Citation

Fronczek R, Raymann RJ, Romeijn N, Overeem S, Fischer M, van Dijk JG, Lammers GJ, Van Someren EJ. Sleep 2008; 31(2): 233-240.

Affiliation

Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.

Copyright

(Copyright © 2008, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

unavailable

PMID

18274271

PMCID

PMC2225580

Abstract

CONTEXT: Impaired vigilance and sleepiness are two majordaily complaints of patients with narcolepsy. We previously showed their sleepiness to be correlated to an abnormally regulated skin temperature, i.e., increased distal skin temperature compared with proximal skin temperature. OBJECTIVE: Our goal was to investigate a possible causal contribution of skin temperature disturbances to impairments in the ability to maintain vigilance and wakefulness in narcolepsy. DESIGN: In a modified constant routine protocol, the Psychomotor Vigilance Task (PVT) and the Maintenance of Wakefulness Test (MWT) were repeatedly assessed. Meanwhile, skin and core body temperatures were mildly manipulated within the thermoneutral range of the normal diurnal rhythm using a thermosuit and hot or cold food and drinks. SETTING: Tertiary narcolepsy referral center in a university hospital PATIENTS OR OTHER PARTICIPANTS: Eight patients (5 males) diagnosed with narcolepsy with cataplexy according to the ICSD-2 criteria (mean age +/- SD: 28.6 +/- 6.4, range 18-35 years). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): MWT sleep latency and PVT response speed. RESULTS: Compared to core cooling, core warming attenuated the typical decline in PVT response speed with increasing time-on-task by 25% (P = 0.02). Compared to distal skin warming, distal skin cooling increased the time that the patients were able to maintain wakefulness by 24% (distal warming: 1.88 min. vs. distal warming: 2.34 min.; P < 0.01). CONCLUSIONS: Core body and skin temperatures causally affect vigilance and sleepiness in narcolepsy. This could lead to future practical applications.

Language: en