Comorbidities in a community sample of narcolepsy

Publication date: Available online 21 November 2017
Source:Sleep Medicine
Author(s): Alexander Cohen, Jay Mandrekar, Erik K. St. Louis, Michael H. Silber, Suresh Kotagal
Study ObjectiveTo assess comorbidities in a community-based cohort of narcolepsy.MethodsA 2000-2014 community-based narcolepsy cohort was identified in Olmsted County, Minnesota. Records were reviewed by a certified sleep specialist for accuracy of diagnosis and comorbidities were extracted and analyzed. Comorbidities in narcolepsy subjects, both at diagnosis and upon follow up were compared with those from an unaffected, age and sex-matched cohort using conditional logistic regression.ResultsAt diagnosis, there was increased association of narcolepsy with anxiety (OR 4.56, 95%CI 1.99-10.44), thyroid disease (3.07, 1.19-7.90), hypertension (2.69, 1.22-5.93), and hyperlipidemia (2.49, 1.05-5.92). At the end of the prolonged observation period of 9.9 years (SD 7.27 years), there was increased association of narcolepsy with peripheral neuropathy (11.21, 1.16-108.11), non-migrainous headache (6.00, 1.73-20.83), glucose intolerance (2.39, 1.05-5.45), and automobile-related trauma (2.43, 1.08-5.45). Persistently increased both at diagnosis and after a prolonged observation period were associations of narcolepsy with obstructive sleep apnea (69.25, 9.26-517.99 decreasing to 13.55, 5.08-36.14), chronic low back pain (5.46, 2.46-12.11 to 2.58, 1.39-4.77), depression (4.88, 2.45-9.73 to 3.79, 2.12-6.79), psychiatric disorders in general (4.73, 2.49-9.01 to 3.40, 1.94-5.98), endocrinopathies (4.15, 1.81-9.56 to 2.45, 1.33-4.49), and obesity (2.27, 1.13-4.56 to 2.07, 1.15-3.7).ConclusionsIn this community-based study of narcolepsy co-morbidities, both at diagnosis and after prolonged follow-up, persistent comorbidities were revealed including obstructive sleep apnea, chronic low back pain, psychiatric disorders in general, endocrinopathies, and obesity. The comprehensive management of narcolepsy requires monitoring for, and managing, these important associated health conditions.



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