Not Only Excessive Daytime Sleepiness but Also Depression Symptoms, Chronological Age and Onset-Age Were Associated with Impulsivity in Narcolepsy Type 1 Patients

Yang Yang; Jun Zhang; Fang Han; Fulong Xiao

doi:10.2147/NSS.S377372

Not Only Excessive Daytime Sleepiness but Also Depression Symptoms, Chronological Age and Onset-Age Were Associated with Impulsivity in Narcolepsy Type 1 Patients

Nat Sci Sleep. 2022 Oct 17:14:1857-1866. doi: 10.2147/NSS.S377372. eCollection 2022.

Authors

Yang Yang¹, Jun Zhang², Fang Han³, Fulong Xiao⁴

Affiliations

¹ Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.
² Department of Neurology, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
³ Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
⁴ Department of General Internal Medicine, Peking University People's Hospital, Beijing, 100044, People's Republic of China.

Abstract

Objective: To detect the factors associated with total and subscales impulsivity scores in narcolepsy and further explore the non-linear relationship between these factors and impulsivity score.

Methods: One hundred and fifty-eight narcolepsy type 1 (NT1) patients were involved in this cross-sectional study. Patients completed questionnaires evaluating impulsivity symptoms (Barratt impulse scale-11, BIS-11), depression symptoms (Center for Epidemiologic Studies Depression Scale for Children, CES-DC or Self-Rating Depression Scale, SDS) and sleepiness (Epworth Sleepiness Scale, ESS). Parameters from polysomnography and multiple sleep latency test were also collected. Linear regression analysis was performed to detect the factors associated with total and subscales impulsivity scores. Then, generalized additive models and smooth curve fitting were performed to explore the non-linear relationship between chronological age and impulsivity scores.

Results: Factors associated with higher total impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher attentional impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher motor impulsivity score were higher ESS, younger onset and depression symptoms. Factors associated with higher non-planning impulsivity score were adolescents, older onset and depression symptoms. A non-linear relationship between age and impulsivity scores (total impulsivity score, attentional impulsivity score and non-planning impulsivity score) was detected in NT1 patients.

Conclusion: Not only excessive daytime sleepiness but also onset-age, depression symptoms and chronological age were associated with impulsivity in NT1 patients. The non-linear relationship between age and impulsivity scores suggested brain and mental development alterations in NT1 patients.

Keywords: depression; excessive daytime sleepiness; impulsivity; narcolepsy; smooth curve fitting.

Grants and funding

This work was supported by the National Natural Science Foundation of China (82070091), International Cooperation and Exchange of the National Natural Science Foundation of China (82020108001), Youth Talent Support Project from China Association for Science and Technology, Project 2020BD028 supported by PKU-Baidu Fund, Beijing Dongcheng District Outstanding Talent Funding Project (DCQYYRC-789-01-DR), Beijing Outstanding Talent Funding Project (2018000021469G235) and Youth Research Funding, Beijing Tiantan Hospital, Capital Medical University (No. 2018-YQN-18).