Manipulation of skin temperature improves nocturnal sleep in narcolepsy
Abstract
OBJECTIVE: Besides excessive daytime sleepiness, disturbed nocturnal sleep is a major complaint of patients with narcolepsy. Previously, alterations in skin temperature regulation in narcoleptic patients have been shown to be related to increased sleepiness. This study tests the hypothesis that direct control of nocturnal skin temperature might be applied to improve the disturbed sleep of narcoleptic patients. METHODS: Participants were eight patients (five males) diagnosed as having narcolepsy with cataplexy according to the ICSD-2 criteria, mean (SD) age 28.6 (6.4) years, range 18-35 years. During two nights, sleep was recorded polysomnographically while proximal and distal skin temperature were manipulated using a comfortable thermosuit that induced skin temperature to cycle slowly with an amplitude of only 0.4 degrees C within the comfortable range normally observed during sleep. Logistic regression was used to evaluate the effect of skin temperature manipulation on the probability of occurrence of different sleep stages and nocturnal wakefulness. RESULTS: Proximal skin warming significantly suppressed wakefulness and enhanced slow wave sleep (SWS). In contrast, distal skin warming enhanced wakefulness and stage 1 sleep at the cost of SWS and REM sleep. The optimal combination of proximal skin warming and distal skin cooling led to a 160% increase in SWS, a 50% increase in REM sleep and a 68% decrease in wakefulness, compared with the least beneficial combination of proximal skin cooling and distal skin warming. INTERPRETATION: Subtle skin temperature manipulations under controlled conditions significantly improved the typical nocturnal sleep problems in narcolepsy.
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Mild skin warming facilitates sleep onset and promotes slow wave sleep and sleep maintenance.
“while mild skin warming facilitates sleep onset [67, 71] and promotes slow wave sleep and sleep maintenance [33, 69].”
From Sleep, vigilance, and thermosensitivity (2012) · cites this paper as [33]
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Background
- Authors
- Fronczek, R., Raymann, R. J. E. M., Overeem, S., Romeijn, N., van Dijk, J. G., Lammers, G. J., & Van Someren, E. J. W.
- Affiliations
- Leiden University Medical Center (NL)
- Netherlands Institute for Neuroscience (NL)
- Corresponding author
- Fronczek, R
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2008-12-01
- Volume
- 79
- Issue
- 12
- Pages
- 1354-1357
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2008376872
- Cited by
- 51
- References
- 25
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 1 · 2013: 5 · 2012: 3
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (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)
- HighWire Press Open Archive (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Leids Universitair Medisch Centrum
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- narcolepsy type 1, nocturnal sleep disturbance, skin warming, skin cooling, slow-wave sleep, REM sleep, sleep stages, nocturnal wakefulness, thermoregulation
- MeSH terms
- Adolescent, Adult, Body Temperature Regulation, Fatigue, Female, Humans, Male, Narcolepsy, Skin Temperature, Sleep, Sleep Wake Disorders, Temperature, Wakefulness, Treatment Outcome, Polysomnography
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