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SOREMs in Sleep Clinic Patients: Association with Sleepiness, Alertness and Fatigue
Chris Y. Kim, Alan Ong, MD, FRCP(C), D.ABPN, D.ABSM, Sharon A. Chung, PhD, Colin M. Shapiro, MBBCh, PhD, MRC Psych, FRCP©
Study objectives: Sleep-onset rapid eye movement (SOREM) during daytime naps is
recognized as a main diagnostic feature of narcolepsy. However, SOREMs have been
reported to occur in other disorders. This study set out to answer three questions: 1)
whether the majority of patients with SOREMs are diagnosed with narcolepsy; 2) if the
number of SOREMs is linked with the degree of daytime sleepiness; and, 3) whether
patients with SOREMs are sleepier than patients without SOREMs.
Methods: One hundred and eighty-five charts of sleep clinic patients with SOREMs on
the Multiple Sleep Latency Test (MSLT) or Maintenance of Wakefulness Test (MWT) were
compared to 178 charts from clinic patients without SOREMs on the MSLT or MWT (control
group). Information was collected from the initial, diagnostic sleep study.
Results: Patients with SOREMs were almost as frequently diagnosed with narcolepsy
as with obstructive sleep apnea (OSA) or depression/anxiety. Subjective measures of
sleepiness, alertness and fatigue were not different between the SOREM and control
groups. The SOREM group did not exhibit shorter mean sleep onset latencies on the MSLT
or MWT but a greater number of SOREMs was associated with increased sleepiness on the
MSLT, but not on the MWT or subjective measures of sleepiness.
Conclusion: SOREMs occur across a wide variety of sleep and psychiatric disorders. Patients
with SOREMs were not sleepier, more fatigued or less alert than those without SOREMs.
The findings of this study indicate that SOREMs are not an accurate or specific diagnostic
marker of narcolepsy.
| Keywords: SOREM, EDS, alertness, fatigue, narcolepsy |
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