Prevalence and incidence of narcolepsy symptoms in the US general population
Maurice M Ohayon, Stephanie Duhoux, Joseph Grieco, Marie-Lise Côte
Sleep Med X. 2023 Nov 30:6:100095.
Abstract
Objective: The objectives of this study are to evaluate the prevalence and incidence of Narcolepsy type 1 and type 2 and to determine the prevalence of narcolepsy diagnosis criteria in the US general population.
Methods: This longitudinal study was conducted in the adult US general population in two occasions. The initial interviews included 15 states (Arizona, California, Colorado, Florida, Idaho, Missouri, New York, North Carolina, North Dakota, Oregon, Pennsylvania, South Dakota, Texas, Washington, and Wyoming). The follow-up interviews, was done three years later in eight of these states. Of the 19,136 contacted individuals, 15,929 completed the initial interview and 10,931 completed the follow-up. Participants were interviewed using the Sleep-EVAL system, an artificial intelligence tool. Narcolepsy Type 1 (with cataplexy) and Narcolepsy Type 2 (without cataplexy) were defined according to the ICSD-3 classification. Symptoms of narcolepsy were assessed by frequency per week and duration. Medical visits and diagnoses were also collected.
Results: Participants were aged between 18 and 102 years of age (mean 45.8 ± 17.9 years), 51.3 % were women. The prevalence of narcolepsy with cataplexy was 12.6 per 100,000 individuals (95 % C.I., 0 to 30) and narcolepsy without cataplexy was 25.1 per 100,000. The incidence per year was 2.6 per 100,000 individuals (95 % C.I., 0 to 11).
Conclusions: Narcolepsy is a rare condition affecting 37.7/100,000 individuals (126,191 individuals in the current US population). Our US general population prevalence is in line with rates found in community-based studies but lower than what is reported in claim database studies.
Keywords: Cataplexy; Hypersomnolence; Narcolepsy; Sleep paralysis.
PREVALENCE OF NARCOLEPSY TYPE 1 AND TYPE 2 IN REPRESENTATIVE SAMPLES OF THE GENERAL POPULATION OF NORTH AMERICA, EUROPE AND SOUTH KOREA
Ohayon, M. M., Dave, S., Shah, A., Swick, T., Cote, M.
ELSEVIER. 2022: S164
Prevalence, incidence, evolution and associated factors of sleep paralysis in a longitudinal study of the US general population
M M Ohayon, A H Pakpour
Sleep Med. 2022 Oct:98:62-67.
Abstract
Background and objective: Sleep paralysis is a common phenomenon which causes and consequences are seldomly studied. The aim of this study was to investigate the incidence and prevalence of sleep paralysis (SP) in the American adult population and its evolution on a 3-year period.
Methods: This longitudinal study was conducted between 2002 and 2015 and included a representative sample of the US general population. A total of 12,218 subjects were initially interviewed (W1) and 10,931 were re-interviewed three years later (W2). The subjects participated in telephone interviews using the Sleep-EVAL expert system. Each interview lasted for about 1 h. SP episodes were assessed according to their frequency and duration.
Results: At W1, 9.7% (95%CI: 9.1%-10.3%) reported having ≥1 episode of SP in the previous year. At W2, 15.1% (95%CI: 14.4%-15.8%) reported SP. A total of 29.9% of subjects with SP at W1 still reported episodes at W2. The 1-year incidence was 2.7% (95%CI: 2.4-3.0%). After adjusting for age and sex, prevalent SP (i.e., present at W2) was predicted by age and race and the following factors present at W1: major depressive disorder, pain, hypersomnolence, cataplexy, hypnagogic and hypnopompic hallucinations, posttraumatic stress disorder, a reduction in sleep duration of ≥60 min, and the use of analgesic/antipyretic medication. Incident SP (i.e. new cases at W2) had similar predictive factors.
Discussion: Episodes of SP are frequent in the general population. Its persistence is predicted by several factors associated with narcolepsy like hypersomnolence and cataplexy but also by other factors like posttraumatic stress disorder or pain.
Keywords: Cataplexy; Hypersomnolence; Hypnagogic hallucination; Hypnopompic hallucination.
OXFORD UNIV PRESS INC. 2022: A245
PREVALENCE AND INCIDENCE OF HYPNAGOGIC HALLUCINATIONS IN A LONGITUDINAL STUDY OF THE AMERICAN GENERAL POPULATION
Ohayon, M., Pakpour, A., Cote, M.
Longitudinal study of narcolepsy symptoms in first, second, and third-degree relatives of simplex and multiplex narcolepsy families
Maurice M Ohayon, Jed Black, Andrew D Krystal, Colin M Shapiro, Todd J Swick, Richard Bogan, Charles C Wells
Sleep Med. 2019 Jan:53:88-93.
Abstract
Objective: To assess the evolution of narcolepsy symptoms in first-, second, and third-degree relatives and to compare multiplex and simplex families.
Methods: A total of 4045 family members and 362 narcoleptic individuals were entered in the study; with 3255 family members interviewed twice, five to seven years apart. A control group (n = 178) composed of spouses or housemates was also interviewed twice. Family members were divided according to their blood relationship with the probands and further divided into multiplex (ie, more than one narcolepsy cases) and simplex (only one narcolepsy case) families. Telephone interviews were conducted with the help of the Sleep-EVAL system; narcolepsy probands were evaluated and diagnosed by a Sleep Specialist in a Sleep Clinic Center.
Results: A total of 1123 family members from 72 families were identified as members of multiplex families while the rest of the sample were a part of simplex families (n = 2132). Multiplex families had higher incidence and chronicity of hypersomnolence than the simplex family members and the control group. For cataplexy-like symptoms, only prevalence at the time of the first assessment distinguished multiplex (5.5%) and simplex (2.9%) families. Prevalence of sleep paralysis was higher among the first- and second-degree relatives coming from multiplex families, while incidence was the highest among second- and third-degree relatives. Hypnagogic hallucinations had similar prevalence between multiplex and simplex families but the incidence and chronicity were significantly higher among multiplex families. For each symptom, predictive factors were also determined in simplex and multiplex families.
Conclusions: Our results show that individuals coming from multiplex families are at greater risks of a broad range of narcolepsy symptoms compared to simplex families.
Keywords: Genetic; Hypersomnolence; Narcolepsy.
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