REM periodicity under ultrashort sleep/wake cycle in narcoleptic patients.

Six narcoleptic patients were tested three times on the 13-min waking/7-min resisting sleep paradigm each time after a night of sleep in the laboratory. The three experiments were conducted after 10 days without any antinarcoleptic treatment or after 2 weeks of daily treatment with either methyl-phenidate or aniracetam. The results showed that patients had pronounced levels of diurnal sleepiness in all three experimental conditions with a midafternoon peak at around 1300-1500 hr and a nadir at around 1800 hr. Methyl-phenidate significantly reduced REM sleep and marginally reduced total sleep in comparison with the no-treatment and aniracetam conditions. REM sleep in the 7/13 paradigm appeared cyclically with a dominant periodicity of 80 min/cycle. The cycles tended to be synchronized across patients and were unrelated to the temporal structure of total sleep. The present results support the continuation of the REM oscillator during brief periods of waking, but suggest that the REM periodicity is unrelated to Kleitman's BRAC model of arousal.