Sleep
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Patients with narcolepsy experience poor maintenance of wakefulness and fragmented night sleep, but the underlying mechanism of sleep boundary dysregulation remains little understood. The goal of this study was to quantify abnormal sleep-wake regulation in narcolepsy patients. ⋯ This study provides further evidence for narcolepsy as a disorder of state boundaries including but not limited to REM sleep and wakefulness. In particular, the increase in transitional periods between REM and WAKE but also between NREM and WAKE indicates abnormal state dynamics in narcolepsy. This pattern may be a consequence of disrupted sleep/wake stabilizing mechanisms due to loss of hypocretin/orexin neurons in the hypothalamus.