ArticleSleep2020
Defining disrupted nighttime sleep and assessing its diagnostic utility for pediatric narcolepsy type 1.
Article in Sleep, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 44 citations in OpenAlex.
- Article
- Impaired attention in pediatric narcolepsy type 1.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Rapid Eye Movement Sleep-Related Indicators with Promising Performance in Diagnosing Narcolepsy.Nature and science of sleep · 2026Article
- Present and Future of Central Disorders of Hypersomnolence.Journal of sleep research · 2025Review
- A Patient-centric Clinical Trial Design to Comprehensively Evaluate Low-Sodium Oxybate in People with Idiopathic Hypersomnia or Narcolepsy.Neurology and therapy · 2025Article
- Rising pressure to understand the risks of hypertension in children with narcolepsy type 1.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Narcolepsy and rapid eye movement sleep.Journal of sleep research · 2025Review
- Article
- Characterizing disrupted nighttime sleep and associated functional outcomes in youth with narcolepsy type 1.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Identifying time-resolved features of nocturnal sleep characteristics of narcolepsy using machine learning.Journal of sleep research · 2024Article
- Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in children: guidance from the American Academy of Sleep Medicine.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Role of Daytime Continuous Polysomnography in the Diagnosis of Pediatric Narcolepsy Type 1.Neurology · 2024Article
- Article
- Diagnosis and management of sleep disorders in Prader-Willi syndrome.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Review
- Disrupted nighttime sleep and sleep instability in narcolepsy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Review
- Stability of nocturnal wake and sleep stages defines central nervous system disorders of hypersomnolence.Sleep · 2021Article
- Narcolepsy type 1 features across the life span: age impact on clinical and polysomnographic phenotype.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review.Nature and science of sleep · 2021Review
- Impact of COVID-19 pandemic lockdown on narcolepsy type 1 management.Brain and behavior · 2021Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
STUDY
objectivesDisrupted nighttime sleep (DNS) is a core narcolepsy symptom of unconsolidated sleep resulting from hypocretin neuron loss. In this study, we define a DNS objective measure and evaluate its diagnostic utility for pediatric narcolepsy type 1 (NT1).
methodsThis was a retrospective, multisite, cross-sectional study of polysomnograms (PSGs) in 316 patients, ages 6-18 years (n = 150 NT1, n = 22 narcolepsy type 2, n = 27 idiopathic hypersomnia, and n = 117 subjectively sleepy subjects). We assessed sleep continuity PSG measures for (1) their associations with subjective and objective daytime sleepiness, daytime sleep onset REM periods (SOREMPs), self-reported disrupted nocturnal sleep and CSF hypocretin levels and (2) their predictive value for NT1 diagnosis. We then combined the best performing DNS measure with nocturnal SOREMP (nSOREMP) to assess the added value to the logistic regression model and the predictive accuracy for NT1 compared with nSOREMP alone.
resultsThe Wake/N1 Index (the number of transitions from any sleep stage to wake or NREM stage 1 normalized by total sleep time) was associated with objective daytime sleepiness, daytime SOREMPs, self-reported disrupted sleep, and CSF hypocretin levels (p's < 0.003) and held highest area under the receiver operator characteristic curves (AUC) for NT1 diagnosis. When combined with nSOREMP, the DNS index had greater accuracy for diagnosing NT1 (AUC = 0.91 [0.02]) than nSOREMP alone (AUC = 0.84 [0.02], likelihood ratio [LR] test p < 0.0001).
conclusionsThe Wake/N1 Index is an objective DNS measure that can quantify DNS severity in pediatric NT1. The Wake/N1 Index in combination with or without nSOREMP is a useful sleep biomarker that improves recognition of pediatric NT1 using only the nocturnal PSG.
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