Manipulation of skin temperature improves nocturnal sleep in narcolepsy
Manipulation of skin temperature improves nocturnal sleep in narcolepsy
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DOI：
10.1136/jnnp.2008.143610
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发表时间：
2008-12-01
影响因子：
11
通讯作者：
Van Someren, E. J. W.
中科院分区：
文献类型：
--
作者：
Fronczek, R.;Raymann, R. J. E. M.;Van Someren, E. J. W.
目的：发作性睡病患者除了白天过度嗜睡外，夜间睡眠障碍也是其主要主诉。以前，发作性睡病患者皮肤温度调节的改变已被证明与嗜睡增加有关。本研究测试的假设，夜间皮肤温度的直接控制可能会被施加到改善发作性睡病patients.Methods：参与者是8例（5名男性）诊断为发作性睡病与cataeprazole根据ICSD-2标准，平均（SD）年龄28.6（6.4）岁，范围18-35岁。在两个晚上，睡眠记录多导睡眠图，而近端和远端皮肤温度操纵使用舒适的保暖衣，诱导皮肤温度周期缓慢，只有0.4摄氏度的幅度在舒适的范围内通常观察到的睡眠。Logistic回归分析评估皮肤温度操作对不同睡眠阶段和夜间觉醒的发生概率的影响。结果：近端皮肤加温显著抑制觉醒和增强慢波睡眠（SWS）。相比之下，远端皮肤加温增强了觉醒和第1阶段睡眠，但以SWS和REM睡眠为代价。近端皮肤变暖和远端皮肤冷却的最佳组合导致SWS增加了160%，REM睡眠增加了50%，清醒减少了68%，与近端皮肤冷却和远端皮肤warming.Interpretation的最不利的组合相比，微妙的皮肤温度控制条件下的操作显着改善了典型的夜间睡眠发作性睡病的问题。
Objective: Besides excessive daytime sleepiness, disturbed nocturnal sleep is a major complaint of patients with narcolepsy. Previously, alterations in skin temperature regulation in narcoleptic patients have been shown to be related to increased sleepiness. This study tests the hypothesis that direct control of nocturnal skin temperature might be applied to improve the disturbed sleep of narcoleptic patients.Methods: Participants were eight patients (five males) diagnosed as having narcolepsy with cataplexy according to the ICSD-2 criteria, mean (SD) age 28.6 (6.4) years, range 18-35 years. During two nights, sleep was recorded polysomnographically while proximal and distal skin temperature were manipulated using a comfortable thermosuit that induced skin temperature to cycle slowly with an amplitude of only 0.4 degrees C within the comfortable range normally observed during sleep. Logistic regression was used to evaluate the effect of skin temperature manipulation on the probability of occurrence of different sleep stages and nocturnal wakefulness.Results: Proximal skin warming significantly suppressed wakefulness and enhanced slow wave sleep (SWS). In contrast, distal skin warming enhanced wakefulness and stage 1 sleep at the cost of SWS and REM sleep. The optimal combination of proximal skin warming and distal skin cooling led to a 160% increase in SWS, a 50% increase in REM sleep and a 68% decrease in wakefulness, compared with the least beneficial combination of proximal skin cooling and distal skin warming.Interpretation: Subtle skin temperature manipulations under controlled conditions significantly improved the typical nocturnal sleep problems in narcolepsy.