Neural mechanisms underlying sleep-onset rapid eye movement (REM) periods (SOREMPs) in narcolepsy and the role of hypocretin in driving sympathetic changes during sleep are misunderstood. We aimed to characterize autonomic changes during sleep in narcolepsy with cataplexy (NC) patients to clarify the nature of SOREMP events and the effect of hypocretin deficiency on sympathetic activity during sleep.We observed 13 hypocretin-deficient NC patients and five healthy controls who underwent nocturnal video-polysomnography (v-PSG) with blood pressure (BP) recording, heart rate (HR), skin sympathetic activity (SSA), and muscle sympathetic nerve activity (MSNA) from the peroneal nerve by microneurography.Compared to wake, control participants displayed a progressive significant decrease of BP and sympathetic activities during nonrapid eye movement (NREM) sleep and an increase of autonomic activity during REM sleep, as expected. NC patients showed: (1) a decrease of sympathetic activities during SOREMP comparable to NREM sleep stage 1 (N1) but in contrast to the increased activity typical of REM sleep; and (2) physiologic sympathetic change during the following sleep stages with a progressive decrease during NREM sleep stage 2 (N2) and NREM sleep stage 3 (N3) and a clear increase in REM sleep, though BP did not show the physiologic decrease during sleep (nondipper pattern).SOREMPs in NC patients lack the sympathetic activation occurring during physiologic REM sleep, thus suggesting a dissociated REM sleep condition. In addition, our data indicated that hypocretin plays a limited role in the regulation of sympathetic changes during sleep.
Sympathetic and cardiovascular changes during sleep in narcolepsy with cataplexy patients / V., Donadio; Liguori, Rocco; Vandi, Stefano; M. P., Giannoccaro; Pizza, Fabio; V., Leta; Plazzi, Giuseppe. - In: SLEEP MEDICINE. - ISSN 1389-9457. - 15:3(2014), pp. 315-321.
|Data di pubblicazione:||2014|
|Titolo:||Sympathetic and cardiovascular changes during sleep in narcolepsy with cataplexy patients|
|Autore/i:||V., Donadio; Liguori, Rocco; Vandi, Stefano; M. P., Giannoccaro; Pizza, Fabio; V., Leta; Plazzi, Giuseppe|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.sleep.2013.12.005|
|Codice identificativo ISI:||WOS:000332769000006|
|Codice identificativo Scopus:||2-s2.0-84895433293|
|Codice identificativo Pubmed:||24503475|
|Citazione:||Sympathetic and cardiovascular changes during sleep in narcolepsy with cataplexy patients / V., Donadio; Liguori, Rocco; Vandi, Stefano; M. P., Giannoccaro; Pizza, Fabio; V., Leta; Plazzi, Giuseppe. - In: SLEEP MEDICINE. - ISSN 1389-9457. - 15:3(2014), pp. 315-321.|
|Tipologia||Articolo su rivista|
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