Download PDF
CC BY-NC-ND 4.0 · Sleep Sci 2021; 14(03): 286-290
DOI: 10.5935/1984-0063.20200070
SHORT COMMUNICATIONS

Medical comorbidities in Saudi patients with narcolepsy: a case-control study

Ahmed Salem BaHammam
1   King Saud University, University Sleep Disorders Center, Department of Medicine, College of Medicine - Riyadh - Riyadh - Saudi Arabia.
2   Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, National Plan - Riyadh - Riyadh - Saudi Arabia.
,
Awad H Olaish
1   King Saud University, University Sleep Disorders Center, Department of Medicine, College of Medicine - Riyadh - Riyadh - Saudi Arabia.
2   Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, National Plan - Riyadh - Riyadh - Saudi Arabia.
,
Majid Al-Omar
1   King Saud University, University Sleep Disorders Center, Department of Medicine, College of Medicine - Riyadh - Riyadh - Saudi Arabia.
,
Aljohara S Almeneessier
1   King Saud University, University Sleep Disorders Center, Department of Medicine, College of Medicine - Riyadh - Riyadh - Saudi Arabia.
3   King Saud University, Family and Community Medicine Department - Riyadh - Riyadh - Saudi Arabia.
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

ABSTRACT

Objective: This case-control study sought to assess comorbid medical disorders in patients with narcolepsy type-1 (NT-1) and type-2 (NT-2).

Material and Methods: The study comprised 80 consecutive Arab (Saudi) patients with narcolepsy (NT-1=56 and NT-2=24) and a control group of 211 adults matched for age, sex, and body mass index (BMI). Data were collected from cases and controls based on a predesigned questionnaire that was formulated based on previous studies to evaluate the chosen medical comorbidities.

Results: Narcolepsy patients had a higher prevalence of hypothyroidism and hyperlipidemia and a higher prevalence of high-risk for OSA than controls. Hyperlipidemia was more common in cases than controls, 8 (10%) vs. 3 (1.4%), p=0.002. After adjusting for age, sex, and BMI, the odds-ratios for hypothyroidism and high risk for OSA in the NT-1 group was 5.49 (95% CI, [0.8 - 38.6]) and 69.99 ((95%CI [20.6 -237.4]), respectively, and in the NT-2 group, 12.5, 95%CI [1.6-97.7], and 33.3, 95%CI [8.2-135.7], respectively.

Conclusion: Arab (Saudi) narcolepsy patients had a higher association with hypothyroidism, hyperlipidemia, and a higher risk of OSA than controls.

Keywords:

Hypertension - Sleep - Diabetes Mellitus - Disorders of Excessive Somnolence - Hyperlipidemias - Hypothyroidism


Publication History

Received: 18 August 2020

Accepted: 06 November 2020

Article published online:
30 November 2023

© 2021. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • REFERENCES

  • 1 Alomar M, Almeneessier AS, Olaish AH, Alshiban A, Alomar A, BaHammam AS. Immune-mediated comorbidities in Saudi patients with narcolepsy. Nat Sci Sleep. 2019 May;11:35- 43.
  • 2 American Academy of Sleep Medicine (AASM). International classification of sleep disorders (ICSD). 3rd ed. Darien: AASM; 2014.
  • 3 Al Rajeh S, Bademosi O, Ismail H, Awada A, Dawodu A, Al-Freihi H, et al. A community survey of neurological disorders in Saudi Arabia: the Thugbah study. Neuroepidemiology. 1993;12(3):164-78.
  • 4 Black J, Reaven NL, Funk SE, McGaughey K, Ohayon MM, Guilleminault C, et al. Medical comorbidity in narcolepsy: findings from the Burden of Narcolepsy Disease (BOND) study. Sleep Med. 2017 May;33:13-8.
  • 5 Cohen A, Mandrekar J, St Louis EK, Silber MH, Kotagal S. Comorbidities in a community sample of narcolepsy. Sleep Med. 2018 Mar;43:14-8.
  • 6 Cremaschi RC, Hirotsu C, Tufik S, Coelho FM. Narcolepsy type 1 and type 2 - a 10-year follow-up: body mass index and comorbidities. Sleep Med. 2017 Apr;32:285-6.
  • 7 Lee MJ, Lee SY, Yuan SS, Yang CJ, Yang KC, Lee TL, et al. Comorbidity of narcolepsy and depressive disorders: a nationwide population-based study in Taiwan. Sleep Med. 2017 Nov;39:95-100.
  • 8 Ohayon MM. Narcolepsy is complicated by high medical and psychiatric comorbidities: a comparison with the general population. Sleep Med. 2013 Jun;14(6):488-92.
  • 9 Yeh JY, Shyu YC, Lee SY, Yuan SS, Yang CJ, Yang KC, et al. Comorbidity of narcolepsy and psychotic disorders: a nationwide population-based study in Taiwan. Front Psychiatry. 2020;11:205.
  • 10 Alasim H, AlQazlan S, Albanyan S, Alsalhi A, Buraik A, Olaish AH, et al. Comorbid psychiatric disorders among patients with narcolepsy. Sleep Breath. 2020 Jun;24(2):629-36.
  • 11 Netzer NC, Hoegel JJ, Loube D, Netzer CM, Hay B, Alvarez-Sala R, et al. Prevalence of symptoms and risk of sleep apnea in primary care. Chest. 2003 Oct;124(4):1406-14.
  • 12 Bahammam AS, Al-Rajeh MS, Al-Ibrahim FS, Arafah MA, Sharif MM. Prevalence of symptoms and risk of sleep apnea in middle-aged Saudi women in primary care. Saudi Med J. 2009 Dec;30(12):1572-6.
  • 13 Kok SW, Roelfsema F, Overeem S, Lammers GJ, Frolich M, Meinders AE, et al. Altered setting of the pituitary-thyroid ensemble in hypocretin-deficient narcoleptic men. Am J Physiol Endocrinol Metab. 2005 May;288(5):E892-9.
  • 14 Messina A, De Fusco C, Monda V, Esposito M, Moscatelli F, Valenzano A, et al. Role of the orexin system on the hypothalamus-pituitary-thyroid axis. Front Neural Circuits. 2016;10:66.
  • 15 Bonvalet M, Ollila HM, Ambati A, Mignot E. Autoimmunity in narcolepsy. Curr Opin Pulm Med. 2017 Nov;23(6):522-9.
  • 16 Barateau L, Lopez R, Arnulf I, Lecendreux M, Franco P, Drouot X, et al. Comorbidity between central disorders of hypersomnolence and immune-based disorders. Neurology. 2017;88(1):93-100.
  • 17 Baumann CR, Mignot E, Lammers GJ, Overeem S, Arnulf I, Rye D, et al. Challenges in diagnosing narcolepsy without cataplexy: a consensus statement. Sleep. 2014 Jun;37(6):1035-42.
  • 18 Peraita-Adrados R, Martínez-Orozco FJ. Sleep disorder comorbidities in narcolepsy. In: Meeta G, Pandi-Perumal SR, Thorpy MJ, eds. Narcolepsy. Switzerland: Springer International Publishing; 2016. p. 161-75.
  • 19 BaHammam AS, Alenezi AM. Narcolepsy in Saudi Arabia. Demographic and clinical perspective of an under-recognized disorder. Saudi Med J. 2006 Sep;27(9):1352-7.
  • 20 Jennum P, Ibsen R, Knudsen S, Kjellberg J. Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study. Sleep. 2013 Jun;36(6):835-40.
  • 21 Almeneessier AS, Alballa NS, Alsalman BH, Aleissi S, Olaish AH, BaHammam AS. A 10- year longitudinal observational study of cataplexy in a cohort of narcolepsy type 1 patients. Nat Sci Sleep. 2019 Oct;11:231-9.
  • 22 Pataka AD, Frangulyan RR, Mackay TW, Douglas NJ, Riha RL. Narcolepsy and sleep- disordered breathing. Eur J Neurol. 2012;19(5):696-702.
  • 23 Hoshino T, Sasanabe R, Mano M, Nomura A, Kato C, Sato M, et al. Prevalence of rapid eye movement-related obstructive sleep apnea in adult narcolepsy. Intern Med. 2019 Aug;58(15):2151-7.
  • 24 Sakurai S, Nishijima T, Takahashi S, Yamauchi K, Arihara Z, Takahashi K. Clinical significance of daytime plasma orexin-A-like immunoreactivity concentrations in patients with obstructive sleep apnea hypopnea syndrome. Respiration. 2004;71(4):380-4.
  • 25 Sakurai S, Nishijima T, Takahashi S, Yamauchi K, Arihara Z, Takahashi K. Low plasma orexin-A levels were improved by continuous positive airway pressure treatment in patients with severe obstructive sleep apnea-hypopnea syndrome. Chest. 2005 Mar;127(3):731-7.
  • 26 Gestreau C, Bevengut M, Dutschmann M. The dual role of the orexin/hypocretin system in modulating wakefulness and respiratory drive. Curr Opin Pulm Med. 2008 Nov;14(6):512- 8.
  • 27 Sansa G, Iranzo A, Santamaria J. Obstructive sleep apnea in narcolepsy. Sleep Med. 2010 Jan;11(1):93-5.
  • 28 Martinez-Orozco FJ, Vicario JL, De Andres C, Fernandez-Arquero M, Peraita-Adrados R. Comorbidity of narcolepsy type 1 with autoimmune diseases and other immunopathological disorders: a case-control study. J Clin Med Res. 2016 Jul;8(7):495-505.
  • 29 Martínez-Orozco FJ, Vicario JL, Villalibre-Valderrey I, De Andrés C, Fernández-Arquero M, Peraita-Adrados R. Narcolepsy with cataplexy and comorbid immunopathological diseases. J Sleep Res. 2014;23(4):414-9.