Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-16T15:03:55.243Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of Nocturnal Gamma-Hydroxybutyrate on Sleep/Waking Patterns in Narcolepsy-Cataplexy

Published online by Cambridge University Press:  18 September 2015

Roger Broughton  and
Mortimer Mamelak
Roger Broughton*
Affiliation:
Division of Neurology of the Ottawa General Hospital and the University of Ottawa, and the Department of Psychiatry, Sunnybrook Hospital and University of Toronto, Canada
Mortimer Mamelak
Affiliation:
Division of Neurology of the Ottawa General Hospital and the University of Ottawa, and the Department of Psychiatry, Sunnybrook Hospital and University of Toronto, Canada
*
Division of Neurology, Ottawa General Hospital, Ottawa, Canada, K1N 5C8
Rights & Permissions [Opens in a new window]

Summary:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Continuous 48-hour polygraphic recordings of sleep/waking patterns were performed on 14 patients with narcolepsy-cataplexy before and after 7-10 days of treatment of their nocturnal sleep with gamma-hydroxybutyrate (GBH). GBH improved the quality of night sleep by increasing the amount of slow wave sleep, reducing stage I, increasing sleep efficiency (percentage of time in bed spent asleep), and reducing the number of periods of short sleep under 15 minutes. Also nighttime REM sleep was reduced in latency and became less fragmented. The daytime period contained less slow wave sleep and REM sleep, and fewer episodes of prolonged sleep. Patients experienced reduction or loss of daytime attacks of irresistible sleep, cataplectic attacks, and other auxiliary symptoms. Residual daytime drowsiness subsequently improved on low doses of methylphenidate. Tolerance did not develop and there were no serious toxic side-effects. Four of the patients had been refractory to previous combinations of antidepresents and high doses of stimulants.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 7 , Issue 1 , February 1980 , pp. 23 - 31
Copyright
Copyright © Canadian Neurological Sciences Federation 1980

References

REFERENCES

Barros-Ferreira, M. and Lairy, G. (1976). Ambiguous sleep in narcolepsy. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P. pp. 57–75. Spectrum: New York.Google Scholar
Broughton, R. (1971). Neurology and sleep research. Can. Psychiatr. Assoc. J., 16, 283–292.CrossRefGoogle ScholarPubMed
Broughton, R. and Ghanem, Q. (1976). A study of the impact of compound narcolepsy on the life of the patient. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P., pp. 201–220. Spectrum: New York.Google Scholar
Broughton, R. and Mamelak, M. (1976). Gamma-hydroxybutyrate in the treatment of compound narcolepsy: A preliminary report. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P. pp. 659–667. Spectrum, New York.Google Scholar
Broughton, R. and Mamelak, M. (1979). The treatment of narcolepsy-cata-plexy with nocturnal gamma-hydroxybutyrate. Can. J. Neurol. Sci., 6, 1–6.CrossRefGoogle ScholarPubMed
Carskadon, M. (1976). The role of sleep onset REM periods in narcolepsy. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passoutant, P. pp. 499–519. Spectrum: New York.Google Scholar
Carskadon, M. and Dement, W,. (1975).Sleep studies on a 90-minute day.Electro-encephalogr. Clin. Neurophysiol., 39,145–155.CrossRefGoogle ScholarPubMed
Daniels, L. (1934). Narcolepsy. Medicine (Baltimore), 13, 1–22.CrossRefGoogle Scholar
Dement, W.C., Carskadon, M.A., Guilleminault, C. and Zarcone, V.P. (1976). Narcolepsy: diagnosis and treatment. Primary Care, 3, 609–623.CrossRefGoogle ScholarPubMed
Doherty, J., Hattox, S., Ando, N., Snead, O., and Roth, R. (1976). Identification of gammahydroxybutyric acid as an endogenous metabolite in monkey and human brain. Fed. Proc, 35, 270.Google Scholar
Godschalk, M., Dzoljic, M.R. and Bonta, I.L. (1977). Slow wave sleep and a state resembling absence epilepsy induced in the rat by gamma-hydroxybutyrate. Eur. J. Pharmacol., 44, 105–111.CrossRefGoogle Scholar
Guilleminault, C., Tilkian, A. and Dement, W. (1976). The sleep apnea syndromes. Annu. Rev. Med., 27, 465–484.CrossRefGoogle ScholarPubMed
Helrich, M., McAslan, T.C., Skolnik, S. and Bessman, S.P. (1964). Correlations of blood levels of 4-hydroxybutyrate with state of consciousness. Anaesthesiology, 25, 771–775.CrossRefGoogle ScholarPubMed
Hishikawa, Y. (1976). Sleep paralysis. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P., pp. 97–123. Spectrum: New York.Google Scholar
Hishikawa, Y. and Kaneko, Z. (1965). Electroencephalographic study on narcolepsy. Electroencephalogr. Clin. Neurophysiol., 18, 249–295.CrossRefGoogle Scholar
Hishikawa, Y., Wakamatsu, H., Furuya, E., Sugita, Y., Masaoka, S., Kaneda, H., Sato, M., Nan’no, H. and Kaneko, Z. (1976). Sleep satiation in narcolepsy patients. Electroencephalogr. Clin. Neurophysiol., 41, 1–18.CrossRefGoogle Scholar
Hoddes, E., Zarcone, V., Smythe, H., Phillip, S. and Dement, W. (1973). Quantification of sleepiness: A new approach. Psychophysiology, 10, 431–436.CrossRefGoogle ScholarPubMed
Hodes, R. and Dement, W. (1964). Depression of electrically induced reflexes (H-reflexes) in man during low voltage EEG “sleep”. Electroencephalogr. Clin. Neurophysiol., 17, 617–629.CrossRefGoogle ScholarPubMed
Jouvet, M. (1962). Recherches sur les structures nerveuses et les mechanisms responsables des differentes phases du sommeil. Arch. Ital. Biol., 100, 125–206.Google Scholar
Jouvet, M. (1967). Neurophysiology of the states of sleep. Physiol. Rev., 47, 117–177.CrossRefGoogle ScholarPubMed
Kales, A., Preston, T., Tan, T. and Allen, C. (1970). Hypnotics and altered dream sleep patterns. Arch. Gen. Psychiat., 23, 211–218.CrossRefGoogle Scholar
Laborit, H. (1964). Sodium-4-hydroxybuty-rate. Int. J. Neuropharmacol., 3, 422–451.CrossRefGoogle Scholar
Mamelak, M., Caruso, V. and Stewart, K. (1979). Narcolepsy — a family study. Biol. Psychiatry (in press).Google ScholarPubMed
Mamelak, M., Escriu, J.M. and Stokan, O. (1977). The effects of gamma-hydroxybutyrate on sleep. Biol. Psychiatry. 12, 273–288.Google ScholarPubMed
Metcalfe, D., Emde, R. and Stripe, J. (1966). An EEG-behavioral study of gam-mahydroxybutyrate in humans. Electro-enceph. Clin. Neurophysiol., 20, 506–512.CrossRefGoogle Scholar
Mitchell, S.A. and Dement, W.C. (1968). Narcolepsy symptoms: antecedent, contiguous and concomitant nocturnal sleep disordering and deprivation. Psychophysiology, 4, 398.Google Scholar
Montplaisir, J.Y., Billard, M., Takahashi, S., Bell, I., Guilleminault, C. and Dement, W.C. (1978) Twenty-four hour recording in REM narcoleptics with special reference to nocturnal sleep disruption. Biol. Psychiatry, 13, 73–89.Google ScholarPubMed
Pompeiano, O. (1976). Mechanisms responsible for spinal inhibition during desynchronized sleep: experimental study. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P., pp. 411–449. Spectrum: New York.Google Scholar
Rechtschaffen, A., Wolpert, E., Dement, W., Mitchell, S. and Fisher, C. (1962). Nocturnal sleep of narcoleptics. Electroencephalogr. Clin. Neurophysiol., 15, 599–609.CrossRefGoogle Scholar
Rechschaffen, A. and Kales, A. (1968). A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. U.S. Department of Health, Education and Welfare Publication No. 204, U.S. Government Printing Office, Washington, D.C.Google Scholar
Snead, O.C., Yu, R.K. and Huttenlocker, P.R. (1976). Gamma hydroxy-butyrate: Correlation of serum and cerebrospinal fluid levels with electroencephalographic and behavioral levels. Neurology (Minneap.), 26, 51–56.CrossRefGoogle Scholar
Vickers, M.D. (1969). Gamma-hydroxybutyrate. Int. Aneasthesiol. Clin., 7, 75–89.CrossRefGoogle Scholar
Vogel, G. (1976). Mentation reported from naps of narcoleptics. In Narcolepsy, edited by Guilleminault, C., Dement, W.C. and Passouant, P., pp. 161–168. Spectrum: New York.Google Scholar
Webb, W. and Cartwright, R. (1978). Sleep and dreams. Annu. Rev. Psychol., 29, 223–252.CrossRefGoogle ScholarPubMed
Weitzman, E., Noegeire, C., Perlow, M., Fuhushunia, D., Sassin, J., Mcgregor, P., Gallagler, T. and Wellman, L. (1974). Effects of a prolonged 3-hour sleep-waking cycle on sleep stages, plasma Cortisol growth hormone and body temperature in man. J. Clin. Endocrinol. Metab., 38, 1018–1030.CrossRefGoogle Scholar
Williams, R.L., Karacan, I., and Hirsch, C.J. (1974). EEG of human sleep: clinical applications. Wiley: New York.Google Scholar
Yamada, Y., Yamamoto, J., Fujiki, A., Hishikawa, Y. and Kaneko, Z. (1967). Effects of butyrolactone and gamma-hydroxybutyrate on the EEG and sleep cycle in man. Electroencephalogr. Clin. Neurophysiol., 22, 538–562.CrossRefGoogle ScholarPubMed
Zarcone, V. (1973). Narcolepsy. N. Engl. J. Med. 288, 1156–1166.CrossRefGoogle Scholar