Hansen Mathias Hvidtfelt, Kornum Birgitte Rahbek, Jennum Poul
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; Molecular Sleep Laboratory, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
Sleep Med. 2017 Jun;34:1-6. doi: 10.1016/j.sleep.2017.01.021. Epub 2017 Mar 14.
To compare diurnal and nocturnal electrophysiological data from narcolepsy patients with undetectable (<20 pg/mL), low (20-110 pg/mL) and normal (>110 pg/mL) cerebrospinal fluid (CSF) hypocretin-1 levels.
PATIENTS/METHODS: A total of 109 narcolepsy patients and 37 controls were studied; all had available CSF hypocretin-1 measurements. The sleep laboratory studies were conducted between 2008 and 2014. The study retrospectively examined measurements of sleep stage transitions in diurnal and nocturnal continuous polysomnography. The percentage distribution of time awake and rapid eye movement (REM) sleep, and the occurrence of sleep onset REM (SOREM) in the nocturnal polysomnography were also measured.
Participants with undetectable hypocretin-1 levels had significantly higher frequencies of transitions than controls and those with normal hypocretin-1 levels. Participants with low hypocretin-1 levels showed more transitions than controls and, in some cases, also more than those with normal hypocretin-1. Participants with normal hypocretin-1 failed to show any significant difference from the controls, except in the overall diurnal transitions.
Undetectable hypocretin-1 levels in particular, but also low hypocretin-1 levels, were associated with a less stable phenotype featuring more sleep state transitions and SOREM episodes. In addition, there was a distinction between nocturnal and diurnal REM sleep in hypocretin-deficient participants, expressed as increased diurnal REM sleep, which was not reflected in nocturnal sleep.
比较脑脊液（CSF）中食欲素-1水平检测不到（<20 pg/mL）、水平较低（20 - 110 pg/mL）和正常（>110 pg/mL）的发作性睡病患者的昼夜电生理数据。
患者/方法：共研究了109例发作性睡病患者和37名对照者；所有人均有可用的脑脊液食欲素-1测量值。睡眠实验室研究在2008年至2014年期间进行。该研究回顾性检查了昼夜连续多导睡眠图中睡眠阶段转换的测量值。还测量了夜间多导睡眠图中清醒时间和快速眼动（REM）睡眠的百分比分布，以及睡眠始发快速眼动（SOREM）的发生情况。
食欲素-1水平检测不到的参与者的转换频率显著高于对照者和食欲素-1水平正常的参与者。食欲素-1水平较低的参与者的转换次数比对照者多，在某些情况下，也比食欲素-1水平正常的参与者多。食欲素-1水平正常的参与者与对照者相比，除了在总体昼夜转换方面外，未显示出任何显著差异。
特别是食欲素-1水平检测不到，但食欲素-1水平较低也与不太稳定的表型相关，其特征是更多的睡眠状态转换和SOREM发作。此外，食欲素缺乏的参与者的夜间和昼夜REM睡眠之间存在差异，表现为昼夜REM睡眠增加，这在夜间睡眠中未得到体现。
