scholarly journals Insomnia with physiological hyperarousal is associated with lower weight: a novel finding and its clinical implications

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rong Ren ◽  
Ye Zhang ◽  
Linghui Yang ◽  
Larry D. Sanford ◽  
Xiangdong Tang
Keyword(s):  
Body Weight ◽  
Sleep Latency ◽  
Clinical Implications ◽  
Sleep Laboratory ◽  
Severe Phenotype ◽  
Lower Weight ◽  
Pathological Mechanism ◽  
Physiological Hyperarousal ◽  
Multiple Sleep Latency ◽  
Physiologic Data

AbstractPrevious studies on the association of insomnia with body mass index (BMI) have been controversial. Physiological hyperarousal, the key pathological mechanism of insomnia, may be an important reason for different findings. We explored whether insomnia with physiological hyperarousal measured by the multiple sleep latency test (MSLT) is associated with body-weight differences. A total of 185 normal sleepers and 440 insomniacs were included in this study. Insomnia was defined by standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent one night of laboratory polysomnography followed by a standard MSLT. We used the median MSLT value (i.e., ≥14 min) to define physiological hyperarousal. BMI was based on measured height (cm) and weight (kg) during the subjects’ sleep laboratory visit. BMI > 25 kg/m2 was defined as overweight, while BMI < 18.5 kg/m2 was defined as underweight. After controlling for confounders, the odds of lower weight rather than overweight were significantly increased among insomnia patients with increased MSLT: insomnia with MSLT 14–17 min and MSLT > 17 min increased the odds of lower weight by approximately 89% (OR = 1.89, 95% CI 1.00–4.85) and 273% (OR = 3.73, 95% CI 1.51–9.22) compared with normal sleepers, respectively. In contrast, insomnia in patients with MSLT 11–14 min and 8–11 min was not different from normal sleepers in terms of body weight. Insomnia associated with physiological hyperarousal, the most severe phenotype of chronic insomnia, is associated with higher odds of lower weight and underweight compared with normal sleepers. This is a novel finding consistent with previous physiologic data and has significant clinical implications.

scholarly journals Late-Onset Narcolepsy: A Case Report with Brief Review of the Literature

2021 ◽  
Author(s):  
Jeny Jacob ◽  
Rajesh Venkataram ◽  
Nandakishore Baikunje ◽  
Rashmi Soori
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Late Onset ◽  
Sleep Latency ◽  
Early Adulthood ◽  
Review Of The Literature ◽  
Multiple Sleep Latency ◽  
Overnight Polysomnography

AbstractNarcolepsy, a sleep disorder, has its onset in childhood and early adulthood but rarely in older adults. This case report focuses on a man in his late fifties who was noticed to have excessive daytime sleepiness during his stay in our hospital for an unrelated medical ailment. He was further evaluated with overnight polysomnography and next day multiple sleep latency test which confirmed the diagnosis of narcolepsy.

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

scholarly journals Smoking Prevalence and Its Clinical Correlations in Patients with Narcolepsy-cataplexy

2016 ◽  
Vol 117 (2-3) ◽  
pp. 81-89 ◽  
Author(s):  
Pavla Peřinová ◽  
Eva Feketeová ◽  
David Kemlink ◽  
Petra Kovalská ◽  
Karolína Chlebušová ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Neurological Disease ◽  
Smoking Prevalence ◽  
Sleep Latency ◽  
Clinical Parameters ◽  
Smoking Duration ◽  
Former Smokers ◽  
Clinical Correlations ◽  
The Mean ◽  
Multiple Sleep Latency

Narcolepsy-cataplexy (NC) is a chronic neurological disease with suggested autoimmune etiopathogenesis. Nicotine stimulates central nervous system and smoking increases the risk of autoimmune diseases. Assessment of smoking habits and its correlation to clinical parameters among 87 adult NC patients (38 male, 49 female) included night polysomnography and multiple sleep latency test. In our sample, 43.7% NC patients were regular smokers, and 19.5% former smokers compared to 22.2%, and 12.6%, respectively, in the general population. Patients started to smoke in the mean age of 20.0 (SD ±6.0) years. 72.2% of NC smokers started to smoke before the onset of NC and the mean of the delay between smoking onset and NC onset was 9.1 (±5.8) years. We found a direct correlation between smoking duration and the number of awakenings, duration of N1 sleep, REM sleep latency, and apnoea/hypopnoea index (AHI), and, on the contrary, indirect correlation between smoking duration and N3 sleep duration, showing that smoking duration consistently correlates with sleep macrostructure. Smoking is highly prevalent in NC and has relationship with clinical features of NC.

scholarly journals Introduction to Sleep Testing

2019 ◽  
pp. 29-80
Author(s):  
Nancy Foldvary-Schaefer ◽  
Madeleine Grigg-Damberger ◽  
Reena Mehra
Keyword(s):  
Sleep Apnea ◽  
Airway Pressure ◽  
Multiple Sleep Latency Test ◽  
Sleep Laboratory ◽  
Maintenance Of Wakefulness Test ◽  
Home Sleep Apnea Testing ◽  
Multiple Sleep Latency ◽  
Apnea Testing

This chapter provides an overview of sleep testing performed inside or outside the sleep laboratory. The chapter reviews the classification of sleep studies and methodology of in-lab polysomnography and home sleep apnea testing. Specifically, the indications for and relative contraindications and limitations of both procedures are discussed. Positive airway pressure (PAP) titration procedures are reviewed and the PAP-NAP, an abbreviated daytime study for patients with sleep apnea and PAP intolerance or hesitancy, is described. The authors also discuss the methodology of, indications for, and interpretation of the multiple sleep latency test and the maintenance of wakefulness test, which are daytime studies performed to evaluate excessive daytime sleepiness. Finally, the role of actigraphy in the evaluation of sleep disorders is discussed.

scholarly journals Periodic hypersomnia, congenital ectodermal disorders and multiple exostosis

1989 ◽  
Vol 47 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Rubens Reimão ◽  
Aron Diament
Keyword(s):  
Acanthosis Nigricans ◽  
Sleep Latency ◽  
Mental Deficiency ◽  
Multiple Sleep Latency Test ◽  
Incontinentia Pigmenti ◽  
Congenital Disorders ◽  
Hereditary Multiple Exostosis ◽  
Multiple Sleep Latency

A case of periodic hypersomnia in an 11-year-old female with the unique features of mental deficiency, incontinentia pigmenti, acanthosis nigricans and hereditary multiple exostosis (diaphysial aclasis) is reported. The clinical, Polysomnographic and Multiple Sleep Latency test features of this case with a follow up of seven years are consistent with a diagnosis of periodic (intermittent) excessive somnolence. The unique presentation, however, does differ from Kleine-Levin syndrome and suggests a relationship between the predominantly ectodermal, congenital disorders and the sleep-wake, pattern dysfunction.

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