Dados do Trabalho

Título

Chrononutrition and Narcolepsy: A behavioral approach to symptom management.

Resumo

INTRODUCTION: Although still incipient, there is an increasing body of data suggesting association between circadian nutritional preferences and obesity. Some studies demonstrated that concomitance between food intake and elevated levels of melatonin in bloodstream would predispose the individual to a higher insulin resistance, higher glucose levels and an increase in body mass index (BMI). It is widely known that obesity is correlated to a higher risk of developing sleep disorders, such as obstructive sleep apnea (OSA), which increments excessive daytime sleepiness (EDS) and conversely decreases quality of life. Also, it is known that patients diagnosed with narcolepsy tend to present with obesity and a sleep phase delay. In addition, it has been demonstrated that patients with narcolepsy tend to have altered bone mineral metabolism. A study using an animal model showed that the use of modafinil, a common drug used in the management of EDS, is associated with a reduction in bone mass. According to another study, circadian disruption plus sleep restriction would also predispose to disruption in bone homeostasis. There are still no studies that investigate the association between circadian nutritional preferences and the elevated BMI observed in patients diagnosed with narcolepsy, nor the reduction of bone mass in this population, to the extent of our knowledge. This is the aim of our study.
METHODS: We have selected 33 patients diagnosed with type 1 and 18 patients diagnosed with type 2 narcolepsy, based on a hypocretin measurement in cerebrospinal fluid previously performed. We intend to use data from medical records to evaluate the times and nutritional values of the main courses and assess their correlation to anthropometric endpoints. Also, we intend to compare bone mass and nutritional intake of micronutrients between these patients, evaluating the potential of these measurements of becoming biomarkers of disease. CONCLUSION: Narcolepsy is commonly associated with an important decrease in quality of life, in part because of its morbidity with obesity and OSA. Defining a behavioral approach to the treatment of obesity, based on nutritional counseling, would optimize symptoms control in these patients. In addition, the definition of a decreased bone mass as a part of the pathophysiology of this disease – and a possible biomarker – wound allow faster and cheaper diagnosis, also favoring a better management of bone homeostasis in clinical follow-up.