Metabolic profile in patients with narcolepsy: a systematic review and meta-analysis

Mohammadi, Soheil; Moosaie, Fatemeh; Saghazadeh, Amene; Mahmoudi, Maryam; Rezaei, Nima

doi:10.1016/j.sleep.2021.02.040

Cited by 24 publications

(10 citation statements)

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“…Moreover, medication for narcolepsy including menthylphenidate can result in medication-induced psychotic symptoms [ 92 ], and there were also case reports with sodium oxybate and modafinil induced psychosis in adult narcolepsy patients [ 93 , 94 , 95 , 96 ]. Although research is less in pediatric patients, drug-induced psychosis has been reported in pediatric narcolepsy patients [ 97 , 98 ]. If psychosis is secondary to medication, tapering or even discontinuation of the suspected medication is recommended, and other medication can be chosen after the psychotic symptoms subside.…”

Section: Treatment Strategy Of Pediatric Narcolepsymentioning

confidence: 99%

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Pediatric Narcolepsy—A Practical Review

et al. 2022

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Pediatric narcolepsy is a chronic sleep-wakefulness disorder. Its symptoms frequently begin in childhood. This review article examined the literature for research reporting on the effects of treatment of pediatric narcolepsy, as well as proposed etiology and diagnostic tools. Symptoms of pediatric narcolepsy include excessive sleepiness and cataplexy. In addition, rapid-eye-movement-related phenomena such as sleep paralysis, sleep terror, and hypnagogic or hypnapompic hallucinations can also occur. These symptoms impaired children’s function and negatively influenced their social interaction, studying, quality of life, and may further lead to emotional and behavioral problems. Therefore, early diagnosis and intervention are essential for children’s development. Moreover, there are differences in clinical experiences between Asian and Western population. The treatment of pediatric narcolepsy should be comprehensive. In this article, we review pediatric narcolepsy and its treatment approach: medication, behavioral modification, and education/mental support. Pharmacological treatment including some promising newly-developed medication can decrease cataplexy and daytime sleepiness in children with narcolepsy. Other forms of management such as psychosocial interventions involve close cooperation between children, school, family, medical personnel, and can further assist their adjustment.

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Section: Treatment Strategy Of Pediatric Narcolepsymentioning

confidence: 99%

“…Narcolepsy patients exhibited high prevalence of obesity [ 97 ]. We suggest diet control and exercise as behavior modification and the compliance for pharmacological treatment of narcolepsy should emphasize to help maintain a more regular lifestyle and diet.…”

Section: Treatment Strategy Of Pediatric Narcolepsymentioning

confidence: 99%

Pediatric Narcolepsy—A Practical Review

et al. 2022

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“…Orexin neurons participate in the regulation of metabolism, including appetite, energy expenditure, and autonomic regulation [ 69 ]; consequently, orexin deficiency in narcolepsy increases the risk for metabolic comorbidities [ 70 ]. Patients with narcolepsy often gain weight, and the body mass index (BMI) of adults in this group is approximately 15% higher than the average BMI [ 4 ].…”

Section: Confounding Factors In the Diagnosis Of Narcolepsymentioning

confidence: 99%

“…Patients with narcolepsy often gain weight, and the body mass index (BMI) of adults in this group is approximately 15% higher than the average BMI [ 4 ]. This has been attributed to orexin-mediated food-seeking behavior [ 70 ], a lower metabolic rate in orexin-deficient individuals [ 71 ], and the effect of the orexin system on brown adipose tissue functionality, which could be partly responsible for the impaired energy homeostasis, potentially resulting in increased adiposity and weight gain in patients with NT1 [ 71 ]. Compared with individuals without narcolepsy, patients with narcolepsy have a higher prevalence of diabetes (by 9.3%) and obesity (by 8.8%) [ 22 ].…”

Section: Confounding Factors In the Diagnosis Of Narcolepsymentioning

confidence: 99%

Current Understanding of Narcolepsy 1 and its Comorbidities: What Clinicians Need to Know

2021

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Narcolepsy is a chronic neurologic disorder associated with the dysregulation of the sleep-wake cycle that often leads to a decreased quality of life and results in a considerable health burden. There is often a delay to diagnosis of narcolepsy, mainly due to the lack of recognition of this disorder. One of the main factors hindering the diagnosis of narcolepsy is the association of comorbidities, which include other sleep disorders, psychiatric disorders, cardiovascular disorders, and metabolic disorders. The signs and symptoms of these comorbidities often overlap with those of narcolepsy, and some of the medications used for their treatment may obscure the symptoms of narcolepsy, leading to a delay in diagnosis. This review is targeted to clinicians unaccustomed to working with sleep disorders and aims to increase recognition and improve the management of narcolepsy.

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“…Sleep-wake stability, in contrast to the sleep-wake cycle, relates to the ability to maintain sleep or wakefulness. Quantity and quality of sleep plays a vital role in regulating many bodily functions, with abnormal reductions in quantity and quality of sleep causing physical effects, such as increased activity of the sympathetic nervous system (2), increased in ammatory responses (3), and changes in metabolism (4)(5)(6)(7). For example, a recent study reported that children experiencing narcolepsy with cataplexy had increased occurrence of obesity and night eating (8).…”

Section: Introductionmentioning

confidence: 99%

Underrecognized Sleep Disorders Across Rare Diseases: Real-world Insights From a Patient and Caregiver Summit

Picone¹,

Naujokas²,

Gorman³

et al. 2021

Preprint

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Background: Disorders of sleep-wake stability have a negative impact on patient and caregiver quality of life. There is evidence that sleep disorders and their sequelae may be an underrecognized burden for people living with rare diseases. Given that the sleep-wake cycle is regulated via the hypothalamus, people with neurological disorders may be particularly affected. To collect real-world insights into the impact of sleep disturbances and excessive daytime sleepiness (EDS) on people with rare disorders, Harmony Biosciences organized a Summit on Sleep Disruption. The attendees were from seven patient advocacy groups, each representing a rare neurological disorder reporting sleep disturbances, specifically EDS: Angelman syndrome, idiopathic hypersomnia, Kleine-Levin syndrome, myotonic dystrophy, narcolepsy, Prader-Willi syndrome, and Smith-Magenis syndrome. One person represented COMBINEDBrain, a patient advocacy consortium representing 25 rare, genetic neurological disorders. Results: The overwhelming response was that disordered sleep, particularly EDS, is a major health problem within their populations that they feel is not adequately diagnosed or treated. Participants felt that burdens associated with sleep disturbances were underrecognized as a treatable medical issue and were not effectively addressed by health care providers. Participants noted the following unmet needs: patient and physician education on sleep disturbance, effective medications approved for these disease populations, and medically acceptable patient-centered devices to measure sleep parameters. Participants described impacts of disordered sleep and EDS on behavior and school performance, describing impaired wakefulness as an interference with normal daytime functioning. Participants also revealed tremendous burdens on the caregivers and family members who live with people experiencing sleep-wake instability. Conclusions: These results provide real-world insights that disordered sleep including EDS and subsequent impaired daytime functioning are major burdens in these rare disease communities. Furthermore, these burdens are underrecognized for caregivers and, for some rare diseases, among the patients themselves. Participants identified gaps in knowledge and treatment of sleep disorders and resolved to continue the dialog to find ways to raise awareness of disordered sleep and reduce burdens in these patient populations.

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Metabolic profile in patients with narcolepsy: a systematic review and meta-analysis

Cited by 24 publications

References 74 publications

Pediatric Narcolepsy—A Practical Review

Pediatric Narcolepsy—A Practical Review

Current Understanding of Narcolepsy 1 and its Comorbidities: What Clinicians Need to Know

Underrecognized Sleep Disorders Across Rare Diseases: Real-world Insights From a Patient and Caregiver Summit

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