Narcolepsy type 1 features across the life span: age impact on clinical and polysomnographic phenotype

Name: Work Video:
Duration: 3 min 30 s
Althea Lividini; Fabio Pizza; Marco Filardi; Stefano Vandi; Francesca Ingravallo; Elena Antelmi; Oliviero Bruni; F. Cosentino; Raffaele Ferri; Biancamaria Guarnieri; Sara Marelli; Luigi Ferini‐Strambi; Andrea Romigi; Enrica Bonanni; Michelangelo Maestri; Michele Terzaghi; Raffaele Manni; Giuseppe Plazzi
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384, 385, 400], 'Brain': [378], 'Behavioral': [380], 'Address': [407], 'correspondence': [408], 'to:': [409], 'Ospedale': [421], 'Bellaria,': [422], 'Padiglione': [423], 'G,': [424], 'Primo': [425], 'Piano,': [426], 'via': [427], 'Altura': [428], '3,': [429], '40139': [430], 'Italy;': [432], 'Tel:': [433], '+39': [434, 438], '051': [435, 439], '4966929;': [436], 'Fax:': [437], '4966176;': [440], 'Email:': [441], 'E-mail': [442], 'Address:': [443], '[email': [444], 'protected]': [445], 'Biomedical,': [457], 'Metabolic': [458], 'Neural': [460], 'Modena': [464], 'Reggio': [466], 'Emilia,': [467], 'Modena,': [468], 'Published': [470], 'Online:July': [471], '1,': [472, 1647], '2021https://doi.org/10.5664/jcsm.9198Cited': [473], 'by:5SectionsAbstractEpubPDF': [474], 'ShareShare': [475], 'onFacebookTwitterLinkedInRedditEmail': [476], 'ToolsAdd': [477], 'to': [478, 516, 519, 569, 623, 679, 709, 842, 895, 908, 946, 1158, 1272, 1284, 1309, 1380, 1537, 1608, 1727, 1754, 1756, 1773, 1776, 1786, 1920, 1927, 1937, 1951, 2261, 2279, 2515, 2539, 2791, 2879, 2893, 2908, 2912, 3012, 3165, 3205, 3291, 3298, 3307, 3350, 3382, 3390, 3431, 3473, 3620, 3650, 3654, 3692, 3776, 3819, 3985, 4004, 4104, 4179, 4228], 'favoritesDownload': [479], 'CitationsTrack': [480], 'Citations': [481], 'AboutABSTRACTStudy': [482], 'Objectives:Narcolepsy': [483], '(NT1)': [486, 872], 'is': [487, 873, 892, 965, 1020, 1917, 3707, 4038, 4235], 'a': [488, 548, 586, 661, 762, 777, 815, 874, 921, 962, 980, 1012, 1024, 1125, 1139, 1167, 1201, 1223, 1232, 1484, 1493, 1525, 1603, 1739, 1904, 1941, 2014, 2947, 3109, 3207, 3435, 3450, 3574, 3579, 3708, 3748, 3767, 3804, 3810, 3820, 3922, 4005, 4061, 4268], 'chronic': [489], 'neurological': [490, 1420], 'disorder': [491, 878, 1142, 1225, 1849, 3046], 'typically': [492, 759, 913], 'arising': [493, 1210], 'during': [494, 770, 915, 942, 1852, 2843, 2876, 3047, 3726, 3882], 'adolescence': [495, 916, 4264], 'young': [497, 602, 763, 918, 1013, 3837], 'adulthood.': [498], 'Recent': [499], 'studies': [500, 3584, 3830, 4074, 4281], 'demonstrated': [501], 'that': [502, 1221, 3352, 3591, 3705, 3790, 3808, 3833, 4119], 'NT1': [503, 525, 538, 891, 1018, 1112, 1183, 1196, 1209, 1235, 1255, 1277, 1299, 1390, 1437, 1692, 2025, 2535, 2600, 2631, 2656, 2708, 2744, 2812, 2869, 2925, 3161, 3201, 3367, 3504, 3983, 4042, 4162], 'presents': [504], 'with': [505, 537, 589, 604, 703, 745, 767, 796, 834, 881, 920, 976, 1023, 1066, 1143, 1166, 1182, 1186, 1200, 1218, 1298, 1418, 1771, 1836, 2039, 2058, 2088, 2509, 2517, 2534, 2566, 2573, 2599, 2630, 2651, 2655, 2658, 2707, 2743, 2765, 2811, 2868, 2924, 3160, 3200, 3357, 3366, 3477, 3503, 3577, 3635, 3658, 3668, 3694, 3735, 3788, 3803, 3828, 3839, 3893, 3927, 3930, 3982, 4015, 4054, 4161, 4248, 4267], 'age-specific': [506], 'features,': [507, 1816], 'especially': [508, 4275], 'in': [509, 526, 567, 599, 612, 629, 647, 676, 686, 701, 783, 814, 830, 887, 902, 952, 955, 1015, 1048, 1055, 1075, 1111, 1134, 1175, 1211, 1276, 1305, 1307, 1444, 1622, 1639, 1683, 1688, 1708, 1722, 1746, 1782, 1797, 1914, 2109, 2295, 2507, 2604, 2705, 2710, 2724, 2727, 2740, 2746, 2788, 2807, 2832, 2849, 2853, 2940, 3156, 3195, 3412, 3415, 3454, 3457, 3517, 3538, 3548, 3633, 3682, 3713, 3718, 3732, 3741, 3752, 3786, 3826, 3863, 3869, 3888, 3891, 3915, 3965, 3980, 4008, 4017, 4024, 4058, 4064, 4100, 4142, 4148, 4159, 4164, 4186, 4214, 4239, 4261, 4272, 4276], 'children.': [510], 'With': [511], 'this': [512, 530, 705, 1798, 2576, 3490], 'study': [513, 826, 1270, 1294, 1448, 3491, 3807, 4107], 'we': [514, 3492, 3737], 'aimed': [515], 'describe': [517], 'compare': [520], 'pictures': [523], 'different': [527, 822, 860, 953, 1640, 2019, 3506], 'groups.Methods:In': [529], 'cross-sectional,': [531, 1292], 'multicenter': [532, 1293], 'study,': [533], '106': [534, 1296], 'untreated': [535, 819, 1286], 'patients': [536, 652, 681, 702, 766, 820, 970, 1077, 1287, 1297, 1317, 1402, 1482, 1520, 1711, 1737, 1743, 2012, 2511, 2557, 2564, 2610, 2665, 2731, 2742, 2769, 2793, 2819, 2851, 2904, 2923, 3105, 3184, 3219, 3346, 3378, 3427, 3469, 3502, 3603, 3634, 3657, 3691, 3734, 3756, 3787, 3838, 3892, 4150, 4193, 4224], 'enrolled': [539, 566], 'at': [540, 761, 791, 926, 933, 956, 979, 1011, 1120, 1321, 1408, 1477, 1819, 1874, 1986, 2024, 2164, 2180, 2201, 2220, 2243, 2543, 2568], 'time': [542, 596, 804, 1410, 1431, 1479, 1621, 1637, 1858, 1911, 2603, 2619, 2638, 3613, 3960, 4227], 'diagnosis': [544, 1019, 1388, 1438, 1693, 2569], 'underwent': [545, 1483, 1738], 'evaluation,': [547], 'semistructured': [549, 1740], 'interview': [550, 1768, 1800], '(including': [551], 'Epworth': [553, 581, 1514, 3121], 'Sleepiness': [554, 582, 1515, 2961, 3122], 'Scale),': [555], 'nocturnal': [556, 695, 756, 1105, 1575, 2099, 2103, 2116, 2235, 2240, 2595, 3525, 3856, 3906, 3918], 'video-polysomnography,': [557], 'Multiple': [560, 672, 1582, 3126], 'Latency': [562, 674, 1584, 3128], 'Test.': [563], 'Patients': [564, 744, 975, 1373, 1417, 2138, 2986, 3250, 3759], 'were': [565, 643, 1374, 1406, 1425, 1600, 1676, 1720, 1744, 1752, 1946, 1979, 2013, 2056, 2078, 2093, 2505, 2536, 2830, 2845, 2886, 2905, 3162, 3202, 3347, 3379, 3428, 3470, 3480], 'order': [568, 1308, 1726], 'establish': [570, 1310], '5': [571, 1311, 2018], 'age-balanced': [572], 'groups': [573, 1314, 3590], '(childhood,': [574], 'adolescence,': [575], 'adulthood,': [576, 919], 'middle': [577], 'age,': [578, 590, 835, 985, 3578, 3928], 'senior).Results:The': [580], 'Scale': [583, 1516], 'score': [584], 'showed': [585, 660, 698, 2813, 3573, 3809, 3832, 3921, 4133], 'significant': [587, 3575, 4135], 'increase': [588, 3576, 3868, 3914], 'while': [591, 961, 2679, 2840, 3447, 3948, 4233, 4279], 'self-reported': [592, 1509, 2837, 3566, 3956], 'diurnal': [593, 2838, 3610, 3627, 3663, 3727, 3957], 'total': [594, 1624, 1635, 1856, 2617, 2636, 3030, 3611, 3664, 3958], 'sleep': [595, 687, 696, 1092, 1095, 1100, 1106, 1303, 1494, 1619, 1625, 1629, 1631, 1636, 1641, 1645, 1667, 1674, 1793, 1829, 1847, 1857, 1973, 2104, 2236, 2241, 2310, 2338, 2353, 2427, 2541, 2618, 2637, 2660, 2685, 2942, 2953, 3013, 3031, 3044, 3147, 3526, 3536, 3550, 3612, 3621, 3640, 3665, 3859, 3864, 3950, 3959], 'was': [597, 1271, 1439, 1449, 1529, 1534, 1548, 1681, 1694, 1706, 1769, 1806, 1860, 1935, 2570, 2703, 2721, 2738, 2785, 2938, 3096, 3113, 3449, 3978, 4067], 'lower': [598, 2739, 2787, 2814, 3768], 'older': [600, 650, 773, 1212, 1369, 3601, 3966, 4277], 'adults,': [603, 2029, 2621, 2663], 'latter': [606], 'also': [607, 1861, 2632, 2697, 2870, 3407, 3825, 3841], 'complaining': [608], 'automatic': [610, 1842, 3673], 'behaviors': [611, 2885, 3051, 3674], 'more': [613, 625, 644, 1918, 2513, 2578, 2602, 2682, 2846, 2887, 3163, 3169, 3203, 3348, 3380, 3408, 3429, 3451, 3471, 4055, 4226], 'than': [614, 1327, 1441, 2519, 2546, 2580, 2606, 2620, 2639, 2662, 2687, 2709, 2726, 2745, 2773, 2817, 2852, 2955, 3174, 3213, 3364, 3414, 3438, 3456, 3479, 3677, 3761, 4195], '90%': [615], 'patients.': [617, 1613], 'Children': [618, 2533, 2810, 3159], 'reported': [619, 646, 790, 1119, 1241, 2108, 2806, 2848, 2871, 2889, 3155, 3604, 3681, 3717, 3766, 3996, 4200], 'cataplexy': [621, 690, 1067, 1129, 1404, 1434, 1697, 1908, 1916, 1931, 1938, 2277, 3150, 3170, 3211, 3286, 3293, 3300, 3341, 3353, 3384, 3411, 3436, 3475, 3970, 3976, 4018, 4065, 4082, 4182], 'attacks': [622, 1880, 3999], 'be': [624, 998, 3355, 4052, 4259], 'frequent': [626, 3847, 4056, 4147], '(>': [627], '1/d': [628], '95%': [630], 'patients).': [632, 4011], '"Recalling': [633], 'an': [634, 683, 882, 909, 1228, 1955, 3313, 3361, 3867, 3912, 4124, 4212, 4236, 4255], 'emotional': [635, 1179, 1956, 3314, 3362, 4086, 4121, 4125, 4168, 4201, 4270], 'event,"': [636, 1957, 4126], '"meeting': [637, 1958, 3386, 3404, 4127], 'someone': [638, 1959, 3319, 3387, 3405, 4128], 'unexpectedly,"': [639, 1960, 4129], '"stress,"': [640, 1963, 4130], '"anger"': [642, 3448, 3478], 'frequently': [645, 1184, 2579, 2888, 3409], 'adult': [648, 651, 1076, 1213, 2917, 3602, 3656, 3835], 'as': [653, 986, 988, 1000, 1550, 1556, 1567, 1998, 2000, 2467, 3085, 3434, 3715, 3851, 3853, 3874, 3939], 'possible': [654, 1274, 4096], 'triggers': [655, 1939, 3153, 3303, 4112, 4141, 4202], 'cataplexy.': [657], 'Neurophysiological': [658], 'data': [659, 1615, 2101, 2156, 3056], 'higher': [662, 2616, 2635, 2659, 2704, 2771, 2948, 3597, 3676, 3750, 3931, 3975], 'number': [663, 817, 1468, 1670, 2002, 2949], 'sleep-onset': [665, 1672, 2951, 3145, 3534], 'rapid': [666, 1088, 2496, 3136], 'eye': [667, 1089, 2497, 3137], 'movement': [668, 1090, 1141, 1224, 1661, 2492, 2783], 'periods': [669, 2954, 3537], 'Test': [675, 1585], 'adolescent': [677], 'compared': [678, 2790, 2878, 2892, 2911, 3389, 3494, 3984], 'senior': [680, 2768, 2903, 3755], 'age-progressive': [684], 'decline': [685, 3862], 'efficiency.Conclusions:Daytime': [688], 'sleepiness,': [689, 752], 'triggers,': [693, 3342], 'structure': [697], 'age-related': [699, 3644, 3913, 4217], 'difference': [700, 2937, 3580], 'NT1;': [704], 'variability': [706], 'may': [707, 775, 1162, 1216, 3552, 3647, 4185], 'contribute': [708, 1755], 'diagnostic': [710, 778, 868, 1046, 1486, 1572, 3651], 'delay': [711], 'misdiagnosis.Citation:Lividini': [713], 'A,': [714], 'Pizza': [715], 'F,': [716], 'Filardi': [717], 'M,': [718], 'et': [719], 'al.': [720], 'Narcolepsy': [721], 'phenotype.': [735], 'J': [736], 'Clin': [737], 'Med.': [739], '2021;17(7):1363–1370.BRIEF': [740], 'SUMMARYCurrent': [741], 'Knowledge/Study': [742], 'Rationale:': [743], 'narcolepsy': [746, 784, 811, 855, 1042, 1065, 3712, 3840], 'experience': [749, 1790, 3383, 3842], 'excessive': [750, 1080], 'daytime': [751, 1081, 1853], 'cataplexy,': [753, 1094, 3523], 'disrupted': [755, 1104], 'sleep,': [757], 'which': [758, 1915], 'appear': [760, 4158], 'age.': [764], 'However,': [765], 'disease': [768, 832, 977, 1009, 1035, 1159, 2544], 'onset': [769, 912, 978, 1435, 1820, 1875, 1987, 2260, 2278, 2545, 2686], 'childhood': [771, 943, 4041], 'or': [772, 949, 983, 1005, 1226, 1368, 1497, 1714, 1825, 1885, 1896, 1901, 1929, 1995, 2834, 3168, 3587, 3877, 4090, 4174], 'adulthood': [774], 'represent': [776, 3686], 'challenge,': [779], 'slight': [781, 1109], 'differences': [782, 1110, 1275, 2055, 2504, 2829, 3194, 3516, 3547, 4136], 'have': [788, 1117, 3553, 3648, 3729, 4075, 4225], 'been': [789, 1072, 1118, 1132, 1198, 1239, 3554, 3631, 3680, 3730, 4022], 'distinct': [792, 1121, 1289], 'stages,': [794, 1123, 1642], 'sometimes': [795, 1263], 'discordant': [797], 'findings.Study': [798], 'Impact:': [799], 'Comparing': [800], 'first': [803, 939, 1062, 1812], 'both': [805, 1144, 3495, 3834, 4032], 'large': [816], 'groups,': [824, 2020, 2650, 2764, 3508, 3989], 'our': [825, 846, 1428, 3600, 3655, 3702, 3742, 4059, 4207], 'documented': [827, 3731, 4023], 'substantial': [828, 1054, 3515], 'modifications': [829], 'presentation': [833, 1130, 1278], 'even': [836, 1174, 1227, 4093, 4163], 'though': [837], 'further': [838], 'investigations': [839], 'are': [840, 2037, 2107, 2465, 2805, 3083, 3154, 3886, 3901, 3908], 'required': [841], 'confirm': [843], 'extend': [845], 'findings.': [847], 'Awareness': [848], 'these': [850, 1155, 3690, 3905], 'age-dependent': [851], 'phenotypes': [852, 1116], 'will': [853], 'facilitate': [854], 'recognition': [858], 'among': [859], 'specialists': [861, 1795], 'could': [863, 3354, 3685, 3799, 4051, 4209], 'advantageously': [864], 'shorten': [865], 'long': [867, 1025], 'delay.INTRODUCTIONNarcolepsy': [869], 'rare,': [875], 'lifelong,': [876], 'central': [877, 1056, 3636], 'hypersomnolence,1': [880], 'estimated': [883], 'prevalence': [884, 1203, 3671, 3751, 3769, 3870], '0.047%': [886], 'European': [889], 'population.2': [890], 'pathophysiologically': [893], 'linked': [894], 'selective': [897], 'loss': [898], 'hypocretin-1-producing': [900], 'neurons': [901], 'hypothalamus,': [904], 'most': [905, 1016, 1778], 'likely': [906, 1919, 2514, 2538, 2907, 3164, 3204, 3349, 3381, 3430, 3472, 3774], 'due': [907, 3775], 'autoimmune': [910], 'process.3,4NT1': [911], 'occurs': [914], 'bimodal': [922], 'distribution': [923], '(first': [924], 'peak': [925, 932], 'around': [927, 4043], '15': [929, 1442], 'years,': [930, 3108, 3764], 'second': [931, 1864], '35': [935], 'years),5,6': [936], 'symptom': [940, 2577, 3710], 'appears': [941], '(defined': [944], 'up': [945, 3818], '10': [948, 1892, 3277], '12': [950], 'years': [951, 1329, 1338, 1347, 1356, 1366, 1443, 4198], 'studies)': [954], 'least': [957], '8%–15%': [958], 'patients,5,7,8': [960], 'late': [963, 984], 'occurrence': [964, 1909, 2873, 3212, 3532, 3740, 3813, 4066], 'extremely': [966], 'rare': [967], '(0.71%': [968], 'after': [971, 1628, 2352, 2684], '60': [973], 'years).9': [974], 'very': [981, 3811], 'early': [982], 'well': [987, 1073, 1999, 3852], 'positive': [989, 1679], 'first-degree': [990], 'familial': [991], 'history': [992], 'symptoms': [994], 'narcolepsy,': [996], 'should': [997], 'regarded': [999], 'red': [1001], 'flags': [1002], 'symptomatic': [1004], 'genetic': [1006], 'forms.10–12Although': [1007], 'arises': [1010], 'patients,': [1017, 1156, 1214, 1686, 2623, 4245], 'usually': [1021], 'established': [1022], 'delay,7': [1026], 'negatively': [1027], 'affecting': [1028], 'treatment': [1030], 'opportunities': [1031], 'and,': [1032, 1587], 'consequently,': [1033], 'burden.13,14': [1036], 'Although': [1037], 'increasing': [1039], 'awareness': [1040], 'has': [1043, 1071, 1131, 1197, 1238, 3629, 3679, 4020, 4108], 'shortened': [1044], 'gap': [1047, 1432], 'many': [1049, 4073], 'countries,7,9': [1050], 'it': [1051, 4177], 'still': [1052, 4246], 'remains': [1053], 'Europe': [1057], '(around': [1058, 3757, 3816], '8.9': [1059], 'years).14Since': [1060], 'its': [1061], 'description,': [1063], '(now': [1068], 'NT1)': [1069], 'picture': [1070, 1237], 'characterized': [1074, 3845], 'comprises': [1079], 'sleepiness': [1082, 2965, 3567, 3964], '(EDS),': [1083], 'untimely': [1084], 'manifestations': [1085], 'dissociated': [1087], '(REM)': [1091], '(ie,': [1093, 1146, 1150], 'paralysis,': [1096, 1974], 'hypnagogic/hypnopompic': [1097, 1975], 'hallucination,': [1098], 'REM': [1099, 1618, 1654, 1673, 1846, 2337, 2426, 2494, 2952, 3134, 3146, 3535], 'behavior': [1101, 1848, 3045], 'disorder),15,16': [1102], '(DNS).16': [1107], 'Nonetheless,': [1108], 'peculiar,': [1126], 'partially': [1127, 4210], 'remitting': [1128], 'described': [1133, 3632], 'pediatric': [1135, 1195, 1234, 1498, 1519, 4102], 'patients,9,17–19': [1136], 'consisting': [1137], 'complex': [1140, 3779], '"negative"': [1145, 4033], 'hypotonic)': [1147], '"active"': [1149], 'hyperkinetic)': [1151], 'motor': [1152, 4036], 'features.18–20': [1153], 'In': [1154, 1518, 1969], 'near': [1157], 'onset,': [1160, 2165, 2181, 2202, 2221, 2244, 2354], 'hypotonia': [1161], 'occur': [1163, 3881], 'subcontinuously,': [1164], 'presenting': [1165, 2565, 2657], 'characteristic': [1168], '"cataplectic': [1169], 'facies"': [1170], 'ataxic': [1172], 'gait,': [1173], 'absence': [1177, 1763, 1826, 1902, 3545, 4097, 4166], 'triggers.18,19,21Moreover,': [1180], 'children': [1181, 1324, 2520, 2581, 2598, 2652, 2688, 2711, 2725, 2747, 2774, 2854, 2880, 3199, 3365, 3391, 3416, 3458, 3481, 3827, 3981, 4143, 4160], 'present': [1185, 1217, 1269, 2516], 'hyperactivity,': [1187], 'attention': [1188, 1934, 3794], 'difficulties,': [1189], 'irritability,': [1190, 1844], 'depressive': [1192], 'symptoms,22–26': [1193], 'associated': [1199, 3356, 3476, 3929, 4053, 4282], 'high': [1202, 3812], 'obesity': [1205], 'precocious': [1207], 'puberty.26–28': [1208], 'instead,': [1215, 3765], 'unusual': [1219], 'mimic': [1222], 'acute': [1229], 'cerebrovascular': [1230], 'disease.11,12While': [1231], 'discrete': [1233], 'extensively': [1240, 3968], 'recognized,': [1243], 'reports': [1244], 'effect': [1247, 3209, 3284, 4063], 'other': [1250, 1419, 3582, 3987, 4010, 4047], 'stages': [1252, 1646, 2695], 'aspects': [1259], 'remain': [1260], 'sparse': [1261], 'discordant.5,8,26,29Therefore,': [1264], 'aim': [1266], 'investigate': [1273, 1728], 'span': [1282], 'characterize': [1285], 'groups.METHODSParticipantsThis': [1291], 'included': [1295], 'recruited': [1300, 1376], 'from': [1301, 1377, 1427, 2258, 2276, 3581, 4204], 'several': [1302], 'centers': [1304], 'Italy,': [1306], 'balanced': [1312], '(roughly': [1315], '20': [1316], 'each': [1319, 1384, 2035], 'group)': [1320], 'diagnosis:': [1322, 2026], '(1)': [1323, 1828], '=': [1325, 1332, 1336, 1341, 1345, 1350, 1354, 1359, 1364, 1371, 2124, 2130, 2136, 2143, 2150, 2476, 2480, 2485, 2489, 2495, 2500, 2795, 2972, 2978, 2984, 2991, 2998, 3120, 3125, 3131, 3135, 3140, 3144, 3236, 3242, 3248, 3255, 3262, 3338], 'younger': [1326, 2922, 3733, 3760, 4194], '11': [1328, 2121, 2969, 3233], 'old': [1330, 1339, 1348, 1357, 1367], '(n': [1331, 1340, 1349, 1358, 1370, 2123, 2129, 2135, 2142, 2149, 2971, 2977, 2983, 2990, 2997, 3235, 3241, 3247, 3254, 3261], '20),': [1333], '(2)': [1334, 1832], 'adolescents': [1335, 2524, 2547, 2585, 2629, 2654, 2690, 2716, 2728, 2751, 2776, 2789, 2858, 2945, 3175, 3395, 3421, 3463, 3486, 3539], '11–18': [1337, 2127, 2975, 3239], '21),': [1342], '(3)': [1343, 1841], 'adults': [1344, 2529, 2551, 2590, 2607, 2640, 2863, 2891, 3179, 3214, 3400, 3442, 3455, 4273], '19–44': [1346, 2133, 2981, 3245], '23),': [1351], '(4)': [1352], 'middle-aged': [1353, 2510, 2556, 2609, 2622, 2664, 2730, 2741, 2766, 2792, 2818, 2850, 2913, 3183, 3218, 3345, 3377, 3426, 3468, 3753, 4149, 4244], '45–64': [1355, 2140, 2988, 3252], '22),': [1360], '(5)': [1362], 'seniors': [1363, 2574, 2625, 2642, 2675, 2680, 2706, 2756, 2824, 2867, 2897, 2956, 3189, 3224, 3343, 3413], '65': [1365], '20).': [1372], 'consecutively': [1375], 'June': [1378, 1381], '2015': [1379], '2016': [1382], 'within': [1383], 'group.': [1386], 'The': [1387, 1430, 1811, 1863, 2561], 'fulfilled': [1391], 'current': [1393], 'International': [1394], 'Classification': [1395], '(third': [1399], 'edition)': [1400], 'criteria.All': [1401], 'had': [1403, 2615, 2633, 2681], 'drug-naïve': [1407, 3501], 'neurophysiological': [1412], 'evaluations': [1413], 'interview.': [1416, 1741], 'disorders': [1421, 1794], 'and/or': [1422, 3697], 'cognitive': [1423], 'impairments': [1424], 'excluded': [1426], 'study.': [1429], 'between': [1433, 1558, 2649, 2699, 2763, 3858], 'shorter': [1440, 3605, 3608], '81/106': [1445], '(76.4%)': [1446], 'patients.The': [1447], 'approved': [1450], 'by': [1451, 1492, 1579, 1602, 1981, 2074, 2890, 3556, 3570, 3846, 3854, 3911, 3944, 4046, 4071], 'Local': [1453], 'Health': [1454], "Trust's": [1455], 'Ethics': [1456], 'Committee': [1457], 'center': [1460], 'reference': [1462, 1772], '(Comitato': [1463], 'Etico': [1464], 'Interaziendale': [1465], 'Bologna-Imola,': [1466], 'Protocol': [1467], '17009),': [1469], 'all': [1471, 1723, 2929, 3992, 4009], 'participants': [1472], 'provided': [1473], 'written': [1474], 'informed': [1475], 'consent': [1476], 'inclusion.AssessmentAll': [1481], 'standardized': [1485], 'protocol': [1487, 1573], 'encompassing': [1488], 'evaluation': [1490], 'performed': [1491, 1707], 'expert': [1495], 'neurologist': [1496], 'neurologist,': [1499], 'anthropometric': [1500], 'assessment': [1501, 1511], 'comprehensive': [1502], 'body': [1504], 'mass': [1505], 'index': [1506, 2761, 2784], '(BMI),': [1507], 'EDS': [1510, 1815, 2801], 'using': [1512, 2080], '(ESS).': [1517], '(aged': [1521], '<': [1522, 1569, 2091, 2120, 2522, 2526, 2531, 2549, 2553, 2559, 2583, 2587, 2592, 2612, 2627, 2644, 2667, 2671, 2677, 2692, 2713, 2718, 2733, 2749, 2753, 2758, 2778, 2821, 2826, 2856, 2860, 2865, 2882, 2900, 2915, 2919, 2931, 2958, 2968, 3106, 3177, 3181, 3186, 3191, 3216, 3221, 3226, 3232, 3272, 3276, 3369, 3373, 3393, 3397, 3402, 3418, 3423, 3445, 3460, 3465, 3483, 3488], '18': [1523, 3107], 'years),': [1524], 'modified': [1526, 3110], 'ESS': [1527, 2815, 3111, 3119, 3598, 3946], 'version': [1528, 3112], 'used,26,30,31': [1530], 'BMI': [1532, 1551, 1557, 1568], 'percentile': [1533, 1541], 'determined': [1535], 'according': [1536], 'Italian': [1539], 'growth': [1540], 'scales': [1542], 'boys': [1544], 'girls32:': [1546], 'Obesity': [1547], 'defined': [1549], '>': [1552, 1897, 2146, 2994, 3258, 3281], '95th': [1553, 1562], 'percentile,': [1554, 1563], 'overweight': [1555], '85th': [1560, 1570], 'normal': [1565, 3883], 'weight': [1566], 'percentile.The': [1571], 'encompassed': [1574], 'polysomnography': [1576, 2117], '(PSG)': [1577], 'followed': [1578, 2073], '5-nap': [1581], '(MSLT),': [1586], 'whenever': [1588], 'possible,': [1589], 'lumbar': [1590], 'puncture': [1591, 1705], 'cerebrospinal': [1593, 1700, 1716], 'fluid': [1594, 1701, 1717], 'hypocretin-1': [1595, 1702, 1718], 'assay.PSG': [1596], 'MSLT': [1599, 1664, 1680, 2804, 2963, 3124, 3528, 3549, 3954], 'scored': [1601], 'board-certified': [1604], 'technician': [1606], 'blinded': [1607], 'status': [1611], '(sleep': [1616], 'latency;': [1617, 1620], 'bed;': [1623], 'time;': [1626], 'wakefulness': [1627, 2683], 'onset;': [1630], 'efficiency;': [1632], 'percentages': [1633, 2050], 'spent': [1638, 2601], 'namely': [1643], 'non-REM': [1644], '2,': [1648], '3': [1649, 1809, 3228, 3588], '[N1,': [1650], 'N2,': [1651], 'N3],': [1652], 'sleep;': [1655], 'apnea-hypopnea': [1656, 2477], 'index;': [1657], 'periodic': [1659, 2490, 2781, 3878, 3898, 3935], 'limb': [1660, 2491, 2782, 3879, 3899, 3936], 'index)': [1662], 'results': [1665, 2087, 3920], '(mean': [1666, 2042], 'latency': [1668, 3551], 'periods)': [1675], 'collected.': [1677], 'A': [1678, 3623, 3861, 3973, 4012], 'registered': [1682], '105/106': [1684], '(99.1%)': [1685], 'remaining': [1690], 'patient': [1691], 'based': [1695, 2021], 'presence': [1698, 1748, 1824, 1900, 2833, 3016], 'deficiency.': [1703], 'Lumbar': [1704], '82/106': [1709], '(77.4%)': [1710], 'low': [1713, 4190], 'absent': [1715], 'levels': [1719], 'found': [1721, 2831, 3514, 3592, 3979, 4118], 'them.In': [1725], 'specific': [1729], 'EDS-,': [1732], 'cataplexy-,': [1733], 'narcolepsy-associated': [1735], 'symptoms,': [1736], 'Pediatric': [1742], 'interviewed': [1745], 'parents,': [1750], 'who': [1751, 4199], 'allowed': [1753], 'their': [1757, 1837, 1983, 3596, 3739, 4085, 4095], "child's": [1758], 'answers': [1759], 'when': [1760, 3385], 'needed.In': [1761], 'validated': [1765, 1780], 'tools,': [1766], 'designed': [1770], 'recent': [1774], 'studies,': [1775], 'influential': [1779], 'questionnaire': [1781], 'field,33–36': [1784], 'practice': [1789], 'participating': [1796], 'study.The': [1799], 'lasted': [1801], 'approximately': [1802], '60–90': [1803], 'minutes': [1804], 'divided': [1807, 2016], 'into': [1808, 2017], 'sections.': [1810], 'one': [1813], 'explored': [1814], 'including': [1817], '(years)': [1821], 'prodromal': [1830], 'signs;': [1831], 'scheduled': [1833], 'naps,': [1834, 2839, 3015], 'together': [1835, 3667], 'duration': [1838, 1888, 2835, 3274], '(minutes);': [1839], 'behaviors,': [1843], '(RBD)': [1850], 'episodes': [1851, 1890, 2842, 3171, 3725, 3785], 'naps.': [1854], 'Diurnal': [1855], '(h/d)': [1859], 'investigated.': [1862], 'part': [1865, 4187], 'focused': [1866, 4077], 'characteristics': [1870, 2097, 2114, 3499], 'cataplexy:': [1872], '(years),': [1876, 1988], 'frequency': [1877, 1990, 3265, 3977, 4019], 'cataplectic': [1879, 3998], '(<': [1881, 1891, 1991], '1/mo,': [1882, 1884, 1992, 1994], '≥': [1883, 1886, 1993, 1996, 3267, 3270], '1/d),': [1887, 1997], 'seconds,': [1893, 1895], '10–120': [1894, 3279], '120': [1898, 3282], 'seconds),': [1899], '"time-of-day': [1905], 'effect"': [1906], '(a': [1910], 'day': [1913, 3173], 'occur),': [1921], 'use': [1924], 'strategies': [1926, 3290, 3297], 'control': [1928, 3299], 'avoid': [1930, 3292], 'attacks.': [1932], 'Particular': [1933], 'paid': [1936], 'wide': [1942], 'range': [1943, 4007], 'events': [1945], 'investigated': [1947, 1980, 3738, 4221], '(namely,': [1948], '"laughter,"': [1949], '"telling/listening': [1950], 'jokes,"': [1952], '"euphoria,"': [1953], '"recalling': [1954], '"surprise,"': [1961], '"anger,"': [1962], '"embarrassment,"': [1964], '"fear,"': [1965], '"sexual': [1967], 'intercourse").': [1968], 'third': [1971], 'section,': [1972], 'hallucinations': [1976, 2216], 'DNS': [1978, 2567, 3926], 'assessing': [1982], 'occurrence,': [1984], 'awakenings': [2004, 3850], 'per': [2005, 3172], 'night': [2006], 'DNS.Statistical': [2008], 'analysisFor': [2009], 'analytical': [2010], 'purposes,': [2011], 'priori': [2015], 'children,': [2027, 2894, 3439, 3714], 'adolescents,': [2028, 2895, 2928, 3440, 4145], 'middle-aged,': [2030], 'seniors.': [2032, 4152], 'Data': [2033], 'group': [2036, 2503, 3099], 'presented': [2038, 2466, 2946, 3084], 'descriptive': [2040], 'statistics': [2041], '±': [2043, 2167, 2169, 2171, 2173, 2175, 2183, 2185, 2187, 2189, 2191, 2204, 2206, 2208, 2210, 2212, 2223, 2225, 2227, 2229, 2231, 2246, 2248, 2250, 2252, 2254, 2264, 2266, 2268, 2270, 2272, 2282, 2284, 2286, 2288, 2290, 2298, 2300, 2302, 2304, 2306, 2313, 2315, 2317, 2319, 2321, 2327, 2329, 2331, 2333, 2335, 2341, 2343, 2345, 2347, 2349, 2356, 2358, 2360, 2362, 2364, 2370, 2372, 2374, 2376, 2378, 2385, 2387, 2389, 2391, 2393, 2400, 2402, 2404, 2406, 2408, 2415, 2417, 2419, 2421, 2423, 2430, 2432, 2434, 2436, 2438, 2442, 2444, 2446, 2448, 2450, 2455, 2457, 2459, 2461, 2463, 2469, 3000, 3002, 3004, 3006, 3008, 3020, 3022, 3024, 3026, 3028, 3034, 3036, 3038, 3040, 3042, 3060, 3062, 3064, 3066, 3068, 3072, 3074, 3076, 3078, 3080, 3087], 'standard': [2044, 2501, 3141], 'deviation': [2045], 'continuous': [2047], 'variables': [2048], 'categorical': [2052], 'data).': [2053], 'Group': [2054], 'analyzed': [2057], 'chi-square': [2060], 'test,': [2061], '1-way': [2063], 'analysis': [2064, 2070, 2481, 3093, 3116], 'variance,': [2066, 2483], 'Kruskal-Wallis': [2069], 'variance': [2072, 3095], 'posthoc': [2075], 'comparisons.': [2076], 'Analyses': [2077], 'conducted': [2079], 'SPSS': [2081], '19.0': [2082], '(SPSS,': [2083], 'Inc.,': [2084], 'Chicago,': [2085], 'IL);': [2086], 'alpha': [2089], 'level': [2090], '.05': [2092, 3269, 3317, 3330], 'considered': [2094], 'statistically': [2095, 3616, 4134], 'significant.RESULTSGeneral': [2096], 'polysomnographyClinical': [2100], 'architecture': [2105, 2293], 'parameters': [2106], 'Table': [2110, 2808, 3157], '1.Table': [2111], 'General': [2113], 'data.Children': [2118], 'Aged': [2119, 2126, 2132, 2139, 2145, 2967, 2974, 2980, 2987, 2993, 3231, 3238, 3244, 3251, 3257], 'Years': [2122, 2128, 2134, 2141, 2148, 2970, 2976, 2982, 2989, 2996, 3234, 3240, 3246, 3253, 3260], '20)Adolescents': [2125, 2973, 3237], '21)Adults': [2131, 2979, 3243], '23)Middle-Aged': [2137, 2985, 3249], '22)Seniors': [2144, 2992, 3256], '64': [2147, 2995, 3259], '20)P': [2151, 3263], '(1-way': [2152], 'ANOVA)Demographic': [2153], 'Male/female,': [2157], 'n14/68/1315/812/107/13ns': [2158], 'Overweight/obese': [2159], '(%)55677310090<': [2160], '.005a': [2161, 2238], 'Hypersomnolence': [2162], 'y6.8': [2166, 2182], '1.6411.9': [2168], '3.0219.6': [2170], '7.2034.7': [2172], '14.3438.1': [2174], '21.27<': [2176], '.0001': [2177, 2193, 2214, 2233, 2256, 2274, 2323, 2366, 2380, 2425, 2452, 3322], 'Cataplexy': [2178, 3229], '1.5111.6': [2184], '2.5621.0': [2186], '8.6340.2': [2188], '14.5943.7': [2190], '19.25<': [2192], 'paralysis': [2195, 2199, 2542], '(%)1552705940<': [2196], '.01a': [2197], 'y6.7': [2203], '2.0811.4': [2205], '2.9122.2': [2207], '8.8237.1': [2209], '15.2345.7': [2211], '18.92<': [2213], 'Hypnagogic/hypnopompic': [2215, 2218], '(%)4567618260nsa': [2217], 'y6.6': [2222], '1.5112.4': [2224], '2.9520.8': [2226], '7.0740.1': [2228], '12.4245.2': [2230], '14.92<': [2232], 'Disrupted': [2234, 2239], '(%)100100879570<': [2237], 'y6.4': [2245], '1.3710.7': [2247], '3.6921.4': [2249], '7.7636.5': [2251], '14.6140.5': [2253], '19.76<': [2255], 'Delay': [2257, 2275], 'hypersomnolence': [2259], 'diagnosis,': [2262, 2280], 'y1.3': [2263, 2281], '1.532.3': [2265], '2.2212.3': [2267], '9.4218.9': [2269], '13.5632.6': [2271], '20.55<': [2273], '1.562.6': [2283], '2.0610.0': [2285], '9.5713.4': [2287], '12.4327.0': [2289], '18.06<': [2291], '.0001Sleep': [2292], 'Time': [2294], 'bed,': [2296], 'min565.7': [2297], '66.24499.7': [2299], '44.08475.1': [2301], '90.43473.7': [2303], '84.77490.9': [2305], '86.25<': [2307], '.005': [2308, 2395, 2668, 3327, 3370], 'Total': [2309], 'time,': [2311, 3032, 3666], 'min512.8': [2312], '59.51446.0': [2314], '53.87371.0': [2316], '88.49390.5': [2318], '83.16361.8': [2320], '88.91<': [2322], 'latency,': [2325, 2339, 2943, 3058], 'min3.9': [2326], '3.783.1': [2328], '2.414.9': [2330], '3.177.2': [2332], '9.427.4': [2334], '6.64ns': [2336], 'min21.8': [2340], '37.0429.5': [2342], '60.5548.7': [2344], '60.9255.6': [2346], '62.4464.5': [2348], '81.65ns': [2350], 'Wakefulness': [2351], 'min49.0': [2355], '37.4550.5': [2357], '39.2790.1': [2359], '52.1594.2': [2361], '50.38131.5': [2363], '72.64<': [2365], 'efficiency': [2368, 2661, 3865], '(%)91.1': [2369], '6.2089.1': [2371], '7.3279.2': [2373], '10.9678.7': [2375], '9.2372.3': [2377], '13.94<': [2379], 'stage': [2382, 2397, 2412, 2428], 'N1': [2383, 2701], '(%)12.3': [2384], '5.3010.3': [2386], '5.0015.5': [2388], '6.3016.7': [2390], '7.6223.1': [2392], '17.92<': [2394], 'N2': [2398, 2720], '(%)35.1': [2399], '4.4444.1': [2401], '8.3842.5': [2403], '8.9245.1': [2405], '10.1533.1': [2407], '7.42<': [2409], '.001': [2410], 'N3': [2413, 2736], '(%)26.2': [2414], '6.5121.7': [2416], '7.3219.0': [2418], '5.3512.5': [2420], '5.4523.9': [2422], '7.62<': [2424], '(%)26.5': [2429], '5.4323.8': [2431], '6.6223.0': [2433], '5.1326.2': [2435], '7.4922.7': [2437], '14.74ns': [2439], 'AHI': [2440, 2475], '(events/h)0.27': [2441], '0.740.9': [2443], '2.776.8': [2445], '9.1312.2': [2447], '14.2317.2': [2449], '16.75<': [2451], 'PLMI': [2453, 2488], '(events/h)14.6': [2454], '14.507.9': [2456], '12.9815.4': [2458], '13.8533.6': [2460], '36.1526.2': [2462], '18.14.002Values': [2464], 'mean': [2468, 2941, 3086], 'SD': [2470, 2499, 3088, 3139], 'unless': [2471, 3089, 3101], 'otherwise': [2472, 3090, 3102], 'indicated.': [2473, 3091, 3103], 'aChi-square.': [2474], 'index,': [2478, 2493], 'ANOVA': [2479], 'ns': [2484, 3130], 'not': [2486, 3132, 3339, 3615, 3909], 'significant,': [2487, 3133], 'movement,': [2498, 3138], 'deviation.Significant': [2502], 'observed': [2506, 2939], 'BMI,': [2508], 'being': [2512, 4139], 'overweight/obesity': [2518], '(P': [2521, 2525, 2530, 2548, 2552, 2558, 2582, 2586, 2591, 2611, 2626, 2643, 2666, 2676, 2691, 2712, 2717, 2732, 2748, 2752, 2757, 2777, 2794, 2820, 2825, 2855, 2859, 2864, 2881, 2914, 2918, 2957, 3176, 3180, 3185, 3190, 3215, 3220, 3225, 3368, 3392, 3396, 3401, 3417, 3422, 3459, 3464, 3482, 3487], '.0001),': [2523, 2554, 2678, 2750, 3394], '.005),': [2527, 2754, 2779, 3178, 3187, 3217, 3398], '.005).': [2532, 2560], 'less': [2537, 2722, 2906, 3778], 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