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Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy

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  4. Restless legs syndrome is associated with major comorbidities in a population of Danish blood donors

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  5. Flow cytometry analysis of T-cell subsets in cerebrospinal fluid of narcolepsy type 1 patients with long-lasting disease

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  1. Sleep in cluster headache revisited: Results from a controlled actigraphic study

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  2. Assessment of diurnal melatonin, cortisol, activity, and sleep-wake cycle in patients with and without diabetic retinopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Disturbed sleep in cluster headache is not the result of transient processes associated with the cluster period

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  4. Neuroimaging markers of global cognition in early Alzheimer's disease: A magnetic resonance imaging-electroencephalography study

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Narcolepsy is a rare disabling hypersomnia disorder that may include cataplexy, sleep paralysis, hypnagogic hallucinations, and sleep-onset rapid eye movement (REM) periods, but also disrupted nighttime sleep by nocturnal awakenings, and REM sleep behavior disorder (RBD). RBD is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with neurodegenerative disorders including Parkinsonisms, but is also reported in narcolepsy in up to 60% of patients. RBD in patients with narcolepsy is, however, a distinct phenotype with respect to other RBD patients and characterized also by absence of gender predominance, elementary rather than complex movements, less violent behavior and earlier age at onset of motor events, and strong association to narcolepsy with cataplexy/hypocretin deficiency. Patients with narcolepsy often present dissociated sleep features including RSWA, increased density of phasic chin EMG and frequent shift from REM to NREM sleep, with or without associated clinical RBD. Most patients with narcolepsy with cataplexy lack the hypocretin neurons in the lateral hypothalamus. Tonic and phasic motor activities in REM sleep and dream-enacting behavior are mostly reported in presence of cataplexy. Narcolepsy without cataplexy is a condition rarely associated with hypocretin deficiency. We proposed that hypocretin neurons are centrally involved in motor control during wakefulness and sleep in humans, and that hypocretin deficiency causes a functional defect in the motor control involved in the development of cataplexy during wakefulness and RBD/RSWA/phasic motor activity during REM sleep.
Original languageEnglish
JournalSleep Medicine
Volume14
Issue number8
Pages (from-to)775-81
Number of pages7
ISSN1389-9457
DOIs
Publication statusPublished - Aug 2013

ID: 42958555