Circadian Rest-Activity Rhythm in Pediatric Type 1 Narcolepsy

• DOI: 10.5665/sleep.5842
• Publication Date: 2016-05-31T21:12:46Z
• Authors: Marco Filardi; Fabio Pizza; Oliviero Bruni; Vincenzo Natale; Giuseppe Plazzi
• Keywords: Male; Schools; Adolescent; Circadian rhythm; Rest; Motor activity; Pediatrics; Actigraphy; actigraphy; circadian rhythms; motor activity; narcolepsy; pediatrics; Circadian Rhythm; 03 medical and health sciences; Cataplexy; 0302 clinical medicine; Humans; Female; Child; Sleep; Students; Algorithms; Narcolepsy

Pediatric type 1 narcolepsy is often challenging to diagnose and remains largely undiagnosed. Excessive daytime sleepiness, disrupted nocturnal sleep, a peculiar phenotype of cataplexy are the prominent features. The knowledge available about regulation circadian rhythms in affected children scarce. This study compared rest-activity rhythm actigraphic estimated sleep measures with versus healthy controls. Twenty-two drug-naïve 21 age- sex- matched controls were monitored for seven days during school week by actigraphy. Circadian activity analyzed through functional linear modeling; diurnal from using validated algorithm. Children presented an altered characterized enhanced motor throughout night blunted first afternoon. No difference was found between timing phase. Actigraphic showed good discriminant capabilities assessing nycthemeral disruption. Actigraphy reliably renders disruption typical recent disease onset, indicating sensibility assessment diagnostic work-up childhood 1. pediatric narcolepsy, showing nighttime increased activity, decrease early afternoon hours. Recording actigraphy promises be reliable objective marker complex pathway children. simple cheap screening could help improve diagnosis, may prove useful assess severity ecologically monitor treatments response.