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. 2012;7(6):e38977.
doi: 10.1371/journal.pone.0038977. Epub 2012 Jun 29.

Non-dipping blood pressure profile in narcolepsy with cataplexy

Yves Dauvilliers  1 , Isabelle Jaussent, Benjamin Krams, Sabine Scholz, Stéphane Lado, Patrick Levy, Jean Louis Pepin
Affiliations

Non-dipping blood pressure profile in narcolepsy with cataplexy

Yves Dauvilliers et al. PLoS One. 2012.

Abstract

Background: Patients with narcolepsy-cataplexy (NC) mostly exhibit undetectable hypocretin levels. Hypocretin system is one of the key players in the complex interaction between sleep and the cardiovascular system. We tested the hypothesis that hypocretin deficiency affects cardiovascular risk factors by measuring nighttime and daytime ambulatory blood pressure (BP) and the night-to-day BP ratio as well as endothelial dysfunction by the digital pulse amplitude response in drug-free patients with NC compared to controls.

Methodology: Sleep, clinical and biological cardiovascular risk factors, fingertip peripheral arterial tonometry, and 24-hour ambulatory BP monitoring were recorded in 50 drug-free patients with NC and 42 healthy control subjects, except for BP monitoring available in all controls but in 36 patients with NC.

Principal findings: More patients than controls were smokers, obese and with dyslipidemia. One-third of patients with NC were "non-dippers" (defined as <10% drop in BP during sleep) compared to only 3% of controls. The diastolic non-dipper BP profile had up to 12-fold higher odds of being associated with NC. We noted negative correlations between mean diastolic BP fall during night, REM sleep percentage and number of sleep onset REM periods, and a positive correlation with mean sleep latency on the MSLT. The digital pulse amplitude response measured by fingertip was similar between NC and controls.

Conclusion: We found a high percentage of non-dippers in patients with NC with association with REM sleep dysregulation. The blunted sleep-related BP dip in NC may be of clinical relevance, as it may indicate increased risk for cardiovascular events.

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Conflict of interest statement

Competing Interests: This was not an industry-supported study. Prs Levy and Pepin, Drs Krams and Lado report no disclosures. Isabelle Jaussent and Sabine Scholz report no disclosures. Prof. Dauvilliers has received speaker’s honoraria and funding for travel to conferences from UCB Pharma, Cephalon, Novartis, and Bioprojet. Prof. Dauvilliers has participated in advisory boards of UCB and Bioprojet. This does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Non-dipping diastolic BP profile in patients with narcolepsy-cataplexy (n = 36) and in controls (n = 42).
Diastolic non-dippers (defined as a nocturnal diastolic BP dip<10% lower than daytime BP) were significantly higher in patients with narcolepsy-cataplexy compared to controls (30.56% vs 2.94%, p = 0.002).
See this image and copyright information in PMC

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