5 In human narcolepsy, total sleep time was initially measured during a 24-h period, before the development of the multiple sleep latency test. 4 In murine narcolepsy, sleep episodes are similarly fragmented, though the total time asleep in these transgenic animals (823 min) is not significantly different from the 783 min observed in wild animals. It also helps alleviate cataplexy and daytime sleepiness.ĭisrupted nighttime sleep in human narcolepsy parallels the fragmented NREM sleep observed in Doberman Pinschers with genetically abnormal hypocretin-2 receptors, though the total duration of sleep is not different from control dogs. The existence of narcoleptic dyssomnia has, in part, led to the recent treatment of sodium oxybate given before and during sleep in narcoleptics, as a means to obtaining more continuous and deep sleep. 3 Recently, much emphasis has been placed on the frequent nighttime awakenings, which may follow an ultradian rhythm in narcoleptics. 2 Up to 71% narcoleptics are unable to sleep without awakening, and 83% complain of early awakenings. In addition, sleep efficiency in narcoleptics tends be lower than in controls. 1 During the night, the most specific feature of nocturnal sleep is a REM sleep period at sleep onset, which is observed in only 25% of patients during the first monitored night. These markers are associated, to various extents, with REM sleep-associated phenomena (i.e., cataplexy, hypnagogic hallucinations, sleep paralysis, REM sleep behavior disorders), disturbed nocturnal sleep, periodic leg movements, depressive mood, and increased weight. THE CLINICAL SYMPTOMS OF NARCOLEPSY INCLUDE CHRONIC, SEVERE, OBJECTIVE DAYTIME SLEEPINESS WITH MULTIPLE DAYTIME SLEEP ONSET REM PERIODS.
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