High bicarbonate levels in narcoleptic children
Corresponding Author
Patricia Franco
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Correspondence
Patricia Franco MD, PhD, Pediatric Sleep Unit, Service Epilepsie, Sommeil, Explorations Fonctionnelles, Neurologiques Pédiatriques, Hôpital Femme Mère Enfant, 59, boulevard Pinel, 69500 Lyon, France.
Tel: +33 427 856 052;
fax: +33 427 869 230;
e-mail: [email protected]
Search for more papers by this authorAurelie Junqua
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorAnne Guignard-Perret
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Search for more papers by this authorAude Raoux
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Search for more papers by this authorMagali Perier
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorVeronique Raverot
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorBruno Claustrat
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorMarie-Paule Gustin
Department of Public Health, Institute of Pharmacy and Service de Biostatistique, University Lyon1, Lyon, France
Search for more papers by this authorClara Odilia Inocente
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorJian-Sheng Lin
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorCorresponding Author
Patricia Franco
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Correspondence
Patricia Franco MD, PhD, Pediatric Sleep Unit, Service Epilepsie, Sommeil, Explorations Fonctionnelles, Neurologiques Pédiatriques, Hôpital Femme Mère Enfant, 59, boulevard Pinel, 69500 Lyon, France.
Tel: +33 427 856 052;
fax: +33 427 869 230;
e-mail: [email protected]
Search for more papers by this authorAurelie Junqua
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorAnne Guignard-Perret
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Search for more papers by this authorAude Raoux
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie–hypersomnie), Lyon, France
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon1, Lyon, France
Search for more papers by this authorMagali Perier
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorVeronique Raverot
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorBruno Claustrat
Service d'Hormonologie, Groupement Est, Université Lyon 1, Lyon, France
Search for more papers by this authorMarie-Paule Gustin
Department of Public Health, Institute of Pharmacy and Service de Biostatistique, University Lyon1, Lyon, France
Search for more papers by this authorClara Odilia Inocente
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorJian-Sheng Lin
Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon1, Lyon, France
Search for more papers by this authorSummary
The objective of this study was to evaluate the levels of plasma bicarbonate levels in narcoleptic children. Clinical, electrophysiological data and bicarbonate levels were evaluated retrospectively in children seen in our paediatric national reference centre for hypersomnia. The cohort included 23 control subjects (11.5 ± 4 years, 43% boys) and 51 patients presenting de-novo narcolepsy (N) (12.7 ± 3.7 years, 47% boys). In narcoleptic children, cataplexy was present in 78% and DQB1*0602 was positive in 96%. The control children were less obese (2 versus 47%, P = 0.001). Compared with control subjects, narcoleptic children had higher bicarbonate levels (P = 0.02) as well as higher PCO2 (P < 0.01) and lower venous pH gas (P < 0.01). Bicarbonate levels higher than 27 mmol L−1 were found in 41.2% of the narcoleptic children and 4.2% of the controls (P = 0.001). Bicarbonate levels were correlated with the Adapted Epworth Sleepiness Scale (P = 0.01). Narcoleptic patients without obesity often had bicarbonate levels higher than 27 mmol L −1 (55 versus 25%, P = 0.025). No differences were found between children with and without cataplexy. In conclusion, narcoleptic patients had higher bicarbonate plasma levels compared to control children. This result could be a marker of hypoventilation in this pathology, provoking an increase in PCO2 and therefore a respiratory acidosis, compensated by an increase in plasma bicarbonates. This simple screening tool could be useful for prioritizing children for sleep laboratory evaluation in practice.
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