{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T07:08:17Z","timestamp":1769756897702,"version":"3.49.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"South-Eastern Norway Regional Health","award":["2017070"],"award-info":[{"award-number":["2017070"]}]},{"name":"Norwegian Ministry of Health and Care Services"},{"DOI":"10.13039\/501100005416","name":"Norwegian Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Danish Medical Council"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objectives<\/jats:title><jats:p>Narcolepsy type 1 (NT1) is characterized by unstable sleep-wake and muscle tonus regulation during sleep. We characterized dream enactment and muscle activity during sleep in a cohort of post-H1N1 NT1 patients and their siblings, and analyzed whether clinical phenotypic characteristics and major risk factors are associated with increased muscle activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>RBD symptoms and polysomnography m. tibialis anterior electromyographical signals [long (0.5\u201315 s); short (0.1\u20130.49 s)] were compared between 114 post-H1N1 NT1 patients and 89 non-narcoleptic siblings. Association sub-analyses with RBD symptoms, narcoleptic symptoms, CSF hypocretin-1 levels, and major risk factors [H1N1-(Pandemrix)-vaccination, HLA-DQB1*06:02-positivity] were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RBD symptoms, REM and NREM long muscle activity indices and REM short muscle activity index were significantly higher in NT1 patients than siblings (all p &amp;lt; 0.001). Patients with undetectable CSF hypocretin-1 levels (&amp;lt;40 pg\/ml) had significantly more NREM periodic long muscle activity than patients with low but detectable levels (40\u2013150 pg\/ml) (p = 0.047). In siblings, REM and NREM sleep muscle activity indices were not associated with RBD symptoms, other narcolepsy symptoms, or HLA-DQB1*06:02-positivity. H1N1-(Pandemrix)-vaccination status did not predict muscle activity indices in patients or siblings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased REM and NREM muscle activity and more RBD symptoms is characteristic of NT1, and muscle activity severity is predicted by hypocretin deficiency severity but not by H1N1-(Pandemrix)-vaccination status. In the patients\u2019 non-narcoleptic siblings, neither RBD symptoms, core narcoleptic symptoms, nor the major NT1 risk factors is associated with muscle activity during sleep, hence not indicative of a phenotypic continuum.<\/jats:p><\/jats:sec>","DOI":"10.1093\/sleep\/zsac316","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T10:34:59Z","timestamp":1671791699000},"source":"Crossref","is-referenced-by-count":2,"title":["Increased muscle activity during sleep and more RBD symptoms in H1N1-(Pandemrix)-vaccinated narcolepsy type 1 patients compared with their non-narcoleptic siblings"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7475-2999","authenticated-orcid":false,"given":"Rannveig","family":"Viste","sequence":"first","affiliation":[{"name":"Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital , Oslo , Norway"},{"name":"Institute of Clinical Medicine, University of Oslo , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise F","family":"Follin","sequence":"additional","affiliation":[{"name":"Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital , Oslo , Norway"},{"name":"Institute of Clinical Medicine, University of Oslo , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2515-9451","authenticated-orcid":false,"given":"Birgitte R","family":"Kornum","sequence":"additional","affiliation":[{"name":"Kornum Laboratory, Department of Neuroscience, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedicte A","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Immunology, University of Oslo and Oslo University Hospital , Oslo , Norway"},{"name":"Department of Medical Genetics, University of Oslo and Oslo University Hospital , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-9269","authenticated-orcid":false,"given":"Marte K","family":"Viken","sequence":"additional","affiliation":[{"name":"Department of Immunology, University of Oslo and Oslo University Hospital , Oslo , Norway"},{"name":"Department of Medical Genetics, University of Oslo and Oslo University Hospital , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9615-1035","authenticated-orcid":false,"given":"Per M","family":"Thorsby","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo , Norway"},{"name":"Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital , Oslo , Norway"},{"name":"Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terje","family":"Rootwelt","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo , Norway"},{"name":"Division of Paediatric and Adolescent Medicine, Oslo University Hospital , Oslo , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A E","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital , Oslo , Norway"},{"name":"T&W Engineering A\/S , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stine","family":"Knudsen-Heier","sequence":"additional","affiliation":[{"name":"Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital 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