title: NREM sleep alterations in narcolepsy/cataplexy.
abstract: OBJECTIVE
  NREM sleep patterns of narcoleptic patients with cataplexy were studied, focusing on their sleep 'microstructure', by analyzing the cyclic alternating pattern (CAP).
  
  
  METHODS
  Forty-nine HLA DQB1*0602-positive patients with narcolepsy/cataplexy (32 men and 17 women, aged 18-46 years) were included together with 37 age-matched normal controls. Each subject underwent one polysomnographic night recording after an adaptation night. Sleep stages were scored following standard criteria and CAP A phases were detected and classified into 3 subtypes (A1, A2, and A3). Power spectra for frequencies between 0.5 and 25 Hz were obtained for each CAP condition, separately in sleep stage 2 and SWS.
  
  
  RESULTS
  Narcoleptic patients displayed reduced total CAP rate. A selective reduction in the number of A1 subtypes/hour and a reduced A3 index were found in narcoleptics who had also a smaller average number of CAP sequences. Narcoleptic patients had higher power spectra for fast frequencies mostly during SWS, while REM sleep power spectra showed significantly higher power density for frequency bins 0.5-1.5, 8.5-9.5, and 17.5-25 Hz. Similarly, CAP A1 subtypes and NCAP epochs during SWS displayed significantly higher power density for fast frequency bins.
  
  
  CONCLUSIONS
  The main finding of this study is that the occurrence of the A1 CAP subtypes is impaired during NREM sleep in narcoleptic patients. Thus, narcolepsy seems to be accompanied not only by alterations of REM but also NREM sleep which is subtly but significantly impaired, as reflected by CAP and the corresponding EEG spectral analysis.
  
  
  CONCLUSIONS
  Our findings might indicate that in narcolepsy very-slow oscillation processes less effective than normal might be present, with a subtly impaired capability of grouping the other sleep EEG activities; this aspect deserves further insight in order to obtain a better understanding of its functional meaning.
authors.affiliation: Department of Neurology IC, Sleep Research Centre, Oasi Institute (IRCCS), Troina, Enna, Italy. rferri@oasi.en.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.forename: Jitka
authors.initials: J
authors.lastname: Vankova
authors.forename: Sona
authors.initials: S
authors.lastname: Nevsimalova
authors.forename: Stefano
authors.initials: S
authors.lastname: Vandi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Montagna
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002385:Cataplexy / Q000150:complications* / Q000503:physiopathology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D009290:Narcolepsy / Q000150:complications* / Q000503:physiopathology*; D009991:Oscillometry; D017286:Polysomnography; D012894:Sleep Stages; D012895:Sleep, REM