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Article: Altered Sleep Stage Transitions of REM Sleep: A Novel and Stable Biomarker of Narcolepsy

TitleAltered Sleep Stage Transitions of REM Sleep: A Novel and Stable Biomarker of Narcolepsy
Authors
KeywordsSleep stage transitions
Sleep onset REM sleep period
Multiple sleep latency test
Narcolepsy
Hypersomnia
Biomarker
Issue Date2015
Citation
Journal of Clinical Sleep Medicine, 2015, v. 11, n. 8, p. 885-894 How to Cite?
AbstractObjectives: To determine the diagnostic values, longitudinal stability, and HLA association of the sleep stage transitions in narcolepsy. Methods: To compare the baseline differences in the sleep stage transition to REM sleep among 35 patients with type 1 narcolepsy, 39 patients with type 2 narcolepsy, 26 unaffected relatives, and 159 non-narcoleptic sleep patient controls, followed by a reassessment at a mean duration of 37.4 months. Results: The highest prevalence of altered transition from stage non-N2/N3 to stage R in multiple sleep latency test (MSLT) and nocturnal polysomnography (NPSG) was found in patients with type 1 narcolepsy (92.0% and 57.1%), followed by patients with type 2 narcolepsy (69.4% and 12.8%), unaffected relatives (46.2% and 0%), and controls (39.3% and 1.3%). Individual sleep variables had varied sensitivity and specifi city in diagnosing narcolepsy. By incorporating a combination of sleep variables, the decision tree analysis improved the sensitivity to 94.3% and 82.1% and enhanced specifi city to 82.4% and 83% for the diagnosis of type 1 and type 2 narcolepsy, respectively. There was a signifi cant association of DBQ1∗0602 with the altered sleep stage transition (OR = 16.0, 95% CI: 1.7-149.8, p = 0.015). The persistence of the altered sleep stage transition in both MSLT and NPSG was high for both type 1 (90.5% and 64.7%) and type 2 narcolepsy (92.3% and 100%), respectively. Conclusions: Altered sleep stage transition is a signifi cant and stable marker of narcolepsy, which suggests a vulnerable wake-sleep dysregulation trait in narcolepsy. Altered sleep stage transition has a signifi cant diagnostic value in the differential diagnosis of hypersomnias, especially when combined with other diagnostic sleep variables in decision tree analysis.
Persistent Identifierhttp://hdl.handle.net/10722/222180
ISSN
2015 Impact Factor: 2.71
2015 SCImago Journal Rankings: 1.210

 

DC FieldValueLanguage
dc.contributor.authorLiu, Yaping-
dc.contributor.authorZhang, Jihui-
dc.contributor.authorLam, Venny-
dc.contributor.authorHo, Crover Kwok Wah-
dc.contributor.authorZhou, Junying-
dc.contributor.authorLi, Shirley Xin-
dc.contributor.authorLam, Siu Ping-
dc.contributor.authorYu, Mandy Wai Man-
dc.contributor.authorTang, Xiangdong-
dc.contributor.authorWing, Yun Kwok-
dc.date.accessioned2015-12-21T06:49:12Z-
dc.date.available2015-12-21T06:49:12Z-
dc.date.issued2015-
dc.identifier.citationJournal of Clinical Sleep Medicine, 2015, v. 11, n. 8, p. 885-894-
dc.identifier.issn1550-9389-
dc.identifier.urihttp://hdl.handle.net/10722/222180-
dc.description.abstractObjectives: To determine the diagnostic values, longitudinal stability, and HLA association of the sleep stage transitions in narcolepsy. Methods: To compare the baseline differences in the sleep stage transition to REM sleep among 35 patients with type 1 narcolepsy, 39 patients with type 2 narcolepsy, 26 unaffected relatives, and 159 non-narcoleptic sleep patient controls, followed by a reassessment at a mean duration of 37.4 months. Results: The highest prevalence of altered transition from stage non-N2/N3 to stage R in multiple sleep latency test (MSLT) and nocturnal polysomnography (NPSG) was found in patients with type 1 narcolepsy (92.0% and 57.1%), followed by patients with type 2 narcolepsy (69.4% and 12.8%), unaffected relatives (46.2% and 0%), and controls (39.3% and 1.3%). Individual sleep variables had varied sensitivity and specifi city in diagnosing narcolepsy. By incorporating a combination of sleep variables, the decision tree analysis improved the sensitivity to 94.3% and 82.1% and enhanced specifi city to 82.4% and 83% for the diagnosis of type 1 and type 2 narcolepsy, respectively. There was a signifi cant association of DBQ1∗0602 with the altered sleep stage transition (OR = 16.0, 95% CI: 1.7-149.8, p = 0.015). The persistence of the altered sleep stage transition in both MSLT and NPSG was high for both type 1 (90.5% and 64.7%) and type 2 narcolepsy (92.3% and 100%), respectively. Conclusions: Altered sleep stage transition is a signifi cant and stable marker of narcolepsy, which suggests a vulnerable wake-sleep dysregulation trait in narcolepsy. Altered sleep stage transition has a signifi cant diagnostic value in the differential diagnosis of hypersomnias, especially when combined with other diagnostic sleep variables in decision tree analysis.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Sleep Medicine-
dc.subjectSleep stage transitions-
dc.subjectSleep onset REM sleep period-
dc.subjectMultiple sleep latency test-
dc.subjectNarcolepsy-
dc.subjectHypersomnia-
dc.subjectBiomarker-
dc.titleAltered Sleep Stage Transitions of REM Sleep: A Novel and Stable Biomarker of Narcolepsy-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.5664/jcsm.4940-
dc.identifier.scopuseid_2-s2.0-84939479146-
dc.identifier.volume11-
dc.identifier.issue8-
dc.identifier.spage885-
dc.identifier.epage894-
dc.identifier.eissn1550-9397-

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