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.
Highlights
Narcolepsy is characterized by excessive daytime sleepiness (EDS) and increased rapid eye movement (REM) sleep propensity leading to sleep onset REM sleep period (SOREMP), cataplexy (CA), sleep paralysis (SP), or hypnagogic hallucination (HH)[1]
Among the eligible consecutive patients with hypersomnia who visited the outpatient clinic of the Japan Somnology Center during May 2008 –February 2014, patients who met the following inclusion criteria were enrolled in this study: (1) diagnosed as NA with CA (NA-CA), NA w/o CA, or IHS w/o LST based on clinical symptoms and findings of a nocturnal polysomnography (n-PSG), and subsequent multiple sleep latency test (MSLT), according to the diagnostic criteria presented in the Second Edition of the International Classification of Sleep Disorders (ICSD-2); and (2) free of psychostimulant medication, antidepressants as anticataplectic drugs or hypnotics, which are potentially associated with sleep-related breathing disorder (SRBD), periodic limb movements during sleep (PLMS) or REM sleep without atonia (RWA), when they underwent nocturnal polysomnographic (n-PSG) and MSLT
Rates of patients with SP and the rate with HH were higher in patients with NA-CA than in patients with NA w/o CA and IHS w/o LST (SP: χ2 = 69.160, df = 2, P
Summary
Narcolepsy is characterized by excessive daytime sleepiness (EDS) and increased rapid eye movement (REM) sleep propensity leading to sleep onset REM sleep period (SOREMP), cataplexy (CA), sleep paralysis (SP), or hypnagogic hallucination (HH)[1]. Sleep Comorbidities in Narcolepsy-Spectrum Disorders has received a consultancy fee from Hisamitsu Pharmaceutical Co. Inc., has provided expert testimony for Philips Respironics GK, Alfresa Pharma Corp., Takeda Pharmaceutical Co. Ltd, MSD K.K., Pacific Medico Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Eisai Co. Ltd., and Mitsubishi Tanabe Pharma Corp., and has received payment for lectures from Philips Respironics GK, Takeda Pharmaceutical Co. Ltd., Astellas Pharma Inc., Yoshitomiyakuhin Corp., Otsuka Pharmaceutical Co. Ltd., and Eisai Co. Ltd. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
