Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
Sleep Med. 2018 Jul;47:1-6. doi: 10.1016/j.sleep.2018.03.020. Epub 2018 Apr 10.
Currently, cardiovascular measurements in children affected with type 1 narcolepsy (NT1) have never been investigated, and neither have their modulation by the administration of sodium oxybate (SO).
Twelve drug-naïve NT1 children (four males, eight females) with a mean age of 11 ± 3.16 years underwent a nocturnal polysomnography, at baseline and during the first night of SO administration. Data were contrasted with those recorded in 23 age-matched healthy controls. Heart rate variability (HRV) analysis was performed by analyzing the electrocardiogram signal for automatic detection of R waves with a computer program calculating a series of standard time-domain measures and obtaining spectral parameters, by means of a Fast-Fourier Transform.
In sleep stages N2 and N3, NT1 children showed increased power in the low-frequency (LF) and very-LF (VLF) ranges, when compared to controls. In addition, HRV (as measured by time domain parameters) during all sleep stages tended to be slightly higher in patients when compared to controls. Treatment with SO did not change significantly any parameter, but an overall trend to mildly decreased HRV that reached a significant value only during R sleep.
HRV during all sleep stages tended to be slightly higher in young patients when compared to controls, confirming the presence of a slight sympathovagal system imbalance even in NT1 children. SO tends to decrease these values especially during REM sleep and in that regard, further studies supporting these preliminary findings and considering the long-term effects of SO on heart rate parameters are warranted.
目前，尚未对 1 型发作性睡病（NT1）患儿的心血管测量值进行研究，也未研究右佐匹克隆（SO）给药对其的调节作用。
12 名未经药物治疗的 NT1 患儿（男 4 例，女 8 例），平均年龄 11±3.16 岁，接受了夜间多导睡眠图检查，分别在基线和 SO 给药的第一晚进行。将数据与 23 名年龄匹配的健康对照者记录的数据进行对比。通过计算机程序自动检测心电图信号进行心率变异性（HRV）分析，该程序计算一系列标准时域测量值并获得频谱参数，采用快速傅里叶变换。
与对照组相比，NT1 患儿在 N2 和 N3 睡眠期低频（LF）和极低频（VLF）范围的功率增加。此外，与对照组相比，患者在所有睡眠阶段的 HRV（通过时域参数测量）略高。SO 治疗并未显著改变任何参数，但 HRV 呈轻度下降趋势，仅在 REM 睡眠时达到显著水平。
与对照组相比，年轻患者在所有睡眠阶段的 HRV 略高，这证实了即使在 NT1 患儿中也存在轻微的交感迷走神经系统失衡。SO 倾向于降低这些值，尤其是在 REM 睡眠时，因此需要进一步的研究来支持这些初步发现，并考虑 SO 对心率参数的长期影响。
