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Early- and late-onset narcolepsy: possibly two distinct clinical phenotypes
Min Wu1,2, Xiao Li3, Shirley Xin Li3,4
1Sleep Medicine Center, West China Hospital, Sichuan University, 28 Dian Xin Nan Jie, Chengdu, 610041, Sichuan Province, China.
Sleep & Breathing = Schlaf & Atmung
|April 12, 2023
Summary
Early- and late-onset narcolepsy present distinct clinical features and risk factors for excessive daytime sleepiness (EDS). Early-onset narcolepsy is linked to REM sleep behavior disorder and disrupted sleep, while late-onset narcolepsy shows more severe self-reported symptoms.
Area of Science:
- Neurology
- Sleep Medicine
- Clinical Research
Background:
- Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness (EDS).
- Understanding the differences between early- and late-onset narcolepsy is crucial for effective management.
- Identifying risk factors for EDS can improve patient outcomes.
Purpose of the Study:
- To investigate the clinical characteristics of early- and late-onset narcolepsy.
- To identify risk factors associated with excessive daytime sleepiness (EDS) in both early- and late-onset narcolepsy patients.
Main Methods:
- 101 narcolepsy patients were divided into early-onset (onset ≤15 years) and late-onset (onset >15 years) groups.
- Demographic, clinical, and sleep parameters were compared between groups.
- Linear regressions analyzed risk factors for subjective and objective EDS.
Main Results:
- Late-onset narcolepsy patients reported higher Epworth Sleepiness Scale (ESS) and Ullanlinna Narcolepsy Scale (UNS) scores, and more frequent sleep paralysis and REM sleep behavior disorder (RBD).
- In early-onset narcolepsy, UNS-cataplexy and sleep paralysis correlated with subjective EDS; N1%, arousal index, and periodic limb movements index correlated with objective EDS.
- These associations were not significant in the late-onset group.
Conclusions:
- Late-onset narcolepsy is associated with more severe self-reported narcolepsy symptoms.
- REM sleep-related symptoms and disrupted nighttime sleep are linked to EDS in early-onset narcolepsy.
- Early- and late-onset narcolepsy may represent distinct clinical phenotypes.
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