Abstract

Narcolepsy with cataplexy (NC) is a neurological sleep disorder characterized by very low or undetectable concentration of hypocretin-1 in the cerebrospinal fluid. It has been recently found that patients with NC have disturbed circadian pattern of blood pressure, with more frequent non-dipping, compared to healthy controls. It has been hypothesized that lack of hypocretin may lead to increase in nocturnal blood pressure. This increase may result also from disturbed sleep architecture regardless of the deficiency of hypocretin. The aim of this study was to compare changes in values of daytime and nighttime blood pressure in NC patients and in patients with disturbed nocturnal sleep due to other sleep disorders. We have retrospectively compared polysomnographic and clinical data of 8 NC patients and 7 age- and sex controls suffering from insomnia. We have compared sleep architecture, mean blood pressure values and dipping pattern in both groups. The groups did not differ in terms of disturbances of sleep architecture. We have not found any statistical differences in values of daytime and nocturnal blood pressure. Non-dipping was equally frequent in both groups (87.5 and 85.7 %). Our results suggest that observed abnormalities in circadian changes of blood pressure values result from disturbed sleep architecture than from deficiency of hypocretin. Patients with sleep disorders should be carefully observed for the presence of increased blood pressure and other vascular risk factors.

Highlights

  • Narcolepsy with cataplexy (NC) is a neurological sleep disorder characterized by the presence of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis

  • Our results suggest that observed abnormalities in circadian changes of blood pressure values result from disturbed sleep architecture than from deficiency of hypocretin

  • Data on hypocretin-1 level in cerebrospinal fluid were available for all NC patients

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Summary

Introduction

Narcolepsy with cataplexy (NC) is a neurological sleep disorder characterized by the presence of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. It has been hypothesized that hypocretin is a relevant factor in central control of the circadian rhythm of fluctuations of the cardiovascular system [3, 4]. One of the most prominent traits of the circadian rhythm of the cardiovascular system is the nocturnal decrease of the blood pressure (BP)—so-called dipping. This phenomenon has a crucial clinical significance—decrease in nocturnal values of blood pressure that below 10 % of the daytime values (so-called non-dipping) or increase of the BP during the night (‘‘inverse dipping’’) are major cardiovascular risk factors [5]

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