title: Catathrenia under sodium oxybate in narcolepsy with cataplexy.
abstract: OBJECTIVE
  This study aims to report on catathrenia occurring in narcolepsy with cataplexy (NC) patients under sodium oxybate (SO) treatment. Catathrenia is a parasomnia characterized by groaning and an abnormal respiratory pattern during sleep.
  
  
  METHODS
  Fifty-one patients with NC and starting SO therapy underwent a baseline overnight polysomnography (PSG) to detect any sleep-related breathing disorders (SRBD). To avoid risks due to a possible central respiratory control depression by SO, all patients with concomitant obstructive sleep apnea (OSA) were treated with a nasal continuous positive airway pressure (nCPAP) device. After 2 months of treatment with SO, all patients underwent a follow-up overnight PSG to investigate possible newly occurring SRBD. They also underwent a semi-structured clinical interview to monitor other potential SO side effects.
  
  
  RESULTS
  At baseline, four out of 51 patients showed simple snoring, and eight, mild to severe OSA. After a titration PSG night, patients with OSA received a nCPAP device. After 2 months of SO treatment, 28 patients (54.9%) showed SO-related side effects, including SRBD in 11 (21.6%). The follow-up PSG showed a respiratory pattern characteristic of catathrenia in seven patients (13.7%) as a newly observed and possibly benign SO side effect, and ruled out a worsening of OSA.
  
  
  CONCLUSIONS
  Catathrenia should be considered a possible side effect in NC patients under SO treatment and should be accurately identified to prevent unnecessary SO withdrawal.
authors.affiliation: Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Lara
authors.initials: L
authors.lastname: Ricotta
authors.forename: Stefano
authors.initials: S
authors.lastname: Vandi
authors.forename: Christian
authors.initials: C
authors.lastname: Franceschini
authors.forename: Fabio
authors.initials: F
authors.lastname: Pizza
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Palaia
authors.forename: Keivan Kaveh
authors.initials: KK
authors.lastname: Moghadam
authors.forename: Donatella
authors.initials: D
authors.lastname: Banal
authors.forename: Roberto
authors.initials: R
authors.lastname: Vetrugno
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thorpy
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002385:Cataplexy / Q000188:drug therapy*; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000188:drug therapy*; D020447:Parasomnias / Q000139:chemically induced*; D010349:Patient Compliance; D017286:Polysomnography / Q000187:drug effects; D020181:Sleep Apnea, Obstructive / Q000188:drug therapy; D012978:Sodium Oxybate / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D012978:Sodium Oxybate