A pilot study on the effects of sodium oxybate on sleep architecture and daytime alertness in narcolepsy.
OBJECTIVE
To measure the effect of nocturnal sodium oxybate administration on sleep architecture in patients with narcolepsy.


METHODS
Open-label study.


METHODS
Four accredited sleep clinics.


METHODS
25 adult patients with narcolepsy-cataplexy.


METHODS
Patients were weaned from previously used anticataplectic medications and administered increasing nightly doses of sodium oxybate over a 10-week period: 4.5 g for 4 weeks, 6 g for 2 weeks, 7.5 g for 2 weeks, and 9 g for 2 weeks. The effect of sodium oxybate was measured using nocturnal polysomnograms, the Epworth Sleepiness Scale, the Maintenance of Wakefulness Test, and a narcolepsy symptoms questionnaire.


RESULTS
The nightly administration of sodium oxybate produced dose-related increases in slow-wave sleep and delta power, rapid eye movement sleep increased initially and then decreased in a dose-related manner, nocturnal awakenings decreased, and daytime sleep latency increased. Significant improvements in daytime symptoms were measured by the Maintenance of Wakefulness Test, the Epworth Sleepiness Scale, and the narcolepsy symptom questionnaire.


CONCLUSIONS
Nocturnal administration of sodium oxybate in patients with narcolepsy produces significant improvements in sleep architecture, which coincide with significant improvements in daytime functioning.
Mamelak
Mortimer
M
Department of Psychiatry, University of Toronto, Toronto, Canada. m.mamelak@utoronto.ca
Black
Jed
J
Montplaisir
Jacques
J
Ristanovic
Ruzica
R
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000284:Administration, Oral; D000328:Adult; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D002940:Circadian Rhythm / Q000187:drug effects*; D003700:Delta Rhythm; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000188:drug therapy*; D010865:Pilot Projects; D017286:Polysomnography / Q000187:drug effects; D012894:Sleep Stages / Q000187:drug effects; D012978:Sodium Oxybate / Q000008:administration & dosage*; D014851:Wakefulness / Q000187:drug effects*
D000759:Adjuvants, Anesthesia; D000697:Central Nervous System Stimulants; D012978:Sodium Oxybate