Disrupted nighttime sleep and sleep instability in narcolepsy.

Cataplexy Humans Narcolepsy / complications Quality of Life Sleep Sodium Oxybate / therapeutic use
disrupted nighttime sleep narcolepsy orexin/hypocretin polysomnography sleep instability

Journal

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
ISSN: 1550-9397
Titre abrégé: J Clin Sleep Med
Pays: United States
ID NLM: 101231977

Informations de publication

Date de publication:
01 01 2022
Historique:
pubmed: 1 9 2021
medline: 19 2 2022
entrez: 31 8 2021
Statut: ppublish

Résumé

This review aimed to summarize current knowledge about disrupted nighttime sleep (DNS) and sleep instability in narcolepsy, including self-reported and objective assessments, potential causes of sleep instability, health consequences and functional burden, and management. One hundred two peer-reviewed publications from a PubMed search were included. DNS is a key symptom of narcolepsy but has received less attention than excessive daytime sleepiness and cataplexy. There has been a lack of clarity regarding the definition of DNS, as many sleep-related symptoms and conditions disrupt sleep quality in narcolepsy (eg, hallucinations, sleep paralysis, rapid eye movement sleep behavior disorder, nightmares, restless legs syndrome/periodic leg movements, nocturnal eating, sleep apnea, depression, anxiety). In addition, the intrinsic sleep instability of narcolepsy results in frequent spontaneous wakings and sleep stage transitions, contributing to DNS. Sleep instability likely emerges in the setting of orexin insufficiency/deficiency, but its exact pathophysiology remains unknown. DNS impairs quality of life among people with narcolepsy, and more research is needed to determine its contributions to cardiovascular risk. Multimodal treatment is appropriate for DNS management, including behavioral therapies, counseling on sleep hygiene, and/or medication. There is strong evidence showing improvement in self-reported sleep quality and objective sleep stability measures with sodium oxybate, but rigorous clinical trials with other pharmacotherapies are needed. Treatment may be complicated by comorbidities, concomitant medications, and mood disorders. DNS is a common symptom of narcolepsy deserving consideration in clinical care and future research. Maski K, Mignot E, Plazzi G, Dauvilliers Y. Disrupted nighttime sleep and sleep instability in narcolepsy.

Identifiants

DOI: 10.5664/jcsm.9638 PMID: 34463249 PMC: PMC8807887
pubmed: 34463249
pii: jcsm.9638
doi: 10.5664/jcsm.9638
pmc: PMC8807887
doi:

Substances chimiques

Sodium Oxybate 7G33012534

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

289-304

Subventions

Organisme : NINDS NIH HHS
ID : K23 NS104267
Pays : United States

Informations de copyright

© 2022 American Academy of Sleep Medicine.

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Auteurs

Kiran Maski (K)

Department of Neurology, Boston Children's Hospital, Boston, Massachusetts.

Emmanuel Mignot (E)

Stanford Center for Sleep Sciences and Medicine, Redwood City, California.

Giuseppe Plazzi (G)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy.
IRCCS, Istituto delle Scienze Neurologiche, Bologna, Italy.

Yves Dauvilliers (Y)

National Reference Network for Narcolepsy, Sleep and Wake Disorders Centre, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France.
University of Montpellier, INSERM Institute for Neurosciences Montpellier, Montpellier, France.

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Classifications MeSH

questionsmedicales.fr › Troubles mentaux › Troubles de la veille et du sommeil › Dyssomnies › Troubles du sommeil d'origine intrinsèque › Troubles du sommeil par somnolence excessive › Narcolepsie › Cataplexie › Disrupted nighttime sleep and sleep...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Disrupted nighttime sleep and sleep...
questionsmedicales.fr › Troubles mentaux › Troubles de la veille et du sommeil › Dyssomnies › Troubles du sommeil d'origine intrinsèque › Troubles du sommeil par somnolence excessive › Narcolepsie › Disrupted nighttime sleep and sleep...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Disrupted nighttime sleep and sleep...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système nerveux › Sommeil › Disrupted nighttime sleep and sleep...
questionsmedicales.fr › Composés chimiques organiques › Acides carboxyliques › Hydroxyacides › Oxybate de sodium › Disrupted nighttime sleep and sleep...