Comorbidities in a community sample of narcolepsy

Alexander Cohen, Jayawant Mandrekar, Erik K St Louis, Michael H. Silber, Suresh Kotagal

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Study objective: To assess comorbidities in a community-based cohort of narcolepsy. Methods: A 2000–2014 community-based narcolepsy cohort was identified in Olmsted County, Minnesota. Records were reviewed by a certified sleep specialist for accuracy of diagnosis, and comorbidities were extracted and analyzed. Comorbidities in narcolepsy subjects, both at diagnosis and upon follow-up, were compared with those in unaffected and age- and sex-matched cohort using conditional logistic regression. Results: At diagnosis, there was increased association of narcolepsy with anxiety (OR 4.56, 95% CI 1.99–10.44), thyroid disease (3.07, 1.19–7.90), hypertension (2.69, 1.22–5.93), and hyperlipidemia (2.49, 1.05–5.92). At the end of the prolonged observation period of 9.9 years (SD 7.27 years), there was increased association of narcolepsy with peripheral neuropathy (11.21, 1.16–108.11), non-migrainous headache (6.00, 1.73–20.83), glucose intolerance (2.39, 1.05–5.45), and automobile-related trauma (2.43, 1.08–5.45). Persistently increased both at diagnosis and after a prolonged observation period were associations of narcolepsy with obstructive sleep apnea (OSA) (69.25, 9.26–517.99 decreasing to 13.55, 5.08–36.14), chronic low back pain (5.46, 2.46–12.11 to 2.58, 1.39–4.77), depression (4.88, 2.45–9.73 to 3.79, 2.12–6.79), psychiatric disorders in general (4.73, 2.49–9.01 to 3.40, 1.94–5.98), endocrinopathies (4.15, 1.81–9.56 to 2.45, 1.33–4.49), and obesity (2.27, 1.13–4.56 to 2.07, 1.15–3.7). Conclusions: In this community-based study of narcolepsy comorbidities, both at diagnosis and after prolonged follow-up, persistent comorbidities were revealed, including OSA, chronic low back pain, psychiatric disorders in general, endocrinopathies, and obesity. The comprehensive management of narcolepsy requires monitoring for and managing these important associated health conditions.

Original languageEnglish (US)
Pages (from-to)14-18
Number of pages5
JournalSleep Medicine
Volume43
DOIs
StatePublished - Mar 1 2018

Fingerprint

Narcolepsy
Comorbidity
Obstructive Sleep Apnea
Low Back Pain
Psychiatry
Obesity
Observation
Automobiles
Somatoform Disorders
Glucose Intolerance
Thyroid Diseases
Peripheral Nervous System Diseases
Hyperlipidemias
Headache
Sleep
Anxiety
Logistic Models
Depression
Hypertension
Health

Keywords

  • Community-based study
  • Comorbidity
  • Narcolepsy
  • Population surveillance

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Comorbidities in a community sample of narcolepsy. / Cohen, Alexander; Mandrekar, Jayawant; St Louis, Erik K; Silber, Michael H.; Kotagal, Suresh.

In: Sleep Medicine, Vol. 43, 01.03.2018, p. 14-18.

Research output: Contribution to journalArticle

Cohen, Alexander ; Mandrekar, Jayawant ; St Louis, Erik K ; Silber, Michael H. ; Kotagal, Suresh. / Comorbidities in a community sample of narcolepsy. In: Sleep Medicine. 2018 ; Vol. 43. pp. 14-18.
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abstract = "Study objective: To assess comorbidities in a community-based cohort of narcolepsy. Methods: A 2000–2014 community-based narcolepsy cohort was identified in Olmsted County, Minnesota. Records were reviewed by a certified sleep specialist for accuracy of diagnosis, and comorbidities were extracted and analyzed. Comorbidities in narcolepsy subjects, both at diagnosis and upon follow-up, were compared with those in unaffected and age- and sex-matched cohort using conditional logistic regression. Results: At diagnosis, there was increased association of narcolepsy with anxiety (OR 4.56, 95{\%} CI 1.99–10.44), thyroid disease (3.07, 1.19–7.90), hypertension (2.69, 1.22–5.93), and hyperlipidemia (2.49, 1.05–5.92). At the end of the prolonged observation period of 9.9 years (SD 7.27 years), there was increased association of narcolepsy with peripheral neuropathy (11.21, 1.16–108.11), non-migrainous headache (6.00, 1.73–20.83), glucose intolerance (2.39, 1.05–5.45), and automobile-related trauma (2.43, 1.08–5.45). Persistently increased both at diagnosis and after a prolonged observation period were associations of narcolepsy with obstructive sleep apnea (OSA) (69.25, 9.26–517.99 decreasing to 13.55, 5.08–36.14), chronic low back pain (5.46, 2.46–12.11 to 2.58, 1.39–4.77), depression (4.88, 2.45–9.73 to 3.79, 2.12–6.79), psychiatric disorders in general (4.73, 2.49–9.01 to 3.40, 1.94–5.98), endocrinopathies (4.15, 1.81–9.56 to 2.45, 1.33–4.49), and obesity (2.27, 1.13–4.56 to 2.07, 1.15–3.7). Conclusions: In this community-based study of narcolepsy comorbidities, both at diagnosis and after prolonged follow-up, persistent comorbidities were revealed, including OSA, chronic low back pain, psychiatric disorders in general, endocrinopathies, and obesity. The comprehensive management of narcolepsy requires monitoring for and managing these important associated health conditions.",
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N2 - Study objective: To assess comorbidities in a community-based cohort of narcolepsy. Methods: A 2000–2014 community-based narcolepsy cohort was identified in Olmsted County, Minnesota. Records were reviewed by a certified sleep specialist for accuracy of diagnosis, and comorbidities were extracted and analyzed. Comorbidities in narcolepsy subjects, both at diagnosis and upon follow-up, were compared with those in unaffected and age- and sex-matched cohort using conditional logistic regression. Results: At diagnosis, there was increased association of narcolepsy with anxiety (OR 4.56, 95% CI 1.99–10.44), thyroid disease (3.07, 1.19–7.90), hypertension (2.69, 1.22–5.93), and hyperlipidemia (2.49, 1.05–5.92). At the end of the prolonged observation period of 9.9 years (SD 7.27 years), there was increased association of narcolepsy with peripheral neuropathy (11.21, 1.16–108.11), non-migrainous headache (6.00, 1.73–20.83), glucose intolerance (2.39, 1.05–5.45), and automobile-related trauma (2.43, 1.08–5.45). Persistently increased both at diagnosis and after a prolonged observation period were associations of narcolepsy with obstructive sleep apnea (OSA) (69.25, 9.26–517.99 decreasing to 13.55, 5.08–36.14), chronic low back pain (5.46, 2.46–12.11 to 2.58, 1.39–4.77), depression (4.88, 2.45–9.73 to 3.79, 2.12–6.79), psychiatric disorders in general (4.73, 2.49–9.01 to 3.40, 1.94–5.98), endocrinopathies (4.15, 1.81–9.56 to 2.45, 1.33–4.49), and obesity (2.27, 1.13–4.56 to 2.07, 1.15–3.7). Conclusions: In this community-based study of narcolepsy comorbidities, both at diagnosis and after prolonged follow-up, persistent comorbidities were revealed, including OSA, chronic low back pain, psychiatric disorders in general, endocrinopathies, and obesity. The comprehensive management of narcolepsy requires monitoring for and managing these important associated health conditions.

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