0805 The Clinical and Humanistic Burden of Narcolepsy: Matched Analysis of US National Health and Wellness Survey Data

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Abstract Introduction Narcolepsy is a chronic neurological disorder that causes debilitating daytime sleepiness among other symptoms. This study compared clinical and humanistic outcomes between those with and without narcolepsy to characterize the extent of disease burden. Methods This study was a retrospective, cross-sectional analysis of 2021/2023 US National Health and Wellness Survey data. The narcolepsy cohort included those who reported a physician diagnosis of narcolepsy. Propensity-score matching (1:3) adjusted for demographic/health characteristics between those with and without narcolepsy (controls). Chi-square tests and t-tests compared comorbidities, symptoms of depression and anxiety, and health-related quality of life (HRQoL) between groups. Results Before matching, respondents with narcolepsy (n=335; female=56%; mean age, 45.5 years; White=68%) and without narcolepsy (n=141,072; female=55%; mean age, 47.8 years; White=72%) were included. Additionally, the narcolepsy cohort had higher mean [SD] body mass index (30.1 [8.4] vs 27.6 [7.1], p<.001) and were more likely to have obesity (44% vs 28%, p<.001) and be current smokers (25% vs 17%, p<.001) than those without narcolepsy. After matching, the narcolepsy cohort reported more frequent physician-diagnosed psychiatric comorbidities vs controls, including depression (58% vs 32%, p<.001), anxiety (54% vs 33%, p<.001), and ADHD (20% vs 6%, p<.001). The narcolepsy cohort had higher reporting of moderate-to-severe depression symptoms via Patient Health Questionnaire-9 (52% vs 33%, p<.001) and moderate-to-severe anxiety via Generalized Anxiety Disorder Questionnaire-7 (41% vs 26%, p<.001). On the Brief Resilience Scale, more respondents with narcolepsy reported low resiliency scale score vs controls (43% vs 28%, p<.001). Compared with controls, the narcolepsy cohort scored lower on HRQoL measures, including mean [SD] mental health composite (32.8 [11.3] vs 40.6 [12.6], p<.001) and physical health composite (35.7 [11.4] vs 42.9 [11.6], p<.001) scores of the RAND 36-Item Health Survey. The narcolepsy cohort reported greater impairment of daily activities vs controls (51% vs 34%, p<.001). Conclusion Narcolepsy is associated with broad clinical and humanistic burden. Those with narcolepsy had more frequent psychiatric comorbidities, more severe depression and anxiety symptoms, less self-reported resiliency, and lower HRQoL. Future strategies should focus on comprehensive management that prioritizes mental health, while investigating new treatments that may improve HRQoL for narcolepsy patients. Support (if any) Alkermes, Inc.