Journal ArticleDOI
Sleep Onset REM Periods during Multiple Sleep Latency Tests in Patients Evaluated for Sleep Apnea
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TLDR
It is concluded that among patients suspected or confirmed to have OSA, one or more of these four variables-male sex, sleepiness, nocturnal REM sleep latency, and extent of oxygen desaturation-could reflect neurophysiological mechanisms responsible for 2omSOREMPs.Abstract:
Although 2 or more sleep onset rapid eye movement (REM) periods (2omSOREMPs) on a Multiple Sleep Latency Test (MSLT) raise the possibility of narcolepsy, patients with obstructive sleep apnea (OSA) also can have 2omSOREMPs, which may then cause diagnostic uncertainty. To explore what features among OSA patients predict 2omSOREMPs on an MSLT that follows nocturnal polysomnography, we reviewed data from 1,145 consecutively studied patients suspected or confirmed to have OSA rather than narcolepsy. Overall, 4.7% of the subjects had 2omSOREMPs. Variables that were independently predictive of 2omSOREMPs in logistic regression models included male gender (OR = 4.4, 95% CI = 1.9 to 12.7), a 5-min decrease in the MSLT-derived mean sleep latency (OR = 1.9, 95% CI = 1.3 to 2.8), a 90-min decrease in nocturnal latency to REM sleep (OR = 1.6, 95% CI = 1.1 to 2.5), and a 15-unit decrease in minimal recorded oxygen saturation (OR = 1.6, 95% CI = 1.3 to 2.0). We conclude that among patients suspected or confirmed to hav...read more
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Journal ArticleDOI
CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions
Yves Dauvilliers,Christian R. Baumann,Bertrand Carlander,Matthias Bischof,T Blatter,Michel Lecendreux,Friedrich E. Maly,A Besset,Jacques Touchon,Michel Billiard,Mehdi Tafti,Claudio L. Bassetti +11 more
TL;DR: Hypocretin ligand deficiency appears not to be the major cause for other hypersomnias, with a possible continuum in the pathophysiology of narcolepsy without cataplexy and idiopathic hypersomnia, however, partial hypocretin lesions without low CSF hypoc retin-1 consequences cannot be definitely excluded in those disorders.
Journal ArticleDOI
Correlates of sleep-onset REM periods during the Multiple Sleep Latency Test in community adults
Emmanuel Mignot,Ling Lin,Laurel Finn,Cecilia Lopes,Kathryn Pluff,Mary L. Sundstrom,Terry Young +6 more
TL;DR: A high prevalence of narcolepsy without cataplexy is suggested, as defined by the International Classification of Sleep Disorders, and/or a large number of false-positives for the Multiple Sleep Latency Test.
Journal ArticleDOI
The neurobiology, diagnosis, and treatment of narcolepsy
TL;DR: Recent advances provide compelling evidence that narcolepsy may be a neurodegenerative or autoimmune disorder resulting in a loss of hypothalamic neurons containing the neuropeptide orexin (also known as hypocretin).
Journal ArticleDOI
Predictors of Hypocretin (Orexin) Deficiency in Narcolepsy Without Cataplexy
Olivier Andlauer,Olivier Andlauer,Hyatt Moore,Seung Chul Hong,Yves Dauvilliers,Takashi Kanbayashi,Seiji Nishino,Fang Han,Michael H. Silber,Tom Rico,Mali Einen,Birgitte Rahbek Kornum,Birgitte Rahbek Kornum,Poul Jennum,Stine Knudsen,Sona Nevsimalova,Francesca Poli,Giuseppe Plazzi,Emmanuel Mignot +18 more
TL;DR: Objective (HLA typing, MSLT, and sleep studies) more than subjective (sleepiness and sleep paralysis) features predicted low concentration of CSF hypocretin-1 in patients with narcolepsy without cataplexy.
Journal ArticleDOI
Clinical, polysomnographic and genome-wide association analyses of narcolepsy with cataplexy: a European Narcolepsy Network study
Gianina Luca,José Haba-Rubio,Yves Dauvilliers,Gert Jan Lammers,Sebastiaan Overeem,C. Donjacour,Geert Mayer,Sirous Javidi,Alex Iranzo,Joan Santamaria,Rosa Peraita-Adrados,Hyun Hor,Zoltán Kutalik,Zoltán Kutalik,Giuseppe Plazzi,Francesca Poli,Fabio Pizza,Isabelle Arnulf,Michel Lecendreux,Claudio L. Bassetti,Johannes Mathis,Raphael Heinzer,Poul Jennum,Stine Knudsen,Peter Geisler,Aleksandra Wierzbicka,Eva Feketeova,Corinne Pfister,Ramin Khatami,Christian R. Baumann,Mehdi Tafti,Mehdi Tafti +31 more
TL;DR: The results indicate that the diagnostic delay remains extremely long, age and gender substantially affect symptoms, and that a genetic predisposition affects the age at onset of symptoms.
References
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Journal ArticleDOI
Guidelines for the multiple sleep latency Test (MSLT) : a standard measure of sleepiness
Journal ArticleDOI
Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects
Gary S. Richardson,Mary A. Carskadon,Wayne Flagg,Johanna Van den Hoed,William C. Dement,Merrill M. Mitler +5 more
TL;DR: It is concluded that the Multiple Sleep latency test, in addition to providing opportunities to clinically document sleep onset REM sleep periods, can demonstrate pathological sleepiness.