title: Impact of acute administration of sodium oxybate on nocturnal sleep polysomnography and on multiple sleep latency test in narcolepsy with cataplexy.
abstract: OBJECTIVE
  To analyze the acute effects of sodium oxybate (SO) on polysomnographic night-time recordings (PSG) and multiple sleep latency test (MSLT) on patients with narcolepsy with cataplexy (NC).
  
  
  METHODS
  Sixteen NC adult patients were recruited, together with 16 normal controls. Two consecutive PSG followed by two MSLT sessions were carried out, before and during the first night of SO assumption, respectively.
  
  
  RESULTS
  The administration of SO was followed by a significant decrease in number of stage shifts and awakenings, wakefulness after sleep onset, and percentage of sleep stage 1. Sleep efficiency and slow wave sleep percentage increased. REM latency decreased significantly from 73 to 12 min. Cyclic alternating pattern (CAP) rate remained unchanged but the percentage of CAP A3 subtypes decreased. The number of CAP A3 subtypes per hour of NREM sleep decreased significantly, whereas that of A1 remained unchanged. The duration of A1 and A3 subtypes was slightly increased. Chin muscle tone was not modified by SO as well as periodic leg movements during sleep, but their periodicity index decreased, becoming similar to that of controls. MSLT sleep latency also significantly improved after SO intake.
  
  
  CONCLUSIONS
  The administration of SO in NC patients is followed by immediate important and complex effects on PSG parameters and MSLT, including an evident (over)increase in slow wave sleep, which does not display a physiological microstructure, a moderate decrease in periodic and isolated LMs, possibly mediated by a disinhibited dopaminergic neuronal activity, and an improvement on daytime mean sleep latency at the MSLT.
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy. Electronic address: giuseppe.plazzi@unibo.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pizza
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Vandi
authors.affiliation: Sleep Research Centre, Department of Neurology I.C., Oasi Institute IRCCS, Troina, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Aricò
authors.affiliation: Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.affiliation: Department of Neurology, Hôpital Gui de Chauliac, CHU Montpellier, National Reference Network for Narcolepsy, Inserm U1061, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.affiliation: Sleep Research Centre, Department of Neurology I.C., Oasi Institute IRCCS, Troina, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
mesh_terms: D000328:Adult; D002385:Cataplexy / Q000188:drug therapy*; D004576:Electromyography / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000188:drug therapy*; D017286:Polysomnography / Q000187:drug effects*; D012890:Sleep / Q000187:drug effects*; D012894:Sleep Stages / Q000187:drug effects*; D012978:Sodium Oxybate / Q000627:therapeutic use*
chemical_list: D012978:Sodium Oxybate
keywords: Chin EMG tone; Cyclic alternating pattern; Narcolepsy with cataplexy; Periodic limb movements during sleep; Periodicity index; REM sleep atonia index; Sodium oxybate