{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:19:33Z","timestamp":1790806773564,"version":"4.1.0"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>To assess the performances of alternative measures of the multiple sleep latency test (MSLT) to identify hypocretin-deficiency in patients with a complaint of hypersomnolence, including patients with narcolepsy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>MSLT parameters from 374 drug-free patients with hypersomnolence, with complete clinical and polysomnographic (PSG) assessment and cerebrospinal hypocretin-1 measurement were collected. Conventional (sleep latency, number of sleep onset REM\u2014SOREM\u2014periods) and alternative (sleep duration, REM sleep latency and duration, sleep stage transitions) MSLT measures were compared as function of hypocretin-1 levels (\u2264110 vs\u2005&amp;gt;\u2005110 pg\/mL). We performed receiver-operating characteristics analyses to determine the best thresholds of MSLT parameters to identify hypocretin-deficiency in the global population and in subgroups of patients with narcolepsy (i.e. typical cataplexy and\/or positive PSG\/MSLT criteria, n\u2005=\u2005223).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with hypocretin-deficiency had shorter mean sleep and REM sleep latencies, longer mean sleep and REM sleep durations and more direct REM sleep transitions during the MSLT. The current standards of MSLT\/PSG criteria identified hypocretin-deficient patients with a sensitivity of 0.87 and a specificity of 0.69, and 0.81\/0.99 when combined with cataplexy. A mean REM sleep duration\u2005\u2265\u20054.1 min best identified hypocretin-deficiency in patients with hypersomnolence (AUC\u2005=\u20050.932, sensitivity 0.87, specificity 0.86) and\u2005\u2265\u20055.7 min in patients with narcolepsy (AUC\u2005=\u20050.832, sensitivity 0.77, specificity 0.82).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Compared to the current neurophysiological standard criteria, alternative MSLT parameters would better identify hypocretin-deficiency among patients with hypersomnolence and those with narcolepsy. We highlighted daytime REM sleep duration as a relevant neurophysiological biomarker of hypocretin-deficiency to be used in clinical and research settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsac247","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T18:23:12Z","timestamp":1665598992000},"source":"Crossref","is-referenced-by-count":19,"title":["Rapid eye movement sleep duration during the multiple sleep latency test to diagnose hypocretin-deficient narcolepsy"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-0553","authenticated-orcid":false,"given":"R\u00e9gis","family":"Lopez","sequence":"first","affiliation":[{"name":"Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier , Montpellier , France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome , Montpellier , France"},{"name":"Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6620-5127","authenticated-orcid":false,"given":"Lucie","family":"Barateau","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier , Montpellier , France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome , Montpellier , France"},{"name":"Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Laura Rassu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier , Montpellier , 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