SCHEDULED NAPS IN THE MANAGEMENT OF DAYTIME SLEEPINESS IN NARCOLEPSY-CATAPLEXY

A repeated testing paradigm was used to assess the efficacy for the ma nagement of daytime sleepiness in narcolepsy-cataplexy of single long, multiple short and no-nap sleep/wake schedule conditions, with total sleep per 24 hours held constant. Eight narcoleptic subjects participa ted and followed each experimental schedule for two consecutive days, the second of which served as a test day during which simultaneous ele ctroencephalogram (EEG) polygraphic recordings were made. Performance tests reported here include a grammatical transformation test and a fo ur-choice reaction time test. A single long nap placed 180-degrees out -of-phase with the nocturnal midsleep time improved sustained performa nce over the no-nap condition. Reaction time performance was significa ntly improved in the long nap condition over the no-nap condition. Tim e-of-day analyses found that the greatest improvement was in the after noon and evening. By contrast, the grammatical transformation test res ults suffered under the napping compared to no-nap schedules, suggesti ng that continuity of wakefulness and/or a long nocturnal sleep period may be important for this test. In addition, unscheduled sleep episod es tended to occur earlier in the day than the period of maximum after noon sleep tendency seen in normal subjects. Two napping strategies ar e suggested for further study.