講師資料
Talks：
Circadian Rhythm Outcome and Predictive Markers in Patients with Narcolepsy following Modafinil Treatment
猝睡症患者經過Modafinil治療後的晝夜節律變化與預測指標
Name：
阮淳藝（Tsun-Yi Roan）
Position：
主治醫師
Affiliation：
Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Email：
Photo：
Research Interests：
Sleep medicine
Child/adolescent psychiatry
Addiction medicine
Selected Publications：
1. Roan TY, Huang YS, Juang HT, Chang SC, Chang CJ, Chin WC. The Risks of Injury and Accident in Patients with Central Hypersomnia: A Cohort Study in Taiwan. Under review.
2. Huang YS, Chin WC, Chung IH, Roan TY, Chang CJ, Juang HT, Chang SC, Ghosh S, Crawford S, Lin HL. The prevalence, incidence and burden of narcolepsy and idiopathic hypersomnia in Taiwan: comparison between the National Health Insurance Research Claims Database and a hospital cohort database. Sleep. 2025.
Abstract：
Objective:
Hypersomnolence is a core manifestation of narcolepsy and is often treated with modafinil, but its impacts on circadian rhythm remain unclear. Non-parametric analysis of actigraphy data can provide minor but important features for clinical assessments. Thus, we used actigraphy to track rest-activity patterns in narcolepsy patients before and after modafinil treatment and analyzed the data by non-parametric methods, in order to assess treatment effects and explore the predictor of treatment response.
Methods:
We prospectively recruited participants with narcolepsy type 1 (NT1) and 2 (NT2). After baseline evaluation including polysomnography and multiple sleep latency test, participants received 200–400 mg of modafinil daily for six months. Actigraphy was worn for 7–14 days before and after treatment, accompanied by subjective questionnaires. We used paired t-tests for pre-post comparison, and independent t-tests and chi-square tests for between-group analysis. Pearson’s correlation was used to examine links between questionnaire scores, REM abnormalities, and circadian data.
Results:
103 participants (mean age: 23.95 ± 10.14 years; 53.4% male) were recruited. After modafinil treatment, significant increases in daytime activity and the most active 10 consecutive hours (M10, p = 0.009 and 0.007) were observed, along with an earlier shift in the midpoint time of M10 (p = 0.006). NT1 patients showed more improvements than NT2 patients. The children/adolescents subgroup showed an earlier shift in the timing of daytime activity (p < 0.001), while the adults exhibited increases in daytime activity and M10 (p = 0.019 and 0.010). Subjective sleepiness and quality of life (QoL) were associated with circadian parameters, particularly the relative amplitude. Lastly, patients with a higher REM percentage or with nocturnal sleep onset REM period (SOREMP) demonstrated greater improvements in circadian parameters.
Conclusion:
Modafinil improves circadian rest-activity rhythms in narcolepsy patients, especially those with NT1. The role of REM percentage and nocturnal SOREMP as predictive markers for treatment outcomes warrant further investigation. 
2025年會：