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Study Objectives: <p>Disrupted nighttime sleep and sleep instability are common in children and adolescents with narcolepsy type 1, but optimal objective sleep measures have not been determined. We compared self-reported and objective sleep measures between young people with narcolepsy type 1 and healthy controls and test the hypotheses that the wake/non-rapid eye movement sleep stage 1 (N1) index is the best objective measure of perceived nocturnal wakings vs other disrupted nighttime sleep measures reported in the literature and is associated with daytime functional problems.</p> Methods: <p>n = 26 healthy controls and n = 27 narcolepsy type 1 participants ages 8–21 years completed a 15-item habitual sleep quality survey and an in-lab polysomnogram. We compared group survey responses and performed stepwise regression of sleep quality and instability measures with a survey question (“During the night, I wake more than once”). Last, we used logistic regression to identify associations between the wake/N1 index with daytime functional concerns across groups.</p> Results: <p>Compared to healthy controls, narcolepsy type 1 participants reported more frequent restless sleep, nighttime moaning/groaning/talking, tossing and turning, and nocturnal wakings (all <i>P</i> values &lt; .01), but no greater difficulties in falling asleep or returning back to sleep. Across groups, self-reported waking from sleep was associated with increased wake/N1 index and selective serotonin reuptake inhibitor/selective norepinephrine re-uptake inhibitor use. The wake/N1 index was associated with daytime fatigue but no other behavioral or cognitive concerns.</p> Conclusions: <p>Disrupted nighttime sleep is a multifactorial complaint that differs from insomnia. We believe the wake/N1 index is a useful sleep instability measure that should be helpful in research and as a treatment target in clinical practice, especially for fatigue concerns.</p> Citation: <p>Heckler G, Worhach J, Wang G, et&#xa0;al. Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1. <i>J Clin Sleep Med</i>. 2025;21(2):355–363.</p>

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Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1

  • 期刊论文

  • 发表日期：

    2025年2月1日

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  • Gillian Heckler,
  • Jennifer Worhach,
  • Grace Wang,
  • Klara Szilagyi,
  • Bo Zhang,
  • Cecilia Diniz Behn,
  • Thomas Scammell,
  • Kiran Maski

摘要

Study Objectives:

Disrupted nighttime sleep and sleep instability are common in children and adolescents with narcolepsy type 1, but optimal objective sleep measures have not been determined. We compared self-reported and objective sleep measures between young people with narcolepsy type 1 and healthy controls and test the hypotheses that the wake/non-rapid eye movement sleep stage 1 (N1) index is the best objective measure of perceived nocturnal wakings vs other disrupted nighttime sleep measures reported in the literature and is associated with daytime functional problems.

Methods:

n = 26 healthy controls and n = 27 narcolepsy type 1 participants ages 8–21 years completed a 15-item habitual sleep quality survey and an in-lab polysomnogram. We compared group survey responses and performed stepwise regression of sleep quality and instability measures with a survey question (“During the night, I wake more than once”). Last, we used logistic regression to identify associations between the wake/N1 index with daytime functional concerns across groups.

Results:

Compared to healthy controls, narcolepsy type 1 participants reported more frequent restless sleep, nighttime moaning/groaning/talking, tossing and turning, and nocturnal wakings (all P values < .01), but no greater difficulties in falling asleep or returning back to sleep. Across groups, self-reported waking from sleep was associated with increased wake/N1 index and selective serotonin reuptake inhibitor/selective norepinephrine re-uptake inhibitor use. The wake/N1 index was associated with daytime fatigue but no other behavioral or cognitive concerns.

Conclusions:

Disrupted nighttime sleep is a multifactorial complaint that differs from insomnia. We believe the wake/N1 index is a useful sleep instability measure that should be helpful in research and as a treatment target in clinical practice, especially for fatigue concerns.

Citation:

Heckler G, Worhach J, Wang G, et al. Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1. J Clin Sleep Med. 2025;21(2):355–363.