Socioeconomic impact of central disorders of hypersomnolence: A national register-based case-control study

Several studies have examined the disease burden of narcolepsy type 1 (NT1). However, comprehensive comparisons of disease impact across NT1, narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) are lacking.

In this single-center retrospective matched case-control study, 433 patients with a central disorder of hypersomnolence (CDH; including NT1, NT2, and IH) were collected from local storage between 2004 and 2022 then matched to population controls from national Danish registry in a ratio 1:4 and compared on comorbidity and socioeconomic, and health outcomes 2 years before and after diagnosis.

Costs were greatest in NT2 (€9.846 vs €1.568; P < .001) and IH (€8.713 vs €2.357; P < .001) compared to NT1 (€6.011 vs €2.143; P < .001). Before CDH diagnosis, NT2 patients had higher psychiatric care costs than controls (€1.224 vs €61; P < .001). Unemployment increased over time in all groups: NT1 9.5%-12.4%, IH 9.6%-25.5%, and NT2 16.9%-28.6%. Unemployment increased in NT1 (OR 2.8, 95% CI 1.2-6.5), NT2 (OR 4.6, 95% CI 2.1-10.1), and IH (OR 2.2, 95% CI 1.2-3.9).

The disease burden of NT2 was more severe than that of other CDH. These findings support subtype-specific clinical attention and multidisciplinary management.