![]() ![]() ![]() Obesity in NC affects more than 50% of children 14, 15 and only 30% of adults. 10, 13Ĭomorbidities may also vary as a result of age in NC. 12 In large groups, there was a decrease in the number of sleep onset rapid eye movement periods (SOREMPs) and an increase of MSL with age gain, with no difference across age in terms of clinical complaints. Indeed, Aran et al reported that children with postpubertal onset of narcolepsy had a higher prevalence of sleep paralysis and hypnagogic hallucinations, and shorter mean sleep latency (MSL) than children with peripubertal and prepubertal onset. There may be several reasons for this delay, including the rarity of NC, reduced awareness about this disorder among clinicians, but also changes in the clinical picture of NC depending on age at diagnosis. 11 Indeed, many people with an NC onset during childhood or adolescence are diagnosed only when they are adults, after they completed and possibly failed their academic studies, gained an almost irreversible obesity and experienced low self-esteem. Despite more than half of patients with NC have a disease onset prior to the age of 18 years, 10 there is a delay of more than 10 years between the disease onset and its diagnosis. The question of age at onset and age at diagnosis is important in the context of NC. Additionally, the human leukocyte antigen (HLA) DQB1*0602 genotype is closely associated with NC. In opposite, in narcolepsy type 2, there is no decrease in hypocretin levels. 7, 8 Indeed, low cerebrospinal fluid (CSF) hypocretin-1 levels (less than or equal to 110 pg/mL) are found in more than 90% of patients with NC (also called narcolepsy type 1 or hypocretin deficient). 4, 5 Narcolepsy with cataplexy is caused by a loss of hypocretin-1 neurons located in the lateral hypothalamus, 6 probably via an autoimmune mechanism. 2, 3 The NC prevalence increased after the H1N1 infection and vaccine. The prevalence of narcolepsy ranges from 0.02% to 0.05% in European and North American populations. 1 The frequent comorbidities of NC include obesity, restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), depressive mood, and symptoms of attention-deficit/hyperactivity disorder (ADHD). Narcolepsy with cataplexy (NC) is a rare neurological disorder characterized by excessive daytime sleepiness (EDS) with irresistible sleep attacks and cataplexy (sudden loss of muscle tone triggered by emotions), associated sometimes with other abnormal rapid eye movement (REM) manifestations such as hypnagogic hallucinations, sleep paralysis, REM sleep behavior disorder (RBD), and disturbed nocturnal sleep. These differences should be considered to ensure a prompt diagnosis. ConclusionĪt time of NC diagnosis, children have more frequent obesity, night eating, parasomnia, sleep talking, drunkenness, and ADHD symptoms than adults, even if sleepiness and cataplexy do not differ. The body mass index ( z-score) was correlated with OAHI ( r = .32). No between-group differences were found at the multiple sleep latency test. Obstructive apnea-hypopnea index (OAHI) was lower in children with higher mean and minimal oxygen saturation than in adults. Quality of life was essentially impacted by depressive feelings in both children and adults. ![]() There was no difference between groups for insomnia and fatigue scores. However, adults had lower quality of life than children. Depressive feelings affected not differently children (24%) and adults (32%). Children scored higher than adults at the attention-deficit/hyperactivity disorder (ADHD) scale. The frequency of obesity (54% vs 17%), night eating (29% vs 7%), parasomnia (89% vs 43%), sleep talking (80% vs 34%), and sleep drunkenness (69% vs 24%) were higher in children than in adults, the frequency of sleep paralysis was lower (20% vs 55%) but the frequency of cataplexy and the severity of sleepiness were not different. The clinical and sleep measures were compared between patients diagnosed before (46 children, median age: 12 year old) and after (46 adults, median age: 28.5 year old) 18 years of age. Methodsĭe novo patients with NC diagnosis completed a standardized questionnaire and interview, followed by a sleep study. To compare symptoms and sleep characteristics in patients diagnosed with narcolepsy-cataplexy (NC) before and after the age of 18 years. ![]()
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