19.9 h-1 in NA-CA, 7.3±15.5 h-1 in NA w/o CA and 11.7±20.1 h-1 in IHS w/o LST). Regarding RWA, patients with NA-CA had higher tonic EMG activity than those with IHS w/o LST (χ2 = 6.665, df = 2, P = .036; 2.8±2.8% in NA-CA, 1.9±1.9% in NA w/o CA and 1.1±0.9% in IHS w/o LST). The phasic EMG activity showed no differences among the three groups (5.6±5.5% in NA-CA, 4.4±4.6% in NA w/o CA and 2.7±3.3% in IHS w/o LST) (Fig 1).


Polysomnographic Assessment of Sleep Comorbidities in Drug-Naïve Narcolepsy-Spectrum Disorders--A Japanese Cross-Sectional Study.

Sasai-Sakuma T, Kinoshita A, Inoue Y - PLoS ONE (2015)

Comparisons of AHI, PLMS index and amount of RWA among the three patient groups.AHI, apnea hypopnea index; PLMS, periodic limb movements during sleep; RWA, rapid eye movement (REM) sleep without atonia; NA, narcolepsy; CA, cataplexy; IHS w/o LST, idiopathic hypersomnia without long sleep time; NREM, non-REM; EMG, electromyogram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556112&req=5

pone.0136988.g001: Comparisons of AHI, PLMS index and amount of RWA among the three patient groups.AHI, apnea hypopnea index; PLMS, periodic limb movements during sleep; RWA, rapid eye movement (REM) sleep without atonia; NA, narcolepsy; CA, cataplexy; IHS w/o LST, idiopathic hypersomnia without long sleep time; NREM, non-REM; EMG, electromyogram.
Mentions: Fig 1a–1f presents the apnea–hypopnea index (AHI), PLMS index and percentages of phasic and tonic EMG activity in NA-CA, NA w/o CA, and IHS w/o LST. No differences were found in the apnea–hypopnea index among the three patient groups (mean±standard deviation was 3.3±4.5 h-1 in NA-CA, 2.7±3.5 h-1 in NA w/o CA and 3.8±7.2 h-1 in IHS w/o LST). Patients with NA-CA had higher PLMS index during total sleep than those with NA w/o CA and IHS w/o LST (χ2 = 19.692, df = 2, P <.001; 5.6±14.4 h-1 in NA-CA, 2.0±6.4 h-1 in NA w/o CA and 3.0±6.4 h-1 in IHS w/o LST). They also had higher PLMS index during REM sleep than those with IHS w/o LST (χ2 = 16.489, df = 2, P <.001; 7.0±14.5 h-1 in NA-CA, 4.5±9.3 h-1 in NA w/o CA and 2.7±6.9 h-1 in IHS w/o LST). In contrast, no differences were found in the PLMS index during NREM sleep among the three patient groups (14.2±19.9 h-1 in NA-CA, 7.3±15.5 h-1 in NA w/o CA and 11.7±20.1 h-1 in IHS w/o LST). Regarding RWA, patients with NA-CA had higher tonic EMG activity than those with IHS w/o LST (χ2 = 6.665, df = 2, P = .036; 2.8±2.8% in NA-CA, 1.9±1.9% in NA w/o CA and 1.1±0.9% in IHS w/o LST). The phasic EMG activity showed no differences among the three groups (5.6±5.5% in NA-CA, 4.4±4.6% in NA w/o CA and 2.7±3.3% in IHS w/o LST) (Fig 1).

Bottom Line: A total of 158 consecutive drug naïve patients with narcolepsy with cataplexy, 295 patients with narcolepsy without cataplexy and 395 patients with idiopathic hypersomnia without long sleep time were enrolled.They had more severe periodic limb movements during sleep especially during rapid eye movement sleep and higher percentages of rapid eye movement sleep without atonia than the other two patient groups.In the present large sample study, Japanese drug naïve patients with narcolepsy with cataplexy showed the highest comorbidity rates of periodic limb movements during sleep, polysomnographically diagnosable rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia among those with the other narcolepsy-spectrum disorders; the rates were lower than those for Western patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan; Department of Life Sciences and Bio-informatics, Division of Biomedical Laboratory Sciences, Graduate School of Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

ABSTRACT
This is a large cross-sectional study which aimed to investigate comorbidity rate, degree of sleep-related breathing disorder, polysomnigraphically diagnosible rapid eye movement sleep behavior disorder/rapid eye movement sleep without atonia and periodic limb movements during sleep in Japanese drug-naïve patients with narcolepsy-spectrum disorders. A total of 158 consecutive drug naïve patients with narcolepsy with cataplexy, 295 patients with narcolepsy without cataplexy and 395 patients with idiopathic hypersomnia without long sleep time were enrolled. From retrospectively analyzed data of nocturnal polysomnography and multiple sleep latency test, higher rates of periodic limb movements during sleep (> = 15 h(-1)) (10.2%) and polysomnographically diagnosable rapid eye movement sleep behavior disorder (1.9%) were found in patients with narcolepsy with cataplexy. They had more severe periodic limb movements during sleep especially during rapid eye movement sleep and higher percentages of rapid eye movement sleep without atonia than the other two patient groups. In the present large sample study, Japanese drug naïve patients with narcolepsy with cataplexy showed the highest comorbidity rates of periodic limb movements during sleep, polysomnographically diagnosable rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia among those with the other narcolepsy-spectrum disorders; the rates were lower than those for Western patients.

No MeSH data available.


Related in: MedlinePlus