CIRCADIAN TEMPERATURE AND ACTIVITY RHYTHMS IN UNMEDICATED NARCOLEPTICPATIENTS

Fifteen unmedicated narcoleptic patients with and without sleep-onset REM period (SOREMP) were compared with 16 unmedicated, age-and-sex-mat ched control subjects with respect to polygraphic, core body temperatu re and motor activity recordings. Whereas narcoleptic patients with SO REMPs had significantly more quiet wakefulness during sleep, those wit hout SOREMPs had significantly more quiet wakefulness during daytime t han the other groups. Compared with that of controls, temperature of b oth narcoleptic groups showed (a) less rise of temperature curve in th e morning, (b) dampening of temperature amplitude, (c) phase advance o f acrophase, and (d) advance of temperature minimum after sleep onset. Maximal temperature decline occurred earlier in patients with SOREMPs during naps and sleep than in the other groups. We could confirm para llels between temperature and motor activity with controls and found n o change in the oscillator of narcoleptic patients. Advanced temperatu re minima and first REMPs relative to sleep onset and maximal temperat ure decline occurring nearer to sleep onset indicate a defect in the t emperature-locked triggering of REM in narcoleptic patients with SOREM P and a circadian rhythm disorder. (C) 1997 Elsevier Science Inc.