Treatment Improves Symptom Severity in Patients With Narcolepsy

Disrupted nighttime sleep in patients with narcolepsy type 1 can improve with treatment, according to study findings published in the journal Sleep.

“We advocate the systematic assessment of this symptom and its inclusion in narcolepsy type 1 management strategy,” wrote researchers from the sleep-wake disorders unit at the Gui-de-Chauliac Hospital in Montpellier, France.

The study investigated variables associated with disrupted nocturnal sleep in 248 consecutive patients at France’s National Reference Center for Narcolepsy.

In both untreated and treated patients, disrupted nocturnal sleep was associated with disease severity, objective sleepiness, and several polysomnographic measures, the study found.

Specifically, drug-free patients with disrupted nocturnal sleep tended to have higher scores on the Narcolepsy Severity Scale, more sleepiness, anxiety/depressive symptoms, autonomic dysfunction, and poorer quality of life, reported researchers. Polysomnographic parameters associated with moderate and severe disrupted nighttime sleep included increased sleep onset REM periods, lower sleep efficiency, longer wake after sleep onset, and other sleep fragmentation markers.

Clinical symptoms were similar in treated patients with disrupted nocturnal sleep, the study found. In the treated population, antidepressant use was also associated with disrupted nocturnal sleep, but the only polysomnographic association was longer REM sleep latency.

In 51 drug-free patients reevaluated during treatment, researchers observed decreases in sleepiness, Narcolepsy Severity Scale scores, depressive symptoms, and total sleep time, as well as in sleep fragmentation markers.

“Disrupted nocturnal sleep improved in 55% of patients,” reported researchers, “without predictors except more baseline anxiety.”

Reference:
Barateau L, Lopez R, Chenini S, et al. Linking clinical complaints and objective measures of disrupted nighttime sleep in narcolepsy type 1. Sleep. Published online March 11, 2022. doi: 10.1093/sleep/zsac054