{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:01:12Z","timestamp":1787738472144,"version":"build-2784847793"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["No.CMRPG3F1582"],"award-info":[{"award-number":["No.CMRPG3F1582"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Taiwan\u2019s Ministry of Science and Technology","doi-asserted-by":"crossref","award":["NO.107-2314-B-182A-128-MY2"],"award-info":[{"award-number":["NO.107-2314-B-182A-128-MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004663","name":"Taiwan\u2019s Ministry of Science and Technology","doi-asserted-by":"crossref","award":["NO.109-2314-B-182A-112-MY3"],"award-info":[{"award-number":["NO.109-2314-B-182A-112-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004663","name":"Taiwan\u2019s Ministry of Science and Technology","doi-asserted-by":"crossref","award":["NO.106-2917-I-564-027"],"award-info":[{"award-number":["NO.106-2917-I-564-027"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004663","name":"Taiwan\u2019s Ministry of Science and Technology","doi-asserted-by":"crossref","award":["NO.108-2221-E-008-095-MY2"],"award-info":[{"award-number":["NO.108-2221-E-008-095-MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Kleine-Levin syndrome (KLS) is a rare recurrent hypersomnia. Our study aimed at monitoring the movements of patients with KLS using actigraphy and evaluating their circadian rhythm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Twenty young patients with KLS and 14 age-matched controls were recruited. Each individual wore an actigraphy for more than 6 months to monitor at least two attacks. Controls kept wearing the device for at least 7 days. The activity counts were averaged in hourly basis and the day-to-night amplitude was quantified by the differences of the averaged activity counts during daytime and nighttime. The hourly activities of different days were aligned and averaged to construct the circadian profile. Parametric and nonparametric estimation of circadian rhythm was calculated. We applied detrended fluctuation analysis to evaluate the temporal correlations beneath the activity fluctuations at multiple time scales.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Circadian rhythm in asymptomatic period showed no significant difference compared to the controls. During hypersomnia attack, the amplitude of the circadian rest\u2013active rhythms drastically decreased and decreased interdaily stability (IS) was found, as well as significant decreased M10 and short-time fractal correlation (\u03b11). Drastically decreased mean and standard deviation of activity were noted, compared to the pre-attack phase and recovery phase. \u03b11 and M10 increased during the late attack phase, and overcompensated IS was noted in the recovery phase.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study confirmed that circadian rest\u2013active rhythms was affected when KLS hypersomnia attack. Several parameters including M10, IS, and \u03b11 may be physiological markers of KLS, which can help to predict the end of hypersomnia episodes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsab096","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T02:45:00Z","timestamp":1618541100000},"source":"Crossref","is-referenced-by-count":22,"title":["Different circadian rest\u2013active rhythms in Kleine-Levin syndrome: a prospective and case\u2013control study"],"prefix":"10.1093","volume":"44","author":[{"given":"Chen","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chih","family":"Chin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5390-516X","authenticated-orcid":false,"given":"Kuo-Chung","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Information Management, National Taipei University of Nursing & Health Sciences , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Paiva","sequence":"additional","affiliation":[{"name":"Neurophysiology and Sleep Medicine, University of Lisbon , Lisboa , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Guilleminault","sequence":"additional","affiliation":[{"name":"Stanford University Sleep Medicine Division , Stanford, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"2022080921183791100_CIT0001","first-page":"19","article-title":"Kleine-Levin syndrome: a review","volume":"6","author":"Miglis","year":"2014","journal-title":"Nat Sci Sleep."},{"issue":"4","key":"2022080921183791100_CIT0002","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/sleep\/23.4.1i","article-title":"Kleine Levin syndrome (KLS) in young 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