Correction: Implications of Oxybate Dosing Regimen for Sleep, Sleep Architecture, and Disrupted Nighttime Sleep in Patients with Narcolepsy: A Commentary

Correction to: Neurol Ther (2023) 12:1805–1820 10.1007/s40120-023-00543-z

In this article Russell Rosenberg is deceased; Chad Ruoff has been denoted as the corresponding author with affiliation ‘Division of Pulmonary Medicine, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA, e-mail: Ruoff.Chad@mayo.edu’.

In Table 2 of this Commentary article, for the number of sleep stage shifts, number of arousals, and patient-reported sleep quality, the values for the REST-ON trial were inadvertently taken from a subgroup analysis of participants taking stimulants presented in Table 2 of the source article [1], rather than from the modified intent-to-treat (mITT) population (reported in Figs. 1–3 of the source article). Additionally, a minus symbol was missing from the value reported for the number of awakenings for the placebo group corresponding to the 6 g dose for SXB trial 2 and values were adjusted to remove “0” after a decimal place where unnecessary for this trial. Table 2 in our Commentary article has been corrected (see next page) to provide the values for the mITT population for the 3 parameters from the REST-ON trial and add the omitted minus symbol and align the decimal places for SXB trial 2.

Table 2.

Effects of oxybate treatment on PSG measures of DNS

	Twice-nightly oxybate (SXB)				Once-nightly oxybate (SXB-ER)
	SXB trial 1	SXB trial 2	Pediatric SXB trial	SXB trial 3	REST-ON trial
PSG measures of DNS	Median change from baseline to 8 weeks	Median change from baseline to 4 weeks (6 g) or 8 weeks (9 g)	Median change from baseline to end of study (individual doses)	Mean at 4 weeks (4.5 g), 6 weeks (6 g), 8 weeks (7.5 g), or 10 weeks (9 g)	LSMD vs placebo at week 3 (6 g), week 8 (7.5 g), or week 13 (9 g)
TST, min	Increased  Placebo: 0.3  SXB 4.5 g: 0  SXB 6 g: 13.0  SXB 9 g: 18.0†	Not significant  Placebo: − 5.5  SXB 6 g: − 5  Placebo: − 0.5  SXB 9 g: − 4.5	–	Not significant (4.5 g decreased)  Baseline: 383.4  SXB 4.5 g: 364.8*  SXB 6 g: 363.0  SXB 7.5 g: 374.1  SXB 9 g: 380.8	–
WASO, min	Decreased  Placebo: 2.0  SXB 4.5 g: − 5.8  SXB 6 g: − 3.8  SXB 9 g: − 22.0†	–	–	–	–
N1, min (except pediatric data)	Decreased  Placebo: − 2.3  SXB 4.5 g: − 9.5  SXB 6 g: − 13.5†††  SXB 9 g: − 22.5†††	Decreased  Placebo: 3.25  SXB 6 g: − 9.5  Placebo: 1.5  SXB 9 g: − 16†††	Decreased  SXB-naive: − 4.6%  Taking SXB at study entry: − 0.6%	Not significant  Baseline: 74.8  SXB 4.5 g: 72.3  SXB 6 g: 68.1  SXB 7.5 g: 69.4  SXB 9 g: 62.6	Decreased  SXB-ER 6 g: − 5.9†  SXB-ER 7.5 g: − 11.0†††  SXB-ER 9 g: − 13.4†††
N2, min	Not significant  Placebo: 3.5  SXB 4.5 g: 9.5  SXB 6 g: 13.0  SXB 9 g: 31.5	Not significant  Placebo: − 5.25  SXB 6 g: 0.5  Placebo: − 8.25  SXB 9 g: 3.5	No change  Values not reported	Not significant  Baseline: 217.8  SXB 4.5 g: 216.9  SXB 6 g: 216.9  SXB 7.5 g: 224.1  SXB 9 g: 238.0	Not significant  SXB-ER 6 g: − 6.6  SXB-ER 7.5 g: 3.6  SXB-ER 9 g: − 13.5
SWS, min (except pediatric data)	Increased  Placebo: 0  SXB 4.5 g: 3.0†  SXB 6 g: 21.0†††  SXB 9 g: 52.5†††	Increased  Placebo: 0  SXB 6 g: 11†  Placebo: 0  SXB 9 g: 43.5†††	Increased  SXB-naive: 12.6%  Taking SXB at study entry: − 1.0%	Increased  Baseline: 3.0 (1st half), 0.6 (2nd half)  SXB 4.5 g: 3.5 (1st half), 0.7 (2nd half)  SXB 6 g: 5.5 (1st half), 4.5 (2nd half)  SXB 7.5 g: 9.8 (1st half), 4.5* (2nd half)  SXB 9 g: 14.2 (1st half), 12.6* (2nd half)	Increased  SXB-ER 6 g: 22.1†††  SXB-ER 7.5 g: 26.8†††  SXB-ER 9 g: 38.4†††
REM, min (except pediatric data)	Decreased  Placebo: − 1.0  SXB 4.5 g: − 6.0  SXB 6 g: − 7.0  SXB 9 g: − 22.0†	Decreased  Placebo: 6.25  SXB 6 g: − 14.5††  Placebo: 10  SXB 9 g: − 38.5†††	Decreased  SXB-naive: − 6.0%  Taking SXB at study entry: not reported	Decreased  Baseline: 31.2 (1st half), 56.0 (2nd half)  SXB 4.5 g: 29.7 (1st half), 43.5* (2nd half)  SXB 6 g: 26.3 (1st half), 42.7*** (2nd half)  SXB 7.5 g: 31.3 (1st half), 34.9*** (2nd half)  SXB 9 g: 22.9 (1st half), 30.5*** (2nd half)	Decreased  SXB-ER 6 g: − 16.7†††  SXB-ER 7.5 g: − 27.2†††  SXB-ER 9 g: − 24.5†††
Shifts from N2/N3/REM to N1/wake	Decreased (LSM change from baseline in shifts per hour)  Placebo: − 0.8  SXB 4.5 g: − 1.7  SXB 6 g: − 2.7†  SXB 9 g: − 4.4†††	Decreased (LSM change from baseline in shifts per night)  Placebo: − 0.6  SXB 9 g: − 16.5†††	–	–	Decreased (LSMD change from baseline in shifts per night to wake or N1 from N1, N2, N3, and REM)  SXB-ER 6 g: − 11.0†††  SXB-ER 7.5 g: − 17.7†††  SXB-ER 9 g: − 22.6†††
Shifts from N2/N3 to N1/wake	Decreased (LSM change from baseline in shifts per hour)  Placebo: − 0.3  SXB 4.5 g: − 0.9  SXB 6 g: − 1.7†  SXB 9 g: − 3.1†††	–	–	–
Shifts from REM to N1/wake	Decreased (LSM change from baseline in shifts per hour)  Placebo: − 1.9  SXB 4.5 g: − 3.8  SXB 6 g: − 5.0  SXB 9 g: − 7.6†	Decreased (LSM change from baseline in shifts per night)  Placebo: − 0.6  SXB 9 g: − 6.0†††	–	–
Arousals	–	–	Decreased  SXB-naive: − 43.0  Taking SXB at study entry: − 1.0	–	Decreased  SXB-ER 6 g: − 11.3†  SXB-ER 7.5 g: − 19.4†††  SXB-ER 9 g: − 23.7†††
Awakenings	Decreased  Placebo: − 0.5  SXB 4.5 g: − 5.0  SXB 6 g: − 8.0††  SXB 9 g: − 12.0††	Decreased  Placebo: − 0.5  SXB 6 g: − 1  Placebo: − 0.5  SXB 9 g: − 6††	No change  SXB-naive: − 4.0 awakenings  Taking SXB at study entry: 1.5 awakenings	Decreased  Baseline: 50.2  SXB 4.5 g: 50.0  SXB 6 g: 45.1  SXB 7.5 g: 37.3***  SXB 9 g: 37.8**	–
Patient-reported sleep quality	Improved (4-point Likert scale)a  Placebo: − 0.10  SXB 4.5 g: − 0.41†  SXB 6 g: − 0.31†  SXB 9 g: − 0.46†††	Improved (LSM change from baseline on question 6 of the PSQI)  Placebo: − 0.07  SXB 9 g: − 0.52†††	–	Improved (Self-reported degree of change)  Baseline: 0% (much), 14% (somewhat)  SXB 4.5 g: 19% (much), 57% (somewhat)  SXB 6 g: 24% (much), 67% (somewhat)  SXB 7.5 g: 24% (much), 62% (somewhat)  SXB 9 g: 24% (much), 57% (somewhat)	Improved (Visual analog scale from 0–100)b  SXB-ER 6 g: 7.0†††  SXB-ER 7.5 g: 9.9†††  SXB-ER 9 g: 10.4†††

DNS disrupted nighttime sleep, LSM least squared mean, LSMD least squared mean difference, N1/2 stage 1/2 non-rapid eye movement sleep, ns not significant, PSG polysomnography, REM rapid eye movement, S3/S4 stage 3/4, SWS slow-wave sleep, SXB sodium oxybate, SXB-ER sodium oxybate for extended release, TST total sleep time, WASO wake after sleep onset

^aAssessed with 4-point Likert-type scale (0, excellent; 1, good; 2, fair; 3, poor)

^bBaseline scores were 53.8 and 55.9 in ON-SXB and placebo groups, respectively

^†P < 0.05 vs placebo. ^††P < 0.01 vs placebo. ^†††P < 0.001 vs placebo. *P < 0.05 vs baseline. **P < 0.01 vs baseline. ***P < 0.005 vs baseline. – denotes a variable not assessed in this trial. No statistical testing was performed in the pediatric trial

Similarly, in the section “Both Twice-Nightly and Once-Nightly Oxybate Regimens Improve PSG Measures of DNS, With a Similar Magnitude of Effect” of this article, the number of stage shifts was incorrectly given as − 19.6 (the value for the subgroup analysis) instead of − 20.5 (the value for the modified intent-to-treat population). The corrected sentence is as follows: “Following 13 weeks of SXB-ER treatment (titrated to 9 g), total shifts per night from N1/2/3/REM to wake and N2/3/REM to N1 decreased significantly from baseline (LSM, − 20.5); this trial did not report stage shifts broken down by sleep stage as were reported in SXB trials 1 and 2 [20].”

These corrections do not impact the conclusions of this Commentary article.

The original article has been corrected.