The Effect of Caffeine on the Narcoleptic Patients

NCT ID: NCT02832336

Last Updated: 2019-03-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 16 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-10-01
• Study Completion Date: 2018-05-07

Brief Summary

Caffeine may be playing a beneficial role in patients with narcolepsy. However, the relationship between caffeine and its effects on narcoleptic patients has not been examined, and it is also unclear whether caffeine provides a beneficial effect or not. Hence, the aim of this study is to assess the effects of caffeine consumption on daytime sleepiness and reaction time in narcoleptic patients.

Detailed Description

The participants will be recruited at the University Sleep Disorders Center, College of Medicine, King Saud University.

Narcolepsy diagnosis: Narcolepsy will be diagnosed based on the American Academy of Sleep Medicine International Classification of Sleep Disorders, 2014 (American academy of sleep medicine. International classification of sleep disorders (ICSD), 3rd ed. Darien, il: American academy of sleep medicine, 2014).

The study will be interventional, randomized, double-blind, placebo control study, to evaluate the effect of caffeine on Narcoleptic Adults (n=30) aged 18-45 years old, following up in the Sleep Disorders Center (SDC) at King Khalid University Hospital (KKUH).

Tools of the study:

The study tools included an interview questionnaire, anthropometric measurements, indirect calorimetry, body composition measurements, blood biochemistry tests & Eye Blink measurement.

1. Interview Questionnaire:

For collecting data for this study, questionnaire well be designed.

The questionnaire consisted of four parts to elicit the following information:

A) Socio-demographic Data

• Personal data: The name of the participant, age, sex, educational level, and residence.
• Social habits: The smoking status
• Activity level: Mild, moderate or intense physical activity.

B) Medical information:

• The occurrence of Narcolepsy with or without cataplexy.
• The occurrence of chronic diseases (hypertension, hyperlipidemia, cardiac diseases, diabetes and obesity).

C) Caffeine expectancy & consumption, modified from:

• Caffeine expectancy questionnaire (CaffEQ) is a self-report measure, which assesses a range of expectancies for caffeine, and Sleep Disturbance (Huntley & Juliano, 2007).
• The Caffeine Consumption Questionnaire (CCQ) used to produce a typical week's average estimate of caffeine consumption in milligrams (Heaton, 2010).

D) Daytime sleepiness Scales :

• Stanford Sleepiness Scale (SSS)
• The Karolinska Sleepiness Scale (KSS)

2. Anthropometric measurements:

The four selected anthropometric measures, see below:

• Weight
• Height for calculating body mass index (BMI)
• Waist circumference
• Hip circumference

3. Indirect calorimetry An automated metabolic measuring cart used for determining Energy Expenditure and for providing key information about the nutrient mixture catabolized for energy by measuring the rates of O2 consumption (VO2) and CO2 production (VCO2), the device name is QUARK.

4. Body Composition Measurement:

The five variables selected for body composition measurements are:

• Fat mass
• Muscle mass
• Bone mass
• Total body water
• Visceral fat rating The body composition machine will be used is Bioelectrical impedance analysis (Tanita BC-418, Japan).

5. Blood biochemistry tests:

Fasting blood glucose, lipids Profile, CBC, LFT, CRP, Bone Profile, Vit D. Biochemical measurements will be done at KKUH, it is equipped with all needed matching to run this study and has well-trained technician and statics to help in performing the test needed.

6. Eye Blink Measurement. Setting/Procedure

In the day of study, subject need to come fasting overnight so their fasting blood glucose levels and lab test sample will be taken. Then the Anthropometric, Body Composition & Indirect calorimetry Measurement for the subject will be documented. The sample will be randomly divided using a software and the tablets will be identically packaged by the pharmacist in opaque capsules and administered orally in a double- blind setting to one of the following Groups:

• Group one: will receive 200 mg Caffeine capsule + water.
• Group two: will receive Placebo (fiber capsule) + water.

Then instruct the patients to take the medication/placebo in the morning for 1 week and come back for reassessment:

• Random Blood sugar will be taken
• Blood Pressure will be measured.
• Eye Blink Measurement
• Daytime sleepiness Scales (part of the questioner data will be filled) We will have a baseline assessment, 1st assessment after single dose of 200 mg Caffeine or placebo and second assessment after one week of chronic use of medication in a dose 200 mg During the patient waiting time, the Interview Questionnaire will be filled.

Data management:

Data will be categorized to age, sex, social, anthropometric measurements, biochemistry lab test, psychological and medical status.

Statistical analysis Data will be entered and statistically analyzed by SPSS software. ANOVA will be used to differentiate among treatment groups. In all the statistical comparisons, differences with p < 0.05 will be considered to be significant.

Steps for assuring data quality include:

• Training: Educate data collectors in a structured manner.
• Data completeness: Using the hospital program (Cerner) that give immediate feedback on issues such as missing or out-of-range values & Excel software
• Data consistency: Compare across sites and over time.
• Data dictionary will be used e.g World Health Organization Drug Dictionary, Cerner program record for normal ranges.

Ethical consideration The study was approved by KKUH Ethical committee, Saudi Food & Drug Authority & Saudi Clinical Trial Registry.

Conditions

Narcolepsy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: DOUBLE

Study Groups

Caffeine

Caffeine is an adenosine receptor antagonist. It inhibits a part of the sleep cycle and, in turn, promotes the wakefulness state.

Generic name :Vivarin(1,3,7-trimethylxanthine), 200 mg/day for one week, Form of Administration:Oral in veg white capsule form (size 1) Drug Class:Central nervous system (CNS) stimulants.

Group Type: EXPERIMENTAL

Vivarin

Intervention Type: DRUG

Adenosine is an endogenous sleep-promoting substance with neuronal inhibitory effects. Adenosine has been proposed to be a sleep-inducing substance accumulating in the brain during prolonged wakefulness. Caffeine is an adenosine receptor antagonist. It inhibits a part of the sleep cycle and, in turn, promotes the wakeup state. Caffeine results in the release of norepinephrine, dopamine and serotonin in the brain and the increase of circulating catecholamines, consistent with reversal of the inhibitory effect of adenosine.Vivarin Drug class :Central nervous system (CNS) stimulants.

Fiber

Fiber powder will be used as placebo, Form of Administration:Oral in veg white capsule form (size 1)

Group Type: PLACEBO_COMPARATOR

Fiber

Intervention Type: DRUG

Fiber will be used as placebo.

Interventions

Vivarin

Adenosine is an endogenous sleep-promoting substance with neuronal inhibitory effects. Adenosine has been proposed to be a sleep-inducing substance accumulating in the brain during prolonged wakefulness. Caffeine is an adenosine receptor antagonist. It inhibits a part of the sleep cycle and, in turn, promotes the wakeup state. Caffeine results in the release of norepinephrine, dopamine and serotonin in the brain and the increase of circulating catecholamines, consistent with reversal of the inhibitory effect of adenosine.Vivarin Drug class :Central nervous system (CNS) stimulants.

Intervention Type: DRUG

Fiber

Fiber will be used as placebo.

Intervention Type: DRUG

Other Intervention Names

1,3,7-Trimethylpurine-2,6-dione; C8H10N4O2; caffeine citrate; Nutrisource Fiber

Eligibility Criteria

Inclusion Criteria

• Case -group should be Narcoleptic with cataplexy

Exclusion Criteria

• Individuals older than 45 years or younger than 18 years old.
• Individuals complaining of any diseases or conditions that affect their dietary intake, as such : renal failure, liver failure, malabsorption problems, cardiac diseases … etc.
• Individuals having hypersensitivity to caffeine.
• Individuals with medical conditions that cause sleepiness (like hypothyroidism) and pregnant or lactating females will be excluded.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

King Saud Medical City

OTHER_GOV

Sponsor Role: collaborator

King Saud University

OTHER

Sponsor Role: lead

Responsible Party

Mona Aldoasri

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mona S Aldosari, Masteral

Role: PRINCIPAL_INVESTIGATOR

King Saud University

Locations

King Khalid University Hospital:King Saud Medical City

Riyadh, , Saudi Arabia

Countries

Saudi Arabia

References

Adamantidis AR, Zhang F, Aravanis AM, Deisseroth K, de Lecea L. Neural substrates of awakening probed with optogenetic control of hypocretin neurons. Nature. 2007 Nov 15;450(7168):420-4. doi: 10.1038/nature06310. Epub 2007 Oct 17.

Reference Type: BACKGROUND

PMID: 17943086 (View on PubMed)

Akerstedt T, Gillberg M. Subjective and objective sleepiness in the active individual. Int J Neurosci. 1990 May;52(1-2):29-37. doi: 10.3109/00207459008994241.

Reference Type: BACKGROUND

PMID: 2265922 (View on PubMed)

Alkaabi J, Al-Dabbagh B, Saadi H, Gariballa S, Yasin J. Effect of traditional Arabic coffee consumption on the glycemic index of Khalas dates tested in healthy and diabetic subjects. Asia Pac J Clin Nutr. 2013;22(4):565-73. doi: 10.6133/apjcn.2013.22.4.09.

Reference Type: BACKGROUND

PMID: 24231017 (View on PubMed)

BaHammam AS, Alenezi AM. Narcolepsy in Saudi Arabia. Demographic and clinical perspective of an under-recognized disorder. Saudi Med J. 2006 Sep;27(9):1352-7.

Reference Type: BACKGROUND

PMID: 16951772 (View on PubMed)

Beitinger PA, Fulda S, Dalal MA, Wehrle R, Keckeis M, Wetter TC, Han F, Pollmacher T, Schuld A. Glucose tolerance in patients with narcolepsy. Sleep. 2012 Feb 1;35(2):231-6. doi: 10.5665/sleep.1628.

Reference Type: BACKGROUND

PMID: 22294813 (View on PubMed)

Benowitz NL. Clinical pharmacology of caffeine. Annu Rev Med. 1990;41:277-88. doi: 10.1146/annurev.me.41.020190.001425.

Reference Type: BACKGROUND

PMID: 2184730 (View on PubMed)

Bruck D, Armstrong S, Coleman G. Sleepiness after glucose in narcolepsy. J Sleep Res. 1994 Sep;3(3):171-179. doi: 10.1111/j.1365-2869.1994.tb00125.x.

Reference Type: BACKGROUND

PMID: 10607123 (View on PubMed)

Burdakov D, Alexopoulos H. Metabolic state signalling through central hypocretin/orexin neurons. J Cell Mol Med. 2005 Oct-Dec;9(4):795-803. doi: 10.1111/j.1582-4934.2005.tb00380.x.

Reference Type: BACKGROUND

PMID: 16364191 (View on PubMed)

Chabas D, Foulon C, Gonzalez J, Nasr M, Lyon-Caen O, Willer JC, Derenne JP, Arnulf I. Eating disorder and metabolism in narcoleptic patients. Sleep. 2007 Oct;30(10):1267-73. doi: 10.1093/sleep/30.10.1267.

Reference Type: BACKGROUND

PMID: 17969460 (View on PubMed)

Chemelli RM, Willie JT, Sinton CM, Elmquist JK, Scammell T, Lee C, Richardson JA, Williams SC, Xiong Y, Kisanuki Y, Fitch TE, Nakazato M, Hammer RE, Saper CB, Yanagisawa M. Narcolepsy in orexin knockout mice: molecular genetics of sleep regulation. Cell. 1999 Aug 20;98(4):437-51. doi: 10.1016/s0092-8674(00)81973-x.

Reference Type: BACKGROUND

PMID: 10481909 (View on PubMed)

Cun Y, Tang L, Yan J, He C, Li Y, Hu Z, Xia J. Orexin A attenuates the sleep-promoting effect of adenosine in the lateral hypothalamus of rats. Neurosci Bull. 2014 Oct;30(5):877-86. doi: 10.1007/s12264-013-1442-8. Epub 2014 Jun 5.

Reference Type: BACKGROUND

PMID: 24898402 (View on PubMed)

Dahmen N, Bierbrauer J, Kasten M. Increased prevalence of obesity in narcoleptic patients and relatives. Eur Arch Psychiatry Clin Neurosci. 2001;251(2):85-9. doi: 10.1007/s004060170057.

Reference Type: BACKGROUND

PMID: 11407443 (View on PubMed)

Daniels E, King MA, Smith IE, Shneerson JM. Health-related quality of life in narcolepsy. J Sleep Res. 2001 Mar;10(1):75-81. doi: 10.1046/j.1365-2869.2001.00234.x.

Reference Type: BACKGROUND

PMID: 11285058 (View on PubMed)

Daniello A, Fievisohn E, Gregory TS. Modeling the effects of caffeine on the sleep/ wake cycle. Biomed Sci Instrum. 2012;48:73-80.

Reference Type: BACKGROUND

PMID: 22846267 (View on PubMed)

Darwish M, Kirby M, Robertson P Jr, Hellriegel ET. Interaction profile of armodafinil with medications metabolized by cytochrome P450 enzymes 1A2, 3A4 and 2C19 in healthy subjects. Clin Pharmacokinet. 2008;47(1):61-74. doi: 10.2165/00003088-200847010-00006.

Reference Type: BACKGROUND

PMID: 18076219 (View on PubMed)

Dresler M, Spoormaker VI, Beitinger P, Czisch M, Kimura M, Steiger A, Holsboer F. Neuroscience-driven discovery and development of sleep therapeutics. Pharmacol Ther. 2014 Mar;141(3):300-34. doi: 10.1016/j.pharmthera.2013.10.012. Epub 2013 Nov 1.

Reference Type: BACKGROUND

PMID: 24189488 (View on PubMed)

Engel A, Helfrich J, Manderscheid N, Musholt PB, Forst T, Pfutzner A, Dahmen N. Investigation of insulin resistance in narcoleptic patients: dependent or independent of body mass index? Neuropsychiatr Dis Treat. 2011;7:351-6. doi: 10.2147/NDT.S18455. Epub 2011 Jun 9.

Reference Type: BACKGROUND

PMID: 21822386 (View on PubMed)

Espana RA, McCormack SL, Mochizuki T, Scammell TE. Running promotes wakefulness and increases cataplexy in orexin knockout mice. Sleep. 2007 Nov;30(11):1417-25. doi: 10.1093/sleep/30.11.1417.

Reference Type: BACKGROUND

PMID: 18041476 (View on PubMed)

Flygare J, Parthasarathy S. Narcolepsy: let the patient's voice awaken us! Am J Med. 2015 Jan;128(1):10-3. doi: 10.1016/j.amjmed.2014.05.037. Epub 2014 Jun 12.

Reference Type: BACKGROUND

PMID: 24931392 (View on PubMed)

Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology. 1973 Jul;10(4):431-6. doi: 10.1111/j.1469-8986.1973.tb00801.x. No abstract available.

Reference Type: BACKGROUND

PMID: 4719486 (View on PubMed)

Honda Y, Doi Y, Ninomiya R, Ninomiya C. Increased frequency of non-insulin-dependent diabetes mellitus among narcoleptic patients. Sleep. 1986;9(1 Pt 2):254-9. doi: 10.1093/sleep/9.1.254.

Reference Type: BACKGROUND

PMID: 3518018 (View on PubMed)

Ingravallo F, Gnucci V, Pizza F, Vignatelli L, Govi A, Dormi A, Pelotti S, Cicognani A, Dauvilliers Y, Plazzi G. The burden of narcolepsy with cataplexy: how disease history and clinical features influence socio-economic outcomes. Sleep Med. 2012 Dec;13(10):1293-300. doi: 10.1016/j.sleep.2012.08.002. Epub 2012 Sep 28.

Reference Type: BACKGROUND

PMID: 23026503 (View on PubMed)

Jennum P, Ibsen R, Knudsen S, Kjellberg J. Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study. Sleep. 2013 Jun 1;36(6):835-40. doi: 10.5665/sleep.2706.

Reference Type: BACKGROUND

PMID: 23729926 (View on PubMed)

Johnston KL, Clifford MN, Morgan LM. Coffee acutely modifies gastrointestinal hormone secretion and glucose tolerance in humans: glycemic effects of chlorogenic acid and caffeine. Am J Clin Nutr. 2003 Oct;78(4):728-33. doi: 10.1093/ajcn/78.4.728.

Reference Type: BACKGROUND

PMID: 14522730 (View on PubMed)

Kaplan GB, Greenblatt DJ, Ehrenberg BL, Goddard JE, Cotreau MM, Harmatz JS, Shader RI. Dose-dependent pharmacokinetics and psychomotor effects of caffeine in humans. J Clin Pharmacol. 1997 Aug;37(8):693-703. doi: 10.1002/j.1552-4604.1997.tb04356.x.

Reference Type: BACKGROUND

PMID: 9378841 (View on PubMed)

Landolt HP. Sleep homeostasis: a role for adenosine in humans? Biochem Pharmacol. 2008 Jun 1;75(11):2070-9. doi: 10.1016/j.bcp.2008.02.024. Epub 2008 Mar 4.

Reference Type: BACKGROUND

PMID: 18384754 (View on PubMed)

Landolt HP, Retey JV, Tonz K, Gottselig JM, Khatami R, Buckelmuller I, Achermann P. Caffeine attenuates waking and sleep electroencephalographic markers of sleep homeostasis in humans. Neuropsychopharmacology. 2004 Oct;29(10):1933-9. doi: 10.1038/sj.npp.1300526.

Reference Type: BACKGROUND

PMID: 15257305 (View on PubMed)

Longstreth WT Jr, Koepsell TD, Ton TG, Hendrickson AF, van Belle G. The epidemiology of narcolepsy. Sleep. 2007 Jan;30(1):13-26. doi: 10.1093/sleep/30.1.13.

Reference Type: BACKGROUND

PMID: 17310860 (View on PubMed)

Mesa YR, Meira E Cruz MG. Narcolepsy with cataplexy after A/H1N1 vaccination - A case reported from Cuba. Sleep Sci. 2014 Mar;7(1):59-61. doi: 10.1016/j.slsci.2014.07.024. Epub 2014 Aug 22.

Reference Type: BACKGROUND

PMID: 26483903 (View on PubMed)

Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam. 2003 Jan;20(1):1-30. doi: 10.1080/0265203021000007840.

Reference Type: BACKGROUND

PMID: 12519715 (View on PubMed)

Partinen M, Saarenpaa-Heikkila O, Ilveskoski I, Hublin C, Linna M, Olsen P, Nokelainen P, Alen R, Wallden T, Espo M, Rusanen H, Olme J, Satila H, Arikka H, Kaipainen P, Julkunen I, Kirjavainen T. Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland. PLoS One. 2012;7(3):e33723. doi: 10.1371/journal.pone.0033723. Epub 2012 Mar 28.

Reference Type: BACKGROUND

PMID: 22470463 (View on PubMed)

Peacock J, Benca RM. Narcolepsy: clinical features, co-morbidities & treatment. Indian J Med Res. 2010 Feb;131:338-49.

Reference Type: BACKGROUND

PMID: 20308759 (View on PubMed)

Peall KJ, Robertson NP. Narcolepsy: environment, genes and treatment. J Neurol. 2014 Aug;261(8):1644-6. doi: 10.1007/s00415-014-7435-3. No abstract available.

Reference Type: BACKGROUND

PMID: 25034273 (View on PubMed)

Plaza-Zabala A, Maldonado R, Berrendero F. The hypocretin/orexin system: implications for drug reward and relapse. Mol Neurobiol. 2012 Jun;45(3):424-39. doi: 10.1007/s12035-012-8255-z. Epub 2012 Mar 20.

Reference Type: BACKGROUND

PMID: 22430644 (View on PubMed)

Poli F, Plazzi G, Di Dalmazi G, Ribichini D, Vicennati V, Pizza F, Mignot E, Montagna P, Pasquali R, Pagotto U. Body mass index-independent metabolic alterations in narcolepsy with cataplexy. Sleep. 2009 Nov;32(11):1491-7. doi: 10.1093/sleep/32.11.1491.

Reference Type: BACKGROUND

PMID: 19928388 (View on PubMed)

al Rajeh S, Bademosi O, Ismail H, Awada A, Dawodu A, al-Freihi H, Assuhaimi S, Borollosi M, al-Shammasi S. A community survey of neurological disorders in Saudi Arabia: the Thugbah study. Neuroepidemiology. 1993;12(3):164-78. doi: 10.1159/000110316.

Reference Type: BACKGROUND

PMID: 8272177 (View on PubMed)

Sakurai T, Amemiya A, Ishii M, Matsuzaki I, Chemelli RM, Tanaka H, Williams SC, Richardson JA, Kozlowski GP, Wilson S, Arch JR, Buckingham RE, Haynes AC, Carr SA, Annan RS, McNulty DE, Liu WS, Terrett JA, Elshourbagy NA, Bergsma DJ, Yanagisawa M. Orexins and orexin receptors: a family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior. Cell. 1998 Feb 20;92(4):573-85. doi: 10.1016/s0092-8674(00)80949-6.

Reference Type: BACKGROUND

PMID: 9491897 (View on PubMed)

Sakurai T, Mieda M, Tsujino N. The orexin system: roles in sleep/wake regulation. Ann N Y Acad Sci. 2010 Jul;1200:149-61. doi: 10.1111/j.1749-6632.2010.05513.x.

Reference Type: BACKGROUND

PMID: 20633143 (View on PubMed)

Sasaki K, Suzuki M, Mieda M, Tsujino N, Roth B, Sakurai T. Pharmacogenetic modulation of orexin neurons alters sleep/wakefulness states in mice. PLoS One. 2011;6(5):e20360. doi: 10.1371/journal.pone.0020360. Epub 2011 May 27.

Reference Type: BACKGROUND

PMID: 21647372 (View on PubMed)

Sellayah D, Bharaj P, Sikder D. Orexin is required for brown adipose tissue development, differentiation, and function. Cell Metab. 2011 Oct 5;14(4):478-90. doi: 10.1016/j.cmet.2011.08.010.

Reference Type: BACKGROUND

PMID: 21982708 (View on PubMed)

Serra L, Montagna P, Mignot E, Lugaresi E, Plazzi G. Cataplexy features in childhood narcolepsy. Mov Disord. 2008 Apr 30;23(6):858-65. doi: 10.1002/mds.21965.

Reference Type: BACKGROUND

PMID: 18307264 (View on PubMed)

Sicard BA, Perault MC, Enslen M, Chauffard F, Vandel B, Tachon P. The effects of 600 mg of slow release caffeine on mood and alertness. Aviat Space Environ Med. 1996 Sep;67(9):859-62.

Reference Type: BACKGROUND

PMID: 9025802 (View on PubMed)

Silber MH, Krahn LE, Olson EJ, Pankratz VS. The epidemiology of narcolepsy in Olmsted County, Minnesota: a population-based study. Sleep. 2002 Mar 15;25(2):197-202. doi: 10.1093/sleep/25.2.197.

Reference Type: BACKGROUND

PMID: 11902429 (View on PubMed)

Thorpy MJ, Krieger AC. Delayed diagnosis of narcolepsy: characterization and impact. Sleep Med. 2014 May;15(5):502-7. doi: 10.1016/j.sleep.2014.01.015. Epub 2014 Feb 15.

Reference Type: BACKGROUND

PMID: 24780133 (View on PubMed)

Wesensten NJ, Belenky G, Thorne DR, Kautz MA, Balkin TJ. Modafinil vs. caffeine: effects on fatigue during sleep deprivation. Aviat Space Environ Med. 2004 Jun;75(6):520-5.

Reference Type: BACKGROUND

PMID: 15198278 (View on PubMed)

Wright KP Jr, Badia P, Myers BL, Plenzler SC. Combination of bright light and caffeine as a countermeasure for impaired alertness and performance during extended sleep deprivation. J Sleep Res. 1997 Mar;6(1):26-35. doi: 10.1046/j.1365-2869.1997.00022.x.

Reference Type: BACKGROUND

PMID: 9125696 (View on PubMed)

Won C, Mahmoudi M, Qin L, Purvis T, Mathur A, Mohsenin V. The impact of gender on timeliness of narcolepsy diagnosis. J Clin Sleep Med. 2014 Jan 15;10(1):89-95. doi: 10.5664/jcsm.3370.

Reference Type: BACKGROUND

PMID: 24426826 (View on PubMed)

Zhang N, Liu HT. Effects of sleep deprivation on cognitive functions. Neurosci Bull. 2008 Feb;24(1):45-8. doi: 10.1007/s12264-008-0910-z.

Reference Type: BACKGROUND

PMID: 18273076 (View on PubMed)

Zhang XY, Yu L, Zhuang QX, Zhu JN, Wang JJ. Central functions of the orexinergic system. Neurosci Bull. 2013 Jun;29(3):355-65. doi: 10.1007/s12264-012-1297-4. Epub 2013 Jan 8.

Reference Type: BACKGROUND

PMID: 23299718 (View on PubMed)

Aldosari MS, Olaish AH, Nashwan SZ, Abulmeaty MMA, BaHammam AS. The effects of caffeine on drowsiness in patients with narcolepsy: a double-blind randomized controlled pilot study. Sleep Breath. 2020 Dec;24(4):1675-1684. doi: 10.1007/s11325-020-02065-6. Epub 2020 Mar 26.

Reference Type: DERIVED

PMID: 32215834 (View on PubMed)

Other Identifiers

SFDA # 16022302

Identifier Type: REGISTRY

Identifier Source: secondary_id

IRB:E-15-1484

Identifier Type: -

Identifier Source: org_study_id