Manipulation of Core Body and Skin Temperature Improves Vigilance and Maintenance of Wakefulness in Narcolepsy
Open accessAbstract
CONTEXT: Impaired vigilance and sleepiness are two majordaily complaints of patients with narcolepsy. We previously showed their sleepiness to be correlated to an abnormally regulated skin temperature, i.e., increased distal skin temperature compared with proximal skin temperature. OBJECTIVE: Our goal was to investigate a possible causal contribution of skin temperature disturbances to impairments in the ability to maintain vigilance and wakefulness in narcolepsy. DESIGN: In a modified constant routine protocol, the Psychomotor Vigilance Task (PVT) and the Maintenance of Wakefulness Test (MWT) were repeatedly assessed. Meanwhile, skin and core body temperatures were mildly manipulated within the thermoneutral range of the normal diurnal rhythm using a thermosuit and hot or cold food and drinks. SETTING: Tertiary narcolepsy referral center in a university hospital PATIENTS OR OTHER PARTICIPANTS: Eight patients (5 males) diagnosed with narcolepsy with cataplexy according to the ICSD-2 criteria (mean age +/- SD: 28.6 +/- 6.4, range 18-35 years). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): MWT sleep latency and PVT response speed. RESULTS: Compared to core cooling, core warming attenuated the typical decline in PVT response speed with increasing time-on-task by 25% (P = 0.02). Compared to distal skin warming, distal skin cooling increased the time that the patients were able to maintain wakefulness by 24% (distal warming: 1.88 min. vs. distal warming: 2.34 min.; P < 0.01). CONCLUSIONS: Core body and skin temperatures causally affect vigilance and sleepiness in narcolepsy. This could lead to future practical applications.
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In younger and older healthy adults, and in patients suffering from either insomnia or narcolepsy, very mild skin cooling enhances sustained task performance and the ability to maintain wakefulness.
“It has been demonstrated in younger and older healthy adults, as well as in patients suffering from either insomnia or narcolepsy, that very mild skin cooling enhances sustained task performance and the ability to maintain wakefulness [34, 70]”
From Sleep, vigilance, and thermosensitivity (2012) · cites this paper as [34]
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Sleep Disordered Breathing Severity Alters Overnight Temperature Changes in Children
Plunkett, G., Shetty, M., Vaz‐Serra, M., Delanaud, S., Nisbet, L. C., Davey, M. J., Nixon, G. M., Horne, R. S. C., & Bach, V. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70340
- Authors
- Fronczek, R., Raymann, R. J. E. M., Romeijn, N., Overeem, S., Fischer, M., Dijk, J. G. V., Jan Lammers, G., & Van Someren, E. J. W.
- Affiliations
- Netherlands Institute for Neuroscience (NL)
- Radboud University Nijmegen (NL)
- Leiden University Medical Center (NL)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02
- Volume
- 31
- Issue
- 2
- Pages
- 233-240
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2225580
- OpenAlex
- W2155964720
- Cited by
- 76
- References
- 26
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 7 · 2015: 2 · 2014: 2 · 2013: 5 · 2012: 3
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (publishedVersion)
- VU Research Portal (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- TNO Repository (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- ZonMw
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (916.56.103, 014-90-001)
- Leids Universitair Medisch Centrum
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- narcolepsy, core body temperature, skin temperature, sustained attention, sleepiness, core cooling, psychomotor vigilance task, maintenance of wakefulness test, sleep latency, cataplexy
- MeSH terms
- Adolescent, Adult, Arousal, Body Temperature, Body Temperature Regulation, Female, Humans, Male, Narcolepsy, Psychomotor Performance, Skin, Wakefulness
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