Narcolepsy tied to elevated risk for heart disease, regardless of sleep apnea status
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Key takeaways:
- People with narcolepsy were more likely to develop heart disease than propensity score-matched people without narcolepsy.
- The association was consistent regardless of sleep apnea or diabetes.
People with narcolepsy were more likely than propensity score-matched people without narcolepsy to develop heart disease, regardless of sleep apnea status, according to a retrospective cohort study.
The findings were presented at SLEEP 2024, the annual meeting of the Associated Professional Sleep Societies, and published in SLEEP.
“Our study, highlighting the independent risk of narcolepsy for cardiovascular disease, underscores the significance of narcolepsy as a major health concern, like obstructive sleep apnea, hypertension, hyperlipidemia and mental health disorders, in precipitating cardiovascular conditions,” Christopher N. Kaufmann, PhD, MHS, assistant professor in the department of health outcomes and biomedical informatics at the University of Florida College of Medicine, told Healio. “Our findings once again reinforce the relevance of sleep and sleep disorders for all clinicians involved in the care of patients at risk of or with cardiovascular conditions.”
Kaufmann and colleagues conducted a retrospective cohort study of participants who appeared in the 2005-2021 IBM MarketScan Commercial and Medicare supplemental databases. The cohort (mean age, 40 years; 62% women) included data from 34,562 patients diagnosed with narcolepsy and 100,405 people without narcolepsy who were matched based on demographics, the presence of relevant health conditions such as sleep apnea and diabetes, and other confounders.
Patients were followed until the end of enrollment or up to Dec. 13, 2021.
Kaufmann and colleagues found that compared with controls, patients with narcolepsy had elevated risk for the following outcomes:
- CVD: HR = 1.77; 95% CI, 1.65-1.89;
- major adverse CV events: HR = 1.82; 95% CI, 1.66-1.99;
- heart failure: HR = 1.64; 95% CI, 1.47-1.83;
- any stroke: HR = 2.04; 95% CI, 1.82-2.89;
- atrial fibrillation: HR = 1.58; 95% CI, 1.4-1.77; and
- myocardial infarction: HR = 1.64; 95% CI, 1.37-1.96.
“Previous research suggested a link between narcolepsy and CVD, but it wasn’t clear whether this connection was driven by comorbid conditions and medications used for treatment or if it was independent of these factors,” Kaufmann told Healio. “Our study confirmed that the association between narcolepsy and CVD persists even when accounting for other common health conditions like obstructive sleep apnea and diabetes. We also found that when accounting for medications commonly used to treat narcolepsy, which themselves can trigger CVD, the association remained intact. Our findings provide compelling data that narcolepsy is independently associated with CVD.”
The findings mean that “physicians should be vigilant in monitoring their patients with narcolepsy for signs of CVD, including more close monitoring of CVD-related outcomes,” Kaufmann told Healio. “They should also take this into consideration when planning treatments for the condition. Additionally, it underscores the importance of physicians to monitor other health conditions that could further increase the risk of CVD in these patients.”
Reference:
For more information:
Christopher N. Kaufmann, PhD, MHS, can be reached at ckaufmann@ufl.edu.
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Kaufmann C, et al. Abstract 0857. Presented at: SLEEP; June 1-5, 2024; Houston.
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