![]() ![]() We measured nighttime and daytime ambulatory blood pressure (BP) and their night-to-day ratio, the digital pulse amplitude response (RH-PAT) to evaluate endothelial dysfunction in drug-free patients with narcolepsy-cataplexy (NC) compared to controls.Īll patients and controls gave their informed written consent to take part in the study which was approved by the Local Ethics Committee (University Hospital, Montpellier, France). īecause hypocretin system is one of the factors involved in the complex interaction between sleep and the cardiovascular system, we tested the hypothesis that hypocretin deficiency may affect markers of cardiovascular risk. Reactive hyperemia peripheral arterial tonometry (RH-PAT) is a non-invasive, operator-independent, easily reproducible technique that effectively predicts endothelial dysfunction (an early marker for atherosclerosis) and future adverse cardiac events –. Endothelial dysfunction is another predictive marker of cardiovascular morbidity and mortality. A meta-analysis showed that nighttime BP was a stronger predictor than daytime BP of adverse cardiovascular events. The nocturnal fall in BP has major clinical implications: a blunted nocturnal BP dip is associated with high risk of cardiovascular morbidity and mortality –. BP and HR variation and day–night BP decrease (the so-called “dipping pattern”) are strongly linked to the sleep-wake circadian rhythm. ĭespite frequent associations between NC and obesity, type 2 diabetes mellitus, and metabolic syndrome, few studies addressing cardiovascular consequences have been conducted in human NC. The increased BP and HR effects have been shown to be mediated mainly by sympathetic activation,. Pharmacological studies in mice or rats have revealed that the administration of hypocretin stimulates arousal and elevates arterial blood pressure, heart rate (HR), oxygen consumption, body temperature, and plasma catecholamine levels –. More recently, blunted NREM and REM sleep-related decreases in BP have been shown in hypocretin-deficient mice. Īnimal studies have explored the cardiovascular status of hypocretin-deficient rodent during wakefulness, showing lower arterial blood pressure (BP) compared to wild type. The hypocretin neurons are located exclusively in the lateral hypothalamus, but project widely throughout the central nervous system, including hypothalamic and brainstem structures known to participate in central autonomic and cardiovascular regulation. Marked decreases in hypocretin-1 in the cerebrospinal fluid and in the number of hypocretin neurons have been demonstrated in NC. Furthermore, frequent occurrences of rapid eye movement (REM) sleep onset periods during daytime and numerous awakenings during nocturnal sleep induce disruption of the sleep-wake cycle. Narcolepsy with cataplexy (NC) is characterized by excessive daytime sleepiness (EDS), cataplexy, and disturbed nocturnal sleep, including parasomnias, obstructive sleep apnea syndrome, and periodic leg movements. This does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials. Dauvilliers has participated in advisory boards of UCB and Bioprojet. ![]() Dauvilliers has received speaker’s honoraria and funding for travel to conferences from UCB Pharma, Cephalon, Novartis, and Bioprojet. Isabelle Jaussent and Sabine Scholz report no disclosures. Prs Levy and Pepin, Drs Krams and Lado report no disclosures. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: The authors have no support or funding to report.Ĭompeting interests: This was not an industry-supported study. Received: MaAccepted: Published: June 29, 2012Ĭopyright: © 2012 Dauvilliers et al. ![]() PLoS ONE 7(6):Įditor: Yoko Hoshi, Tokyo Metropolitan Institute of Medical Science, Japan (2012) Non-Dipping Blood Pressure Profile in Narcolepsy with Cataplexy. ![]() Citation: Dauvilliers Y, Jaussent I, Krams B, Scholz S, Lado S, Levy P, et al. ![]()
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