Neurology · 2020
REM Sleep Behavior Disorder in Children With Type 1 Narcolepsy Treated With Sodium Oxybate.
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Antelmi Elena, Filardi Marco, Pizza Fabio, Vandi Stefano, Moresco Monica, Franceschini Christian, Tinazzi Michele, Ferri Raffaele, Plazzi Giuseppe
Аннотация
OBJECTIVE: To study the effect of stable treatment with sodium oxybate (SO) on nocturnal REM sleep behavior disorder (RBD) and REM sleep without atonia (RSWA) that severely affected children with type 1 narcolepsy (NT1).
METHODS: Nineteen children and adolescents with NT1 (9 female, mean age 12.5 ± 2.7 years, mean disease duration 3.4 ± 1.6 years) underwent neurologic investigations and video-polysomnography (v-PSG) at baseline and after 3 months of stable treatment with SO. v-PSG was independently analyzed by 2 sleep experts to rate RBD episodes. RSWA was automatically computed by means of the validated REM sleep atonia index (RAI).
RESULTS: Compared to baseline, RAI significantly improved (p < 0.05) and complex movements during REM sleep were remarkably reduced after stable treatment with SO. Compared to baseline, children also reported improvement in clinical complaints and showed a different nighttime sleep-stage architecture.
CONCLUSIONS: RBD and RSWA improved after treatment with SO, pointing to a direct role of the drug in modulating motor control during REM sleep.
CLASSIFICATION OF EVIDENCE: This study offers Class IV evidence of the positive effect of SO on modulation of muscle atonia during REM sleep in children with NT1 because of the absence of a control group.
METHODS: Nineteen children and adolescents with NT1 (9 female, mean age 12.5 ± 2.7 years, mean disease duration 3.4 ± 1.6 years) underwent neurologic investigations and video-polysomnography (v-PSG) at baseline and after 3 months of stable treatment with SO. v-PSG was independently analyzed by 2 sleep experts to rate RBD episodes. RSWA was automatically computed by means of the validated REM sleep atonia index (RAI).
RESULTS: Compared to baseline, RAI significantly improved (p < 0.05) and complex movements during REM sleep were remarkably reduced after stable treatment with SO. Compared to baseline, children also reported improvement in clinical complaints and showed a different nighttime sleep-stage architecture.
CONCLUSIONS: RBD and RSWA improved after treatment with SO, pointing to a direct role of the drug in modulating motor control during REM sleep.
CLASSIFICATION OF EVIDENCE: This study offers Class IV evidence of the positive effect of SO on modulation of muscle atonia during REM sleep in children with NT1 because of the absence of a control group.