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Narcolepsy and psychiatric comorbidity: a review of the literature
Lies Verstraete1,2, Maarten Van Den Bossche1,2
1Geriatric Psychiatry, University Psychiatric Center KU Leuven, Herestraat 49, Leuven 3000, Belgium.
Introduction:
Narcolepsy is a chronic sleep-wake disorder characterized by recurrent episodes of excessive daytime sleepiness, hypnagogic hallucinations, and sleep paralysis. There are two subtypes: narcolepsy type 1 (with cataplexy) and narcolepsy type 2 (without cataplexy). This review aims to investigate the comorbidity of psychiatric disorders in narcolepsy.
Methods:
We examined this association through a systematic literature review conducted on July 20, 2024. Searches were performed in PubMed and Embase.
Results:
In general, the prevalence of comorbid psychiatric disorders in patients with narcolepsy varies considerably. Depression, anxiety disorders and ADHD are considerably more prevalent in patients with narcolepsy than in the general population. The prevalence of comorbid psychotic disorders and a formal diagnosis of an eating disorder seems also higher in narcolepsy, albeit to a lesser extent. Neurodegenerative disorders and addictive problems were not more prevalent than in general population. More evidence is needed on bipolar disorder, obsessive compulsive disorder, autism, intellectual disability and personality disorders.
Conclusion:
Overall psychiatric disorders are more prevalent in patients with narcolepsy, but prevalence rates vary widely across disorders. High prevalence of comorbid depression, anxiety disorders and ADHD is reported in narcolepsy. For other psychiatric disorders, current evidence is less conclusive. It is important that clinicians and patients are aware of the comorbidity of narcolepsy and psychiatric disorders.
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