Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study

Sleep. 2013 Jun 1;36(6):835-40. doi: 10.5665/sleep.2706.

Abstract

Study objectives: To identify the factual morbidity and mortality of narcolepsy in a controlled design.

Setting: National Patient Registry.

Patients: All national diagnosed patients (757) with health information at least 3 years prior to and after diagnose of narcolepsy.

Controls: Randomly selected four citizens (3,013) matched for age, sex, and socioeconomic status from the Danish Civil Registration System Statistics.

Results: Increased morbidity prior to narcolepsy diagnosis included (odds ratio, 95% confidence interval):- diseases of the endocrine, nutritional, and metabolic systems (2.10, 1.32-3.33); nervous system (5.27, 3.65-7.60); musculoskeletal system (1.59, 1.23-2.05); and other abnormal symptoms and laboratory findings (1.66, 1.25-2.22). After the diagnosis, narcolepsy patients experienced diseases of the endocrine, nutritional, and metabolic (2.31, 1.51-3.54), nervous (9.19, 6.80-12.41), musculoskeletal (1.70, 1.28-2.26), eye (1.67, 1.03-2.71), and respiratory systems (1.84, 1.21-2.81). Specific diagnoses were diabetes (2.4, 1,2-4.7, P < 0.01), obesity (13.4, 3.1-57.6, P < 0.001), sleep apnea (19.2, 7.7-48.3, P < 0.001), other sleep disorders (78.5, 11.8-523.3, P < 0.001), chronic obstructive pulmonary disease (2.8, 1.4-5.8, P < 0.01), lower back pain (2.5, 1.4-4.2, P < 0.001), arthrosis/arthritis (2.5, 1.3-4.8, P < 0.01), observation of neurological diseases (3.5, 1.9-6.5, P < 0.001), observation of other diseases (1.7, 1.2-2.5, P < 0.01), and rehabilitation (5.0, 1.5-16.5, P < 0.005). There was a trend towards greater mortality in narcolepsy (P = 0.07).

Conclusions: Patients with narcolepsy present higher morbidity several years prior to diagnose and even higher thereafter. The mortality rate due to narcolepsy was slightly but not significantly higher.

Keywords: Narcolepsy; morbidity; mortality; sleep apnea.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Denmark / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Narcolepsy / diagnosis
  • Narcolepsy / epidemiology
  • Narcolepsy / mortality*
  • Prospective Studies
  • Registries
  • Retrospective Studies
  • Young Adult