Polysomnographic and actigraphic characteristics of patients with H1N1-vaccine-related and sporadic narcolepsy

Sleep Medicine

Volumn 16, Issue 1, 2015, Pages 39-44

  Alakuijala, Anniina ^a,b,c   Sarkanen, Tomi ^b,c,d   Partinen, Markku ^b,c  

^a HELSINKI UNIVERSITY CENTRAL HOSPITAL   (Finland)

^b UNIVERSITY OF HELSINKI   (Finland)

^c Vitalmed Research Centre   (Finland)

^d CENTRAL FINLAND CENTRAL HOSPITAL   (Finland)

Author keywords

Actigraphy; Circadian rhythm; H1N1; Narcolepsy; Pandemrix ; Sleep fragmentation

Indexed keywords

FERRITIN; HLA DQB1 ANTIGEN; INFLUENZA VACCINE; OREXIN A;

ACTIMETRY; ADULT; AGE DISTRIBUTION; ARTICLE; ASSESSMENT OF HUMANS; CASE STUDY; CHILD; CIRCADIAN RHYTHM; COMPARATIVE STUDY; CONTROLLED STUDY; DELAYED DIAGNOSIS; DRUG INDUCED DISEASE; FEMALE; FERRITIN BLOOD LEVEL; H1N1 VACCINE RELATED NARCOLEPSY; HUMAN; INFLUENZA VACCINATION; MAJOR CLINICAL STUDY; MALE; MULTIPLE SLEEP LATENCY TEST; NARCOLEPSY; ONSET AGE; PERIODIC LIMB MOVEMENT DISORDER; POLYSOMNOGRAPHY; QUANTITATIVE ANALYSIS; SEX DIFFERENCE; SLEEP; SLEEP DISORDER; SLEEP EFFICIENCY; SLEEP FRAGMENTATION; SLEEP ONSET REM PERIOD; SLEEP TIME; SLEEP WAKING CYCLE; SPORADIC NARCOLEPSY; ADOLESCENT; AGE; CASE CONTROL STUDY; COMPLICATION; IMMUNOLOGY; INFLUENZA A VIRUS (H1N1); INFLUENZA, HUMAN; MIDDLE AGED; PATHOPHYSIOLOGY; PHYSIOLOGY; PRESCHOOL CHILD; YOUNG ADULT;

ACTIGRAPHY; ADOLESCENT; ADULT; AGE FACTORS; CASE-CONTROL STUDIES; CHILD; CHILD, PRESCHOOL; FEMALE; HUMANS; INFLUENZA A VIRUS, H1N1 SUBTYPE; INFLUENZA VACCINES; INFLUENZA, HUMAN; MALE; MIDDLE AGED; NARCOLEPSY; POLYSOMNOGRAPHY; SLEEP; YOUNG ADULT;

EID: 84921419336     PISSN: 13899457     EISSN: 18785506     Source Type: Journal    
DOI: 10.1016/j.sleep.2014.07.024     Document Type: Article

References (47)

1. Poli F., Overeem S., Lammers G.J., Plazzi G., Lecendreux M., Bassetti C.L., et al. Narcolepsy as an adverse event following immunization: case definition and guidelines for data collection, analysis and presentation. Vaccine 2013, 31:994-1007.
2. Dauvilliers Y., Montplaisir J., Cochen V., Desautels A., Einen M., Lin L., et al. Post-H1N1 narcolepsy-cataplexy. Sleep 2010, 33:1428-1430.
3. THL National Institute for Health and Welfare recommends discontinuation of Pandemrix vaccinations. Finnish National Institute for Health and Welfare website Available from, accessed 14.11.12. http://www.thl.fi/en_US/web/en/pressrelease?id=22930.
4. Medical Products Agency (Läkemedelsverket) A registry based comparative cohort study in four Swedish counties of the risk for narcolepsy after vaccination with Pandemrix - A first and preliminary report, by the Medical Products Agency Available from, accessed 14.11.12. http://www.lakemedelsverket.se/upload/nyheter/2011/PandemrixRegReport110328.pdf.
5. Nohynek H., Jokinen J., Partinen M., Vaarala O., Kirjavainen T., Sundman J., et al. AS03 adjuvanted AH1N1 vaccine associated with an abrupt increase in the incidence of childhood narcolepsy in Finland. PLoS ONE 2012, 7:e33536.
6. Partinen M., Saarenpää-Heikkilä O., Ilveskoski I., Hublin C., Linna M., Olsén P., et al. Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland. PLoS ONE 2012, 7:e33723.
7. Dauvilliers Y., Arnulf I., Lecendreux M., Monaca Charley C., Franco P., Drouot X., et al. Increased risk of narcolepsy in children and adults after pandemic H1N1 vaccination in France. Brain 2013, 136:2486-2496.
8. Heier M.S., Gautvik K.M., Wannag E., Bronder K.H., Midtlyng E., Kamaleri Y., et al. Incidence of narcolepsy in Norwegian children and adolescents after vaccination against H1N1 influenza A. Sleep Med 2013, 14:867-871.
9. Miller E., Andrews N., Stellitano L., Stowe J., Winstone A.M., Shneerson J., et al. Risk of narcolepsy in children and young people receiving AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine: retrospective analysis. BMJ 2013, 346:f794.
10. Szakács A., Darin N., Hallböök T. Increased childhood incidence of narcolepsy in western Sweden after H1N1 influenza vaccination. Neurology 2013, 80:1315-1321.
11. Wijnans L., Lecomte C., de Vries C., Weibel D., Sammon C., Hviid A., et al. The incidence of narcolepsy in Europe: before, during, and after the influenza A (H1N1) pdm09 pandemic and vaccination campaigns. Vaccine 2013, 31:1246-1254.
12. THL Increased risk of narcolepsy observed also among adults vaccinated with Pandemrix in Finland. Finnish National Institute for Health and Welfare website Available from, accessed 14.11.12. http://www4.thl.fi/en_US/web/en/pressrelease?id=33516.
13. Persson I., Granath F., Askling J., Ludvigsson J.F., Olsson T., Feltelius N. Risks of neurological and immune-related diseases, including narcolepsy, after vaccination with Pandemrix: a population- and registry-based cohort study with over 2 years of follow-up. J Intern Med 2014, 275:172-190.
14. Han F., Lin L., Warby S.C., Faraco J., Li J., Dong S.X., et al. Narcolepsy onset is seasonal and increased following the 2009 H1N1 pandemic in China. Ann Neurol 2011, 70:410-417.
15. Wu H.J., Zhuang J., Stone W.S., Zhang L., Zhao Z., Wang Z., et al. Symptoms and occurrences of narcolepsy: a retrospective study of 162 patients during a 10-year period in eastern China. Sleep Med 2014, 15:607-613.
16. Plazzi G., Serra L., Ferri R. Nocturnal aspects of narcolepsy with cataplexy. Sleep Med Rev 2008, 12:109-128.
17. Drakatos P., Kosky C.A., Higgins S.E., Muza R.T., Williams A.J., Leschziner G.D. First rapid eye movement sleep periods and sleep-onset rapid eye movement periods in sleep-stage sequencing of hypersomnias. Sleep Med 2013, 14:897-901.
18. Marti I., Valko P.O., Khatami R., Bassetti C.L., Baumann C.R. Multiple sleep latency measures in narcolepsy and behaviourally induced insufficient sleep syndrome. Sleep Med 2009, 10:1146-1150.
19. Andlauer O., Moore H., Jouhier L., Drake C., Peppard P.E., Han F., et al. Nocturnal rapid eye movement sleep latency for identifying patients with narcolepsy/hypocretin deficiency. JAMA Neurol 2013, 70:891-902.
20. Pizza F., Moghadam K.K., Vandi S., Detto S., Poli F., Mignot E., et al. Daytime continuous polysomnography predicts MSLT results in hypersomnias of central origin. J Sleep Res 2013, 22:32-40.
21. Pizza F., Peltola H., Sarkanen T., Moghadam K.K., Plazzi G., Partinen M. Childhood narcolepsy with cataplexy: comparison between post-H1N1 vaccination and sporadic cases. Sleep Med 2014, 15:262-265.
22. Han F., Lin L., Li J., Dong X.S., Mignot E. Decreased incidence of childhood narcolepsy 2 years after the 2009 H1N1 winter flu pandemic. Ann Neurol 2013, 73:560.
23. Hajek M., Meier-Ewert K., Wirz-Justice A., Tobler I., Arendt J., Dick H., et al. Bright light does not improve narcoleptic symptoms. Eur Arch Psychiatry Neurol Sci 1989, 238:203-207.
24. Bruck D., Kennedy G.A., Cooper A., Apel S. Diurnal actigraphy and stimulant efficacy in narcolepsy. Hum Psychopharmacol Clin Exp 2005, 20:105-113.
25. Middelkoop H.A.M., Lammers G.J., Van Hilten B.J., Ruwhof C., Pijl H., Kamphuisen H.A.C. Circadian distribution of motor activity and immobility in narcolepsy: assessment with continuous motor activity monitoring. Psychophysiology 1995, 32:286-291.
26. Bradshaw D.A., Yanagi M.A., Pak E.S., Peery T.S., Ruff G.A. Nightly sleep duration in the 2-week period preceding multiple sleep latency testing. J Clin Sleep Med 2007, 3:613-619.
27. Kushida C.A., Chang A., Gadkary C., Guilleminault C., Carrillo O., Dement W.C. Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med 2001, 2:389-396.
28. Morgenthaler T., Alessi C., Friedman L., Owens J., Kapur V., Boehlecke B., et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep 2007, 30:519-529.
29. Sack R.L., Auckley D., Auger R.R., Carskadon M.A., Wright K.P., Vitiello M.V., et al. Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. Sleep 2007, 30:1460-1483.
30. Ancoli-Israel S., Cole R., Alessi C., Chambers M., Moorcroft W., Pollak C.P. The role of actigraphy in the study of sleep and circadian rhythms. American Academy of Sleep Medicine Review Paper. Sleep 2003, 26:342-392.
31. American Academy of Sleep Medicine International classification of sleep disorders 2005, American Academy of Sleep Medicine, Westchester, IL. 2nd ed.
32. Littner M.R., Kushida C., Wise M., Davila D.G., Morgenthaler T., Lee-Chiong T., et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 2005, 28:113-121.
33. Iber C., Ancoli-Israel S., Chesson A., Quan S.F. The AASM manual for the scoring of sleep & associated events: rules, terminology and technical specifications 2007, American Academy of Sleep Medicine, Westchester, IL.
34. Berry R.B., Brooks R., Gamaldo C.E., Harding S.M., Marcus C.L., Vaughn B.V. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0 2012, American Academy of Sleep Medicine, Darien, IL.
35. Van Someren E.J.W., Swaab D.F., Colenda C.C., Cohen W., McCall W.V., Rosenquist P.B. Bright light therapy: improved sensitivity to its effects on rest-activity rhythms in Alzheimer patients by application of nonparametric methods. Chronobiol Int 1999, 16:505-518.
36. Dowling G.A., Hubbard E., Mastick J., Luxenberg J.S., Burr R.L., Van Someren E.J.W. Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. Int Psychogeriatr 2005, 17:221-236.
37. American Academy of Sleep Medicine International classification of sleep disorders 2014, American Academy of Sleep Medicine, Darien, IL. 3rd ed.
38. Knudsen S., Gammeltoft S., Jennum P.J. Rapid eye movement sleep behavior disorder in patients with narcolepsy is associated with hypocretin-1 deficiency. Brain 2010, 133:568-579.
39. Plazzi G., Ferri R., Franceschini C., Vandi S., Detto S., Pizza F., et al. Periodic leg movements during sleep in narcoleptic patients with or without restless legs syndrome. J Sleep Res 2012, 21:155-162.
40. Frauscher B., Ehrmann L., Mitterling T., Gabelia D., Gschliesser V., Brandauer E., et al. Delayed diagnosis, range of severity, and multiple sleep comorbidities: a clinical and polysomnographic analysis of 100 patients of the Innsbruck narcolepsy cohort. J Clin Sleep Med 2013, 9:805-812.
41. Michaud M., Soucy J.P., Chabli A., Lavigne G., Montplaisir J. SPECT imaging of striatal pre- and postsynaptic dopaminergic status in restless legs syndrome with periodic leg movements in sleep. J Neurol 2002, 249:164-170.
42. Eisensehr I., Linke R., Tatsch K., von Lindeiner H., Kharraz B., Gildehaus F.J., et al. Alteration of the striatal dopaminergic system in human narcolepsy. Neurology 2003, 60:1817-1819.
43. Takei Y., Komada Y., Namba K., Sasai T., Nakamura M., Sugiura T., et al. Differences in findings of nocturnal polysomnography and multiple sleep latency test between narcolepsy and idiopathic hypersomnia. Clin Neurophysiol 2012, 123:137-141.
44. Nightingale S., Orgill J.C., Egrahim I.O., De Lacy S.F., Agrawal S., Williams A.J. The association between narcolepsy and REM behavior disorder (RBD). Sleep Med 2005, 6:253-258.
45. Dauvilliers Y., Jennum P., Plazzi G. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy. Sleep Med 2013, 14:775-781.
46. Luca G., Haba-Rubio J., Dauvilliers Y., Lammers G.J., Overeem S., Donjacour C.E., et al. Clinical, polysomnographic and genome-wide association analyses of narcolepsy with cataplexy: a European Narcolepsy Network study. J Sleep Res 2013, 22:482-495.
47. Won C., Mahmoudi M., Qin L., Purvis T., Mathur A., Mohsenin V. The impact of gender on timeliness of narcolepsy diagnosis. J Clin Sleep Med 2014, 10:89-95.