Table 2.
Summary of studies involving PSG assessment of wake-sleep stages (duration, number, or transitions) during nocturnal sleep in narcolepsy.
| Narcolepsy vs Controls | NwC/NT1 vs NwoC/NT2 | Narcolepsy vs Other Disorders of Hypersomnolence | CSF hcrt-1 Levels | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Antelmi 201728 | Vandi 201930 | Pizza 201531 | Pizza 201531 | Maski 202132 | Maski 202132 | Sorensen 201336 | Pizza 201531 | Maski 202132 | Pizza 201531 | Pizza 201531 | Maski 202039 | Maski 202132 | Maski 202132 | Barateau 202060 | Sorensen 201336 | |
| Comparison | NT1 vs HC | NT1 vs C | NT1 vs sHS | NT2 vs sHS | NT1 vs SSS | NT2 vs SSS | NwC vs NwoC | NT1 vs NT2 | NT1 vs NT2 | NT1 vs IH | NT2 vs IH | NT1 vs NT2/ IH/ SSS | NT1 vs IH | NT2 vs IH | CSF hcrt-1 ≤ 110 pg/mL vs CSF hcrt-1 > 110 pg/mL | CSF hcrt-1 < 129 pg/mL vs CSF hcrt-1 ≥ 129 pg/mL |
| Population | Ped | Ped | Adult | Adult | Primarily ped (5–21 y) | Primarily ped (5–21 y) | Adult | Adult | Primarily ped (5–21 y) | Adult | Adult | Ped | Primarily ped (5–21 y) | Primarily ped (5–21 y) | Adult (n = 229) and ped (n = 71) | Adult |
| Group sizes | NT1: 40 HC: 22 | NT1: 27 C: 19 | NT1: 79 sHS: 52 | NT2: 22 sHS: 52 | NT1: 46 SSS: 48 | NT2: 12 SSS: 48 | NwC: 43 NwoC: 20 | NT1: 79 NT2: 22 | NT1: 46 NT2: 12 | NT1: 79 IH: 22 | NT2: 22 IH: 22 | NT1: 150 NT2: 22 IH: 27 SSS: 117 | NT1: 46 IH: 18 | NT2: 12 IH: 18 | CSF hcrt-1 ≤ 110 pg/mL: 164 CSF hcrt-1 > 110 pg/mL: 136 | CSF hcrt-1 < 129 pg/mL: 37 CSF hcrt-1 ≥ 129 pg/mL: 20 |
| Transitions between/among wake, sleep, sleep stages (bidirectional) | ||||||||||||||||
| Wake, sleep | ↑a | – | ↑a | nsa | – | – | ↑b | ↑a | – | ↑a | nsa | – | – | – | – | ↑b |
| Wake, NREM sleep, REM sleep | ↑a | – | ↑a | nsa | – | – | – | ↑a | – | ↑a | nsa | – | – | – | – | – |
| Wake, N1, N2/N3, REM sleep | ↑a | – | ↑a | nsa | – | – | – | ↑a | – | ↑a | nsa | – | – | – | – | – |
| REM sleep, NREM sleep | – | – | – | – | – | – | nsb | – | – | – | – | – | – | – | – | nsb |
| N1, N2, N3 | – | – | – | – | – | – | nsb | – | – | – | – | – | – | – | – | nsb |
| N1, N2, N3, REM | – | – | – | – | – | – | nsb | – | – | – | – | – | – | – | – | nsb |
| Wake, N1, N2, N3, REM sleep | – | ns (↑ P = .07)c | – | – | – | – | – | – | – | – | – | – | – | – | – | |
| Transitions from sleep to wake (directional) | ||||||||||||||||
| Sleep to wake | – | – | – | – | – | – | – | – | – | – | – | ↑d | – | – | ↑ | – |
| REM sleep to wake | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| REM sleep to N1/wake | – | – | – | – | – | – | – | – | – | – | – | ↑d | – | – | – | – |
| NREM sleep to wake | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| N1 to wake | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – | |
| N2 to wake | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| N3 to wake | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| N2/N3 to N1/wake | – | – | – | – | – | ↑d | – | – | – | |||||||
| N2/N3/REM sleep to N1/wake | – | – | – | – | – | – | – | – | – | – | – | ↑d | – | – | – | – |
| Sleep to wake and N2/N3/REM sleep to N1 | – | – | – | – | – | – | – | – | – | – | – | ↑d | – | – | – | – |
| Transitions from wake to sleep (directional) | ||||||||||||||||
| Wake to sleep | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Wake to REM sleep | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Wake to NREM sleep | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Wake bouts | ||||||||||||||||
| Wake bouts, total number | – | – | – | – | ↑ | ns | – | – | ↑ | – | – | – | ↑ | ns | ↑ | – |
| Wake bouts/h of wake time, index | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↓ | – |
| Wake bouts of 30 s, % | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Wake bouts of 1 min 30 s, % | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Sleep bouts | ||||||||||||||||
| Sleep bouts, total number | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Sleep bouts/h of sleep time, index | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Sleep bouts of ≤14 min (2–5 min), % | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↑ | – |
| Sleep bouts of >32 min 30 s, number | – | – | – | – | – | – | – | – | – | – | – | – | – | – | ↓ | – |
| N1 bouts, number | ↑ | ns | ↑ | ↑ | ns | |||||||||||
| N2 bouts, number | ↑ | ns | ↑ | ns | ns | |||||||||||
| N3 bouts, number | ns | ns | ns | ns | ns | |||||||||||
| REM sleep bouts, number | ↑ | ns | ns | ↑ | ns | |||||||||||
Number of transitions between states divided by time in bed (in hours). bNumber of transitions per hour of sleep of the investigated sleep stage. cNumber of transitions per hour between the start and the end of nocturnal sleep. dNumber of transitions per hour of total sleep time. C = control, CSF = cerebrospinal fluid, HC = healthy control, hcrt-1 = hypocretin-1, IH = idiopathic hypersomnia, N1/2/3 = stage 1/2/3 non-REM sleep, NREM = nonrapid eye movement, ns = not significant, NT1 = narcolepsy type 1, NT2 = narcolepsy type 2, NwC = narcolepsy with cataplexy, NwoC = narcolepsy without cataplexy, ped = pediatric, PSG = polysomnography, REM = rapid eye movement, sHS = subjective hypersomnolence, SSS = subjectively sleepy subjects.