Gagnon Katia, Rey Amandine E, Guignard-Perret Anne, Guyon Aurore, Reynaud Eve, Herbillon Vania, Lina Jean-Marc, Carrier Julie, Franco Patricia, Mazza Stéphanie
Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, FORGETTING, F-69500 Bron, France.
National Reference Center for Narcolepsy in the Service of Epilepsy, Sleep and Neuropediatric Functional Explorations of the Woman Mother Child Hospital of Bron, 59, bd Pinel, F-69677 Bron, France.
Children (Basel). 2023 Oct 18;10(10):1702. doi: 10.3390/children10101702.
Electroencephalographic sleep stage transitions and altered first REM sleep period transitions have been identified as biomarkers of type 1 narcolepsy in adults, but not in children. Studies on memory complaints in narcolepsy have not yet investigated sleep-dependent memory consolidation. We aimed to explore stage transitions; more specifically altered REM sleep transition and its relationship with sleep-dependent memory consolidation in children with narcolepsy. Twenty-one children with narcolepsy-cataplexy and twenty-three healthy control children completed overnight polysomnography and sleep-dependent memory consolidation tests. Overnight transition rates (number of transitions per hour), global relative transition frequencies (number of transitions between a stage and all other stages/total number of transitions × 100), overnight transitions to REM sleep (transition from a given stage to REM/total REM transitions × 100), and altered first REM sleep period transitions (transitions from wake or N1 to the first REM period) were computed. Narcoleptic children had a significantly higher overnight transition rate with a higher global relative transition frequencies to wake. A lower sleep-dependent memory consolidation score found in children with narcolepsy was associated with a higher overnight transition frequency. As observed in narcoleptic adults, 90.48% of narcoleptic children exhibited an altered first REM sleep transition. As in adults, the altered sleep stage transition is also present in children with narcolepsy-cataplexy, and a higher transition rate could have an impact on sleep-dependent memory consolidation. These potential biomarkers could help diagnose type 1 narcolepsy in children more quickly; however, further studies with larger cohorts, including of those with type 2 narcolepsy and hypersomnia, are needed.
脑电图睡眠阶段转换以及首次快速眼动（REM）睡眠期转换的改变已被确定为成人发作性睡病1型的生物标志物，但在儿童中并非如此。关于发作性睡病记忆障碍的研究尚未探讨睡眠依赖性记忆巩固。我们旨在探索阶段转换；更具体地说是探讨发作性睡病儿童中REM睡眠转换的改变及其与睡眠依赖性记忆巩固的关系。21名发作性睡病猝倒症儿童和23名健康对照儿童完成了夜间多导睡眠图检查和睡眠依赖性记忆巩固测试。计算了夜间转换率（每小时转换次数）、全局相对转换频率（一个阶段与所有其他阶段之间的转换次数/总转换次数×100）、夜间向REM睡眠的转换（从给定阶段到REM的转换/总REM转换次数×100）以及首次REM睡眠期转换的改变（从清醒或N1到第一个REM期的转换）。发作性睡病儿童的夜间转换率显著更高，向清醒的全局相对转换频率也更高。发作性睡病儿童较低的睡眠依赖性记忆巩固得分与较高的夜间转换频率相关。正如在发作性睡病成人中所观察到的，90.48%的发作性睡病儿童表现出首次REM睡眠转换的改变。与成人一样，发作性睡病猝倒症儿童也存在睡眠阶段转换的改变，较高的转换率可能会对睡眠依赖性记忆巩固产生影响。这些潜在的生物标志物有助于更快地诊断儿童发作性睡病1型；然而，需要对更大的队列进行进一步研究，包括2型发作性睡病和发作性睡病样睡眠障碍患者。
