Normal rapid eye movement (REM) sleep is characterized by tonic features, including cortical electroencephalogram (EEG) desynchronization and muscle atonia, as well as phasic events, including bursts of REM, phasic activities of both chin and limb electromyography (EMG), and cardiorespiratory variability.
Persons with narcolepsy, however, have a high frequency of REM sleep without atonia and of elevated EMG phasic density, according to a study published in the July 1st issue of the journal SLEEP.
The study, conducted by Jacques Montplaisir, MD, PhD, of the Sleep Disorders Center at the Universit' de Montr'al in Canada, focused on 16 patients with narcolepsy and cataplexy, who were matched for age and sex with 16 patients with ,idiopathic, REM sleep behavior disorder (RBD) and with 16 normal controls.
In his research, Dr. Montplaisir discovered that higher percentages of REM sleep without atonia, phasic EMG activity and REM density were found in patients with narcolepsy than normal controls. In contrast, RBD patients had a higher percentage of REM sleep without atonia, but a lower REM density than patients with narcolepsy and normal controls.
Based on a threshold of 80 percent for percentage of REM sleep with atonia, 50 percent of narcoleptics and 87.5 percent of RBD patients had abnormal REM sleep muscle activity. A higher frequency of periodic limb movements during wake and during sleep in narcoleptic patients, compared to controls, was also noted.