Introduction
A published study was conducted by Avadel Pharmaceuticals identifying the top 20 comorbidities in over 2,000 people with narcolepsyi, revealing that psychiatric, sleep, and pain disorders were most common, while cardiovascular diseases were notably absent. Conducted using the Mayo Clinic Platform, this analysis provides insights into the unique health challenges faced by narcolepsy patients, aiming to enhance treatment approaches.ii The paper was published onlineiii in Sleep Advances. These real-world findings were previously presented at the American Neurological Association Annual Meeting in October 2022. Results describing demographic characteristics and the top 20 comorbidities were based on a review of deidentified electronic health data from more than 2,000 people with narcolepsy and 2,000 matched controls.
The retrospective analysis was conducted through Mayo Clinic Platform, which leverages AI software to provide access to curated, deidentified electronic health data in a secure, privacy-protected environment. These types of data provide a more comprehensive view of patient information than claims data alone.
Findings and Implications
The study found that people with narcolepsy were more likely to have psychiatric, sleep, and pain disorders. Among the top 20 comorbidities, five disorders were related to various types of painiv. Surprisingly, cardiovascular diseases, including hypertension, were not among the top 20 comorbidities.
The top 20 narcolepsy comorbidities (along with odds ratio) were:
- Restless Legs Syndrome (3.94)
- Obstructive sleep apnea (3.27)
- Chronic pain syndrome (2.20)
- Depression (2.11)
- Migraine (1.96)
- Irritable bowel syndrome (1.95)
- Fibromyalgia (1.90)
- Dysthymia (1.86)
- Insomnia (1.84)
- Carpal tunnel syndrome (1.80)
- Myalgia (1.69)
- Anxiety (1.67)
- Long QT syndrome (1.58)
- Asthma (1.52)
- Cervical spondylosis (1.49)
- Syncope (1.45)
- Hypothyroidism (1.33)
- Vitamin D deficiency (1.30)
- Allergic rhinitis (1.29)
- Chronic sinusitis (1.27)
Melissa Lipford, MD, a neurologist at the Center for Sleep Medicine at Mayo Clinic and lead author of the paper stated, “This is the first real-world study in narcolepsy to use aggregate electronic health record data. Understanding which comorbid conditions are most common should help clinicians better understand the challenges faced by patients with narcolepsy and help them optimize the management of their symptoms with the most appropriate treatment.”
Jennifer Gudeman, PharmD, senior vice president of medical and clinical affairs of Avadel, adds in a release, “We were proud to collaborate with Mayo Clinic Platform to generate these real-world deidentified data from patients seen at the Mayo Clinic Health System.
Narcolepsy is a chronic and complex neurological disorder and understanding the most prevalent comorbidities increased in this patient population may help to inform optimal management. In contrast to claims-based studies, cardiovascular disease was not among the top 20 comorbidities found to be increased in the narcolepsy cohort compared to the matched cohort.
Summary
In summary, psychiatric, sleep, and pain disorders emerged as the most common comorbidities in people with narcolepsy. Unlike previous studies, cardiovascular diseases did not appear in the top 20 comorbidities among narcolepsy patients. The study used aggregate electronic health records, offering a comprehensive view beyond claims data.
Narcolepsy Education
Sleepedu.org & Respiratoryedu.org are dedicated to meeting the educational needs for professionals in the sleep medicine, respiratory therapists and DME suppliers’ staff in the sleep and respiratory industries. Included in our vast course catalog is an AARC, BRPT, and DUAL CERTIFICATE (AARC & BRPT) course on narcolepsy. This module is not only designed to educate sleep clinicians but also provide a basis for recognition of a disorder that is grossly underdiagnosed and misunderstood.
This course offers an overview of narcolepsy, to also include the neuroanatomy of wakefulness. We will include the pathophysiology, diagnostic challenges and treatment options for narcolepsy.
