Narcolepsy and cardiovascular health: A big picture perspective

Narcolepsy is an uncommon, chronic neurologic disorder characterized by pervasive excessive daytime sleepiness (EDS) that can occur with cataplexy (narcolepsy type 1) or without cataplexy (narcolepsy type 2). People with narcolepsy have an increased risk of comorbid psychiatric disorders and primary sleep disorders, as well as increased healthcare utilization compared to the general population. Over the past several years, clinicians and patients in the narcolepsy community have frequently received communications regarding cardiovascular disease (CVD) risk but disproportionately inadequate information regarding proactive steps to promote cardiovascular (CV) health. Given the frequent interactions that sleep clinicians and people with narcolepsy need to effectively manage symptoms, there is an opportunity to promote CV health, particularly as the American Heart Association (AHA) recently added Get Healthy Sleep as a cornerstone to their Life's Essential 8™ recommendations. In addition to Get Healthy Sleep, the AHA's recommendations to improve and maintain CV health include 7 other components: Eat Better, Manage Weight, Be More Active, Manage Blood Pressure, Control Cholesterol, Manage Blood Sugar, and Quit Tobacco. People with narcolepsy, particularly those with uncontrolled symptoms of EDS, cataplexy, and disrupted nighttime sleep, may have challenges implementing many of the Life's Essential 8 recommendations, such as Be More Active and Eat Better, which could have deleterious effects on cholesterol and blood glucose management. Sleep clinicians and their patients with narcolepsy often have a special and trusted relationship, providing a critical opportunity to support and preserve CV health longitudinally.