Sleep · 2026
High-resolution sleep fragmentation assessment in narcolepsy type 1 and their non-narcoleptic siblings: a 5-s mini-epoch study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Follin Louise Frøstrup, Viste Rannveig, Vevelstad Janita, Langdalen Kristin, Hansen Berit Hjelde, Grande Ragnhild Kristine Berling, Kaufmann Tobias, Christensen Julie Anja Engelhard, Zahid Alexander Neergaard, Viken Marte Kathrine, Juvodden Hilde T, Knudsen-Heier Stine
Аннотация
STUDY OBJECTIVES: Narcolepsy type 1 (NT1) is characterized by fragmented sleep, yet brief transitions may be concealed in traditional 30-s epochs. We therefore aimed to assess sleep fragmentation in NT1 patients and their non-narcoleptic siblings using 5-s mini-epochs.
METHODS: We analyzed sleep stages from human-scored 30-s epochs and automatically (U-Sleep) scored 5-s mini-epochs in polysomnographies from 125 NT1 patients and their 100 non-narcoleptic siblings. Sleep fragmentation was quantified using transition indices and probabilities in epochs and mini-epochs, furthermore, stratified by 1st and 2nd night-half. Predictors (H1N1-vaccination, CSF hypocretin-1 deficiency severity (low [40-150 pg/mL]; undetectable [<40 pg/mL]), HLA-DQB1*06:02-positivity, narcolepsy core symptom severity) for sleep transitions were explored.
RESULTS: NT1 patients had significantly higher all-stages and sleep-wake transition indices compared to siblings in epochs and mini-epochs. Both epoch and mini-epoch transition indices varied significantly from 1st to 2nd night-half. Only in mini-epochs, sleep-wake fragmentation was (a) higher in patients with severe core symptoms, and (b) increased in the 2nd night-half in NT1 patients with severe hypocretin-1 deficiency (<40 pg/mL) and/or severe core symptoms.
CONCLUSIONS: Our findings suggest that sleep fragmentation, a core feature of NT1, is associated with disease severity and hypocretin deficiency severity when high-resolution sleep stages are analyzed. Five-second sleep staging and split-night analyses enhance detection of sleep instability and reveal new specific patterns and clinical associations. Automated mini-epoch analyses may improve future NT1 phenotyping and possibly its borderland by supplementing with clinically relevant high-resolution features otherwise hidden in traditional full-night 30-s epoch analyses. Statement of Significance This study demonstrates that high-resolution 5-s sleep staging provides more detailed sleep characterization than epochs and additionally uncovers clinically relevant sleep fragmentation patterns in narcolepsy type 1 which remain hidden in traditional 30-s analyses. By combining 5-s mini-epoch scoring with split-night analyses, we identified specific associations between disease severity and increased sleep-wake fragmentation. In mini-epochs, but not in epochs, sleep-wake fragmentation was significantly higher in patients with all core narcolepsy symptoms and increased significantly from the 1st to the 2nd night-half in patients with undetectable hypocretin-1 levels (<40 pg/mL) and/or all core narcolepsy symptoms. These findings highlight the clinical value of high-resolution, temporally sensitive sleep stage analyses for detailed phenotyping and detection of future disease biomarkers.
METHODS: We analyzed sleep stages from human-scored 30-s epochs and automatically (U-Sleep) scored 5-s mini-epochs in polysomnographies from 125 NT1 patients and their 100 non-narcoleptic siblings. Sleep fragmentation was quantified using transition indices and probabilities in epochs and mini-epochs, furthermore, stratified by 1st and 2nd night-half. Predictors (H1N1-vaccination, CSF hypocretin-1 deficiency severity (low [40-150 pg/mL]; undetectable [<40 pg/mL]), HLA-DQB1*06:02-positivity, narcolepsy core symptom severity) for sleep transitions were explored.
RESULTS: NT1 patients had significantly higher all-stages and sleep-wake transition indices compared to siblings in epochs and mini-epochs. Both epoch and mini-epoch transition indices varied significantly from 1st to 2nd night-half. Only in mini-epochs, sleep-wake fragmentation was (a) higher in patients with severe core symptoms, and (b) increased in the 2nd night-half in NT1 patients with severe hypocretin-1 deficiency (<40 pg/mL) and/or severe core symptoms.
CONCLUSIONS: Our findings suggest that sleep fragmentation, a core feature of NT1, is associated with disease severity and hypocretin deficiency severity when high-resolution sleep stages are analyzed. Five-second sleep staging and split-night analyses enhance detection of sleep instability and reveal new specific patterns and clinical associations. Automated mini-epoch analyses may improve future NT1 phenotyping and possibly its borderland by supplementing with clinically relevant high-resolution features otherwise hidden in traditional full-night 30-s epoch analyses. Statement of Significance This study demonstrates that high-resolution 5-s sleep staging provides more detailed sleep characterization than epochs and additionally uncovers clinically relevant sleep fragmentation patterns in narcolepsy type 1 which remain hidden in traditional 30-s analyses. By combining 5-s mini-epoch scoring with split-night analyses, we identified specific associations between disease severity and increased sleep-wake fragmentation. In mini-epochs, but not in epochs, sleep-wake fragmentation was significantly higher in patients with all core narcolepsy symptoms and increased significantly from the 1st to the 2nd night-half in patients with undetectable hypocretin-1 levels (<40 pg/mL) and/or all core narcolepsy symptoms. These findings highlight the clinical value of high-resolution, temporally sensitive sleep stage analyses for detailed phenotyping and detection of future disease biomarkers.