Prevalence of narcolepsy symptomatology and diagnosis in the European general population

Ohayon, Maurice M.; Priest, R. G.; Zulley, Jürgen; Smirne, Salvatore; Paiva, Teresa

doi:10.1212/wnl.58.12.1826

Cited by 347 publications

(166 citation statements)

References 15 publications

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“…In the whole sample, daytime sleepiness, cataplexy, hypnagogic or hypnopompic hallucinations, and sleep paralysis were reported by 15%, 1.2%, 24%, and 6.2% of the participants, respectively. Some factors may explain these discrepancies in the symptom proportion between our results and the study of Ohayon et al 30 Firstly, we assessed EDS using only the Epworth Sleepiness Scale. Although this is the most widely used instrument for the evaluation of sleepiness, EDS comprises other clinical features in narcolepsy, such as the irresistible sleep attack and the relief of sleepiness provided by naps.…”

Section: Discussioncontrasting

confidence: 74%

“…The frequency of cataplectic-like symptom in the present study was within the range of 7.6% to 29.3% previously reported in different ethnic populations. [26][27][28][29] A study of five European countries by Ohayon et al 30 has investigated the prevalence of the narcolepsy tetrad in a general population. In the whole sample, daytime sleepiness, cataplexy, hypnagogic or hypnopompic hallucinations, and sleep paralysis were reported by 15%, 1.2%, 24%, and 6.2% of the participants, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study

Kim

Coelho

Hirotsu

et al. 2015

Journal of Clinical Sleep Medicine

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Objectives: Narcolepsy is a disabling disease with a delayed diagnosis. At least 3 years before the disorder identifi cation, several comorbidities can be observed in patients with narcolepsy. The early recognition of narcolepsy symptoms may improve long-term prognosis of the patients. Thus, we aimed to investigate the prevalence of the symptoms associated with narcolepsy and its social and psychological association in a sample of Sao Paulo city inhabitants. Methods: We performed a cross-sectional evaluation with 1,008 individuals from the Sao Paulo Epidemiologic Sleep Study (EPISONO). Excessive daytime sleepiness (EDS) was assessed by the Epworth Sleepiness Scale. Volunteers were also asked about the occurrence of cataplectic-like, hypnagogic or hypnopompic hallucinations, and sleep paralysis symptoms. The participants underwent a full-night polysomnography and completed questionnaires about psychological, demographic, and quality of life parameters. Results: We observed a prevalence of 39.2% of EDS, 15.0% of cataplectic-like symptom, 9.2% of hypnagogic or hypnopompic hallucinations, and 14.9% of sleep paralysis in Sao Paulo city inhabitants. A frequency of 6.9% was observed when EDS and cataplectic-like symptoms were grouped. The other associations were EDS + hallucinations (4.7%) and EDS + sleep paralysis (7.5%). Symptomatic participants were predominantly women and younger compared with patients without any narcolepsy symptom (n = 451). Narcolepsy symptomatology was also associated with a poor quality of life and symptoms of depression, anxiety, and fatigue. Conclusions: Narcolepsy-related symptoms are associated with poor quality of life and worse psychological parameters. A lthough narcolepsy may be considered a rare neurological condition, the repercussions of this disorder are substantial. Narcolepsy induces a 1.5-fold increase in the mortality rate compared with healthy individuals.1 As a consequence, narcoleptic patients have approximately 2-fold increased rates of hospital or other medical services admissions.2 Narcolepsy is often associated with a tetrad of symptoms, including, excessive daytime sleepiness (EDS), hypnagogic or hypnopompic hallucinations, sleep paralysis, and cataplexy. EDS is the most frequent symptom observed in narcoleptic patients. 3 In the natural history of EDS, several cardiometabolic and psychiatric conditions are associated with the incidence and persistence of EDS. 4 Patients with narcolepsy experience the symptoms over a long period until receiving the defi nitive diagnosis, ranging between 10 and 15 years. 5,6 A possible factor associated with this delay could be the failure to recognize the characteristic clinical features.7 Indeed, Jennum et al. demonstrated that narcoleptic patients present a wide range of comorbidities at least 3 years before the narcolepsy diagnosis, including a higher frequency of neurological diseases and other sleep disorders. 8 The recognition of the symptoms associated with narcolepsy seems to be an important approach for a better long-term progn...

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study

Kim

Coelho

Hirotsu

et al. 2015

Journal of Clinical Sleep Medicine

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show abstract

“…[23][24][25][26] Hypocretin deficiency, which is tightly associated with cataplexy, [27][28][29][30][31] has not been described to be influenced by gender, although studies addressing this specific question have not been rigorously performed. The possibility of a true gender difference, however, should not be discounted.…”

Section: Menmentioning

confidence: 99%

The Impact of Gender on Timeliness of Narcolepsy Diagnosis

Won

Mahmoudi

Qin

et al. 2014

Journal of Clinical Sleep Medicine

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the Yale Center of Sleep Medicine. All patients completed polysomnography (PSG) and multiple sleep latency test (MSLT), and a structured interview by an independent sleep specialist. Patients were administered a standardized 8-page questionnaire within 4 weeks of their narcolepsy diagnosis. Sixteen patients did not complete the questionnaire or had missing data, and were excluded. The study was approved by the Yale Institutional Review Board. QuestionnaireThe standardized questionnaire, in addition to other sleep disorder symptoms, sleep history and habits, current medications, and social, psychological, psychiatric, surgical, and Study Objectives: To examine the impact of gender in narcoleptic patients on timeliness of diagnosis, symptomology, and health and lifestyle impairment Methods: This is a cross-sectional study of 109 consecutive patients (68 women) with newly diagnosed narcolepsy with and without cataplexy, from a University sleep disorders center. Consecutive patients were administered an 8-page questionnaire at the time of their diagnosis regarding sleep habits, medications, and medical conditions, lifestyle impairments, as well as details regarding narcolepsy-related symptoms. Results: Men and women presented with remarkably similar narcolepsy related symptoms, yet women were more likely to be delayed in diagnosis; 85% of men were likely to be diagnosed by 16 years after symptom onset, compared to 28 years in women. More women were likely to remain undiagnosed at any given time point after symptom onset (hazard ratio for diagnosis of men compared to women 1.53; 95% CI 1.01-2.32; p = 0.04). Men and women reported similar degree of subjective sleepiness as measured by the Epworth Sleepiness Scale (mean 16.2 ± 4.5; p = 0.18), though women demonstrated signifi cantly more severe objective sleepiness on multiple sleep latency testing (MSLT) (mean sleep latency in women = 5.4 min (± 4.1), in men 7.4 min (± 3.5); p = 0.03). Despite being more objectively sleepy, women were less likely to report lifestyle impairments in the areas of personal relationships (71% men, 44% women, p = 0.01) and physical activity (36% men, 16% women, p = 0.02), but were also more likely to self-medicate with caffeine (63.4% men, 82.4% women; p = 0.03). Conclusions: Narcolepsy impacts men and women's health and lifestyle differently, and may cause delays diagnosis for women. Keywords: Narcolepsy, gender, sex, sleep, hypersomnia, diagnosis, women S C I E N T I F I C I N V E S T I G A T I O N SS leep disorders affect women and men differently. This is well described, for example, in sleep disordered breathing, insomnia, and restless leg syndrome. In these common sleep disorders, there are notable sex differences in disease prevalence, manifestation, health effects, and social consequences, 1-9 as well as sex-related discrepancies in diagnosis and health care delivery. 10 There is some evidence from animal models and genetic studies to suggest sex differences in the susceptibility and manifestation of narcolepsy.11-13 However, sex d...

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“…Narcolepsy-cataplexy (NC) is a chronic neurological disease with a prevalence of approximately 0.045% in North America and Europe (Ohayon et al, 2002). The manifestations of NC are excessive daytime sleepiness (EDS) and cataplexy, and roughly half of patients experience hypnagogic hallucinations and sleep paralysis.…”

Section: Introductionmentioning

confidence: 99%

Smoking Prevalence and Its Clinical Correlations in Patients with Narcolepsy-cataplexy

et al. 2016

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Narcolepsy-cataplexy (NC) is a chronic neurological disease with suggested autoimmune etiopathogenesis. Nicotine stimulates central nervous system and smoking increases the risk of autoimmune diseases. Assessment of smoking habits and its correlation to clinical parameters among 87 adult NC patients (38 male, 49 female) included night polysomnography and multiple sleep latency test. In our sample, 43.7% NC patients were regular smokers, and 19.5% former smokers compared to 22.2%, and 12.6%, respectively, in the general population. Patients started to smoke in the mean age of 20.0 (SD ±6.0) years. 72.2% of NC smokers started to smoke before the onset of NC and the mean of the delay between smoking onset and NC onset was 9.1 (±5. Report / Vol. 117 (2016) No. 2-3, p. 81-89 a direct correlation between smoking duration and the number of awakenings, duration of N1 sleep, REM sleep latency, and apnoea/hypopnoea index (AHI), and, on the contrary, indirect correlation between smoking duration and N3 sleep duration, showing that smoking duration consistently correlates with sleep macrostructure. Smoking is highly prevalent in NC and has relationship with clinical features of NC. 82) Prague Medical

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Prevalence of narcolepsy symptomatology and diagnosis in the European general population

Abstract: This is the first epidemiologic study that estimates the prevalence of narcolepsy in the general population of these five European countries. The disorder affects 47 individuals/100,000 inhabitants.

Cited by 347 publications

References 15 publications

Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study

Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study

The Impact of Gender on Timeliness of Narcolepsy Diagnosis

Smoking Prevalence and Its Clinical Correlations in Patients with Narcolepsy-cataplexy

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