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Título

Bad dreams in narcolepsy type 1

Resumo

Introduction - Narcolepsy can present with different combinations of severity and frequency of sleep paralysis, sleep-related hallucinations, and cataplexy. Symptoms related to REM sleep can happen frequently, such as lucid dreams, vivid dreams, epic dreams, and nightmares.
Objective - The objective is to highlight the increased frequency of bad dreams in patients with type 1 narcolepsy, their impact on sleep quality, and possible factors associated with this increased frequency.
Methodology - We evaluated 52 patients diagnosed with type 1 narcolepsy according to the ICSD3 diagnostic criteria. They underwent clinical evaluation and application of the Pittsburgh Sleep Quality Rating Scale, Epworth Sleepiness Scale, and Narcolepsy Severity Scale. In addition to clinical data, data from complementary diagnostic tests and medications in use were also recorded.
Results - Mean age of patients was 37.62 ± 11.974, with a minimum of 18 and a maximum of 70. Females corresponded for 59.6%. More than half of the patients, 55.8% had bad dreams more than once a week in the month of the interview, 15.4% had them less than once a week and 28.8% had none in the last month. There was no correlation between the frequency of symptoms related to bad dreams and the narcolepsy severity scale (person 13.785, p = 0.130). Regarding symptomatic scales, the prevalence of poor sleep was associated with the Pittsburgh sleep quality index score (F 5.278; p= 0.003), but without association with the Epworth sleepiness scale (F0.616; p = 0.608). When correlating with the use of medications, there was no correlation between the use of stimulants (person 1.192; p=0.755) or anticataplectics (person 5.120; p= 0.163). There was also no individual difference between each type of stimulant in use (person 7.591; p=0.576). The use of different anticataplectic antidepressants correlated differently with the prevalence of bad dreams (person 25.919; p=0.011), with tricyclic showing a negative association with a higher frequency of bad dreams and selective serotonin reuptake inhibitors having a positive association with the absence of bad dreams.
Conclusion - Oneiric symptoms are frequent in type 1 narcoleptic population. The use of antidepressants with an anti-cataplectic effect may help to control these symptoms.

Palavras Chave

Narcolepsy; dreams; antidepressants

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