Measurement of Sleep-Onset REM Episodes During Sleep With and Without Sleep Deprivation - SOREM Episodes: State or Trait?

Descrizione riassuntiva dello studio

Approximately 5% of the general population suffers from central hypersomnolence disorders. This group of diseases includes various clinical pictures, such as narcolepsy type 1 (NT1) and type 2 (NT2), idiopathic hypersomnia (IH), and non-organic hypersomnias, among others. The common main symptom is excessive daytime sleepiness and/or increased sleep duration, with NT1 additionally characterized by cataplexy. Cataplexy is a temporary loss of muscle tone triggered by emotional situations. For the diagnosis of hypersomnolence, standardized nocturnal sleep studies (polysomnography; PSG) and daytime tests (multiple sleep latency test; MSLT) are conducted to obtain objective measurements. The key measurements are the time to sleep onset and the number of early REM sleep (=dream sleep) episodes, also called sleep onset REM (SOREM) episodes. The problem with current diagnostics is the unreliable test results of the MSLT test. Upon repetition of the MSLT, the same patient unexpectedly exhibited either more or fewer SOREM episodes, leading to a change in diagnosis in about 50% of patients. In our research project, we aim to find out whether an improved version of the MSLT test provides more reliable results and thus can improve diagnostics. An essential influencing factor on SOREM episodes seems to be the preceding sleep duration and body temperature. This work therefore investigates the occurrence of SOREM episodes depending on sleep duration and body temperature. To this end, a partial or total sleep deprivation is applied, and the number of SOREM episodes is measured in three hypersomnia groups. Using continuous temperature measurements, we investigate whether sleep deprivation is associated with a change in body temperature.

(BASEC)

Intervento studiato

With the study, we aim to improve the reliability of the MSLT test for the diagnosis of hypersomnolence. To do this, we need to understand what determines the occurrence of SOREM episodes. So far, we know that narcolepsy patients form REM sleep (=dream sleep) very quickly and easily, but we still understand too little about which factors influence the occurrence of REM sleep. Recent studies in animals indicate that a change in external temperature strongly influences the tendency to REM sleep. Earlier observations showed that REM sleep also depends on sleep duration. For this reason, the study seeks to determine whether experimentally induced sleep deprivation promotes the tendency for REM sleep and whether this is associated with a change in body temperature. We suspect that sleep deprivation especially promotes the tendency for REM sleep and thus the number of SOREM episodes in narcolepsy patients, while this does not occur in patients with other hypersomnolences. In scientific language, the planned experimental sleep deprivation is referred to as intervention. The intervention is randomized, meaning that patients are randomly assigned to one of three groups of experimental sleep deprivation. Patients must then stay awake either during the first half of the night, the second half of the night, or the entire night. Additionally, the study examines using two tests (watching funny videos and a children's game

(BASEC)

Malattie studiate

Narcolepsy type 1 (NT1), Narcolepsy type 2 (NT2), hypersomnolence of other causes (idiopathic hypersomnia, insufficient sleep syndrome, sleep apnea syndrome, etc.)

(BASEC)

Sponsor

Klinik Barmelweid

(BASEC)

Nome del comitato etico approvante (per studi multicentrici solo il comitato principale)

Commissione d'etica svizzera nord-ovest/centrale EKNZ

(BASEC)

Data di approvazione del comitato etico

22.08.2022

(BASEC)

Risultati dello studio