Pain, sleep, mood disorders most common comorbidities in patients with narcolepsy

CHICAGO — Pain, sleep and mood disorders were the most commonly found comorbidities among those with narcolepsy, with chronic pain being more than twice as likely to occur compared with matched controls, a poster showed at ANA 2022.

“Our goal was to look at a large cohort of patients with narcolepsy and analyze what other comorbidities patients face and really look at the patient experience from the time of diagnosis throughout their course of treatment,” Melissa C. Lipford, MD, of the department of neurology and sleep medicine at the Mayo Clinic, told Healio.

Lipford and colleagues sought to characterize demographic characteristics, along with medical and psychiatric comorbidities, of patients with narcolepsy who treated at the Mayo Clinic.

Researchers conducted an electronic health record search between 2000 and 2020 to identify 2,057 individuals (59.6% women, 92.6% white) who sought initial treatment for narcolepsy at any Mayo campus. A separate control cohort of 2,057 participants (58.9% women, 94.6% white) was propensity-score matched by birth year, age at initial treatment, sex, race, ICD code and mortality.

Results showed that of the top 20 comorbidities identified in the narcolepsy group, sleep, pain and mood disorders were the most frequently reported, compared with the control group. Sleep disorders (sleep apnea, 39.5% vs. 16.7%; OR = 3.27, 95% CI, 2.83-3.79; insomnia, 22.5% vs. 13.6%; OR = 1.84, 95% CI, 1.57-2.17; restless leg syndrome, 15.3% vs. 4.4%; OR = 3.94, 95% CI, 3.09-5.02); mood disorders (anxiety, 41.8% vs. 30.1%; OR = 1.67, 95% CI, 1.46-1.89; depression, 45.9% vs. 28.7%; 95% CI, 1.86-2.4; dysthymia, 15.9% vs. 9.2%; 95% CI, 1.54-2.25); pain disorders (myalgia, 24.9% vs. 16.4%; OR = 1.69, 95% CI, 1.45-1.97; migraine, 22.7% vs. 13.%; OR = 1.96, 95% CI, 1.66-2.31).

Hypothyroidism, asthma, allergic rhinitis and chronic sinusitis were among other comorbidities found in both groups, although higher percentages were reported in the narcolepsy cohort.

“We knew that this group of patients already struggles with the symptoms that are inherent to narcolepsy: intense daytime sleepiness and the impact that has on their quality of life and work productivity, relationships with others and some of the medications that they’re on,” Lipford said. “But we were surprised to find some of the comorbidities, particularly other sleep disorders, and most prominent were some of the pain disorders.”