MOTOR DYSCONTROL IN SLEEP OF NARCOLEPTIC PATIENTS (A LIFELONG DEVELOPMENT)

In our retrospective study 27 narcoleptic patients were divided into t wo groups: Group A comprised 14 patients (10 male, 4 female) with a hi story of REM behaviour disorder (RBD) and Group B comprised 13 age- an d sex-matched patients (10 male, 3 female) without a history of RBD. P olygraphic and videometry data, medical history, medication, blood che mistry, psychological and neuroradiological data of the two groups of patients were compared. The narcoleptic patients with a history of RBD differed from the narcoleptic control group without history of RBD in that they had: (a) a higher frequency of parasomnias in their history ; (b) a higher percentage of stage 1 REM (P < 0.01); (c) a lower numbe r of arousals during REM sleep; (d) fewer sleep stage changes. Compare d to the heterogenous RBD patient group of Mahowald and Schenck, the R EM behaviour of most of our narcoleptic patients was less violent. Thu s it can be speculated that the motor disorder in REM sleep might stil l be in the process of developing towards a full-blown REM sleep behav iour disorder. In a possible lifelong development of a motor disorder starting in NREM sleep, the onset of narcolepsy might represent the tu rning point for its intrusion into REM sleep.