title: Core Body and Skin Temperature in Type 1 Narcolepsy in Daily Life; Effects of Sodium Oxybate and Prediction of Sleep Attacks.
abstract: Previous laboratory studies in narcolepsy patients showed altered core body and skin temperatures, which are hypothesised to be related to a disturbed sleep wake regulation. In this ambulatory study we assessed temperature profiles in normal daily life, and whether sleep attacks are heralded by changes in skin temperature. Furthermore, the effects of three months of treatment with sodium oxybate (SXB) were investigated.
  
  
  
  Twenty-five narcolepsy patients and 15 healthy controls were included. Core body, proximal and distal skin temperatures, and sleep-wake state were measured simultaneously for 24 hours in ambulatory patients. This procedure was repeated in 16 narcolepsy patients after at least 3 months of stable treatment with SXB.
  
  
  
  Increases in distal skin temperature and distal-to-proximal temperature gradient (DPG) strongly predicted daytime sleep attacks (P < 0.001). As compared to controls, patients had a higher proximal and distal skin temperature in the morning, and a lower distal skin temperature during the night (all P < 0.05). Furthermore, they had a higher core body temperature during the first part of the night (P < 0.05), which SXB decreased (F = 4.99, df = 1, P = 0.03) to a level similar to controls. SXB did not affect skin temperature.
  
  
  
  This ambulatory study demonstrates that daytime sleep attacks were preceded by clear changes in distal skin temperature and DPG. Furthermore, changes in core body and skin temperature in narcolepsy, previously only studied in laboratory settings, were partially confirmed. Treatment with SXB resulted in a normalisation of the core body temperature profile. Future studies should explore whether predictive temperature changes can be used to signal or even prevent sleep attacks.
authors: Leiden University Medical Centre, Leiden, The Netherlands.
authors: Astrid
authors: A
authors: van der Heide
authors: Department of Neurology, University Hospital Zurich, Switzerland.
authors: Esther
authors: E
authors: Werth
authors: Leiden University Medical Centre, Leiden, The Netherlands.|SleepWake Centre SEIN, Zwolle, The Netherlands.
authors: Claire E H M
authors: CE
authors: Donjacour
authors: Leiden University Medical Centre, Leiden, The Netherlands.
authors: Robert H A M
authors: RH
authors: Reijntjes
authors: Leiden University Medical Centre, Leiden, The Netherlands.|SleepWake Centre SEIN, Heemstede, The Netherlands.
authors: Gert Jan
authors: GJ
authors: Lammers
authors: Department Sleep & Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.|Departments of Integrative Neurophysiology and Psychiatry GGZ inGeest, Centre for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Centre, Amsterdam, The Netherlands.
authors: Eus J W
authors: EJ
authors: Van Someren
authors: Department of Neurology, University Hospital Zurich, Switzerland.
authors: Christian R
authors: CR
authors: Baumann
authors: Leiden University Medical Centre, Leiden, The Netherlands.
authors: Rolf
authors: R
authors: Fronczek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature / Q000187:drug effects*; D016022:Case-Control Studies; D002491:Central Nervous System Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D012881:Skin Temperature / Q000187:drug effects; D012978:Sodium Oxybate / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002491:Central Nervous System Agents; D012978:Sodium Oxybate
keywords: core body temperature; narcolepsy; skin temperature; sleep