Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study
Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types di...
Ausführliche Beschreibung
Autor*in: |
Kuniyuki Niijima [verfasserIn] Masakazu Wakai [verfasserIn] |
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E-Artikel |
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Englisch |
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2023 |
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In: Sleep Science and Practice - BMC, 2018, 7(2023), 1, Seite 5 |
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Übergeordnetes Werk: |
volume:7 ; year:2023 ; number:1 ; pages:5 |
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DOI / URN: |
10.1186/s41606-023-00091-3 |
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Katalog-ID: |
DOAJ092115055 |
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520 | |a Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. | ||
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10.1186/s41606-023-00091-3 doi (DE-627)DOAJ092115055 (DE-599)DOAJ75fde175b0ff4926951c7773567500fc DE-627 ger DE-627 rakwb eng Kuniyuki Niijima verfasserin aut Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. Narcolepsy type1 Narcolepsy type2 Sleep fragmentation Difficult maintaining sleep Prevalence Medicine R Masakazu Wakai verfasserin aut In Sleep Science and Practice BMC, 2018 7(2023), 1, Seite 5 (DE-627)880932333 (DE-600)2885817-7 23982683 nnns volume:7 year:2023 number:1 pages:5 https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/article/75fde175b0ff4926951c7773567500fc kostenfrei https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/toc/2398-2683 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2023 1 5 |
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10.1186/s41606-023-00091-3 doi (DE-627)DOAJ092115055 (DE-599)DOAJ75fde175b0ff4926951c7773567500fc DE-627 ger DE-627 rakwb eng Kuniyuki Niijima verfasserin aut Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. Narcolepsy type1 Narcolepsy type2 Sleep fragmentation Difficult maintaining sleep Prevalence Medicine R Masakazu Wakai verfasserin aut In Sleep Science and Practice BMC, 2018 7(2023), 1, Seite 5 (DE-627)880932333 (DE-600)2885817-7 23982683 nnns volume:7 year:2023 number:1 pages:5 https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/article/75fde175b0ff4926951c7773567500fc kostenfrei https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/toc/2398-2683 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2023 1 5 |
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10.1186/s41606-023-00091-3 doi (DE-627)DOAJ092115055 (DE-599)DOAJ75fde175b0ff4926951c7773567500fc DE-627 ger DE-627 rakwb eng Kuniyuki Niijima verfasserin aut Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. Narcolepsy type1 Narcolepsy type2 Sleep fragmentation Difficult maintaining sleep Prevalence Medicine R Masakazu Wakai verfasserin aut In Sleep Science and Practice BMC, 2018 7(2023), 1, Seite 5 (DE-627)880932333 (DE-600)2885817-7 23982683 nnns volume:7 year:2023 number:1 pages:5 https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/article/75fde175b0ff4926951c7773567500fc kostenfrei https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/toc/2398-2683 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2023 1 5 |
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10.1186/s41606-023-00091-3 doi (DE-627)DOAJ092115055 (DE-599)DOAJ75fde175b0ff4926951c7773567500fc DE-627 ger DE-627 rakwb eng Kuniyuki Niijima verfasserin aut Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. Narcolepsy type1 Narcolepsy type2 Sleep fragmentation Difficult maintaining sleep Prevalence Medicine R Masakazu Wakai verfasserin aut In Sleep Science and Practice BMC, 2018 7(2023), 1, Seite 5 (DE-627)880932333 (DE-600)2885817-7 23982683 nnns volume:7 year:2023 number:1 pages:5 https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/article/75fde175b0ff4926951c7773567500fc kostenfrei https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/toc/2398-2683 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2023 1 5 |
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10.1186/s41606-023-00091-3 doi (DE-627)DOAJ092115055 (DE-599)DOAJ75fde175b0ff4926951c7773567500fc DE-627 ger DE-627 rakwb eng Kuniyuki Niijima verfasserin aut Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. Narcolepsy type1 Narcolepsy type2 Sleep fragmentation Difficult maintaining sleep Prevalence Medicine R Masakazu Wakai verfasserin aut In Sleep Science and Practice BMC, 2018 7(2023), 1, Seite 5 (DE-627)880932333 (DE-600)2885817-7 23982683 nnns volume:7 year:2023 number:1 pages:5 https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/article/75fde175b0ff4926951c7773567500fc kostenfrei https://doi.org/10.1186/s41606-023-00091-3 kostenfrei https://doaj.org/toc/2398-2683 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2023 1 5 |
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Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. |
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Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. |
abstract_unstemmed |
Abstract Introduction Narcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan. |
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These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2. Methods Subjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter. Results Among the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2. Conclusions Fragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Narcolepsy type1</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Narcolepsy type2</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Sleep fragmentation</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Difficult maintaining sleep</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Prevalence</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medicine</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">R</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Masakazu Wakai</subfield><subfield code="e">verfasserin</subfield><subfield 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