Impaired Sleep-Dependent Memory Consolidation in Pediatric Narcolepsy Type 1

K Maski; G Heckler; J Worhach; D Mylonas; G Wang; K Szilagyi; B Zhang; C Diniz Behn; T E Scammell; R Stickgold

doi:10.1093/sleep/zsae238

Impaired Sleep-Dependent Memory Consolidation in Pediatric Narcolepsy Type 1

Sleep. 2024 Oct 18:zsae238. doi: 10.1093/sleep/zsae238. Online ahead of print.

Authors

K Maski¹, G Heckler¹, J Worhach¹, D Mylonas^{2

3}, G Wang¹, K Szilagyi¹, B Zhang¹, C Diniz Behn^{4

5}, T E Scammell⁶, R Stickgold⁷

Affiliations

¹ Department of Neurology, Boston Children's Hospital, Boston, MA, USA.
² Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
³ Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA USA.
⁴ Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO, USA.
⁵ Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
⁶ Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁷ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.

PMID: 39420719
DOI: 10.1093/sleep/zsae238

Abstract

Study objectives: Disrupted nighttime sleep (DNS) is common in pediatric Narcolepsy type 1, yet its cognitive impact is unknown. As N2 sleep spindles are necessary for sleep-dependent memory consolidation, we hypothesized that Narcolepsy Type 1 impairs memory consolidation via N2 sleep fragmentation and N2 sleep spindle alterations.

Methods: We trained 28 pediatric Narcolepsy Type 1 participants and 27 healthy controls (HC) on a spatial declarative memory task before a nocturnal in-lab polysomnogram and then gave them a cued recall test upon awakening in the morning. We extracted wake and sleep stage bout numbers and N2 spindle characteristics from the polysomnogram and conducted mixed model analysis of sleep-dependent memory consolidation to identify group differences.

Results: Narcolepsy Type 1 participants had shorter N2 bout durations and associated shorter N2 spindles vs. HC, but other N2 spindle features were similar. Narcolepsy Type 1 participants had worse memory performance post-sleep than HCs after adjusting for age and gender (mean memory consolidation HC: -3.1% ± 18.7, NT1: -15.6 ± 24.8, main effect group x time of testing F=5.3, p=0.03). We did not find significant relationships between sleep-dependent memory consolidation and N2 spindle characteristics. Notably, increased N1% was associated with worse sleep-dependent memory consolidation with results driven by the Narcolepsy Type 1 group.

Conclusions: Sleep-dependent memory consolidation is mildly impaired in youth with Narcolepsy Type 1 and findings may be attributed to increases in N1 sleep. Further studies are needed to determine if these findings are generalizable and reversible with sleep-based therapies.

Keywords: Narcolepsy; children; cognition; disrupted nighttime sleep; memory; pediatric; sleep; sleep instability; sleep spindles.

Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.