The effects of sodium oxybate on core body and skin temperature regulation in narcolepsy.
Patients suffering from narcolepsy type 1 show altered skin temperatures, resembling the profile that is related to sleep onset in healthy controls. The aim of the present study is to investigate the effects of sodium oxybate, a widely used drug to treat narcolepsy, on the 24-h profiles of temperature and sleep-wakefulness in patients with narcolepsy and controls. Eight hypocretin-deficient male narcolepsy type 1 patients and eight healthy matched controls underwent temperature measurement of core body and proximal and distal skin twice, and the sleep-wake state for 24 h. After the baseline assessment, 2 × 3 g of sodium oxybate was administered for 5 nights, immediately followed by the second assessment. At baseline, daytime core body temperature and proximal skin temperature were significantly lower in patients with narcolepsy (core: 36.8 ± 0.05 °C versus 37.0 ± 0.05 °C, F = 8.31, P = 0.01; proximal: 33.4 ± 0.26 °C versus 34.3 ± 0.26 °C, F = 5.66, P = 0.03). In patients, sodium oxybate administration increased proximal skin temperature during the day (F = 6.46, P = 0.04) to a level similar as in controls, but did not affect core body temperature, distal temperature or distal-proximal temperature gradient. Sodium oxybate administration normalised the predictive value of distal skin temperature and distal-proximal temperature gradient for the onset of daytime naps (P < 0.01). In conclusion, sodium oxybate administration resulted in a partial normalisation of the skin temperature profile, by increasing daytime proximal skin temperature, and by strengthening the known relationship between skin temperature and daytime sleep propensity. These changes seem to be related to the clinical improvement induced by sodium oxybate treatment. A causal relationship is not proven.
Leiden University Medical Centre, Leiden, the Netherlands.
Astrid
A
van der Heide
Leiden University Medical Centre, Leiden, the Netherlands.|SleepWake Centre SEIN, Zwolle, the Netherlands.
Claire E H M
CE
Donjacour
Leiden University Medical Centre, Leiden, the Netherlands.
Hanno
H
Pijl
Leiden University Medical Centre, Leiden, the Netherlands.
Robert H A M
RH
Reijntjes
Sleep Medicine Centre 'Kempenhaeghe', Heeze, the Netherlands.|Radboud University Medical Centre, Nijmegen, the Netherlands.
Sebastiaan
S
Overeem
Leiden University Medical Centre, Leiden, the Netherlands.|SleepWake Centre SEIN, Heemstede, the Netherlands.
Gert J
GJ
Lammers
Department of Sleep & Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands.|Departments of Integrative Neurophysiology and Medical Psychology, Centre for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Centre, Amsterdam, the Netherlands.
Eus J W
EJ
Van Someren
Leiden University Medical Centre, Leiden, the Netherlands.
Rolf
R
Fronczek
D000293:Adolescent; D000328:Adult; D000368:Aged; D001833:Body Temperature Regulation / Q000187:drug effects*; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000188:drug therapy / Q000503:physiopathology*; D000068797:Orexins / Q000172:deficiency; D012881:Skin Temperature / Q000187:drug effects*; D012890:Sleep / Q000187:drug effects / Q000502:physiology; D012978:Sodium Oxybate / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
D000068797:Orexins; D012978:Sodium Oxybate
constant routine protocol; core body temperature; distal-proximal temperature gradient; sleep disorder; sleep onset; slow-wave sleep