Abstract
BackgroundNarcolepsy is a chronic sleep disorder that is likely to have neuropsychiatric comorbidities. Psychotic disorders are characterized by delusion, hallucination, and reality impairments. This study investigates the relationship between narcolepsy and psychotic disorders.Design and MethodsThis study involves patients who were diagnosed with narcolepsy between January 2002 and December 2011 (n = 258) and age- and gender-matched controls (n = 2580) from Taiwan’s National Health Insurance database. Both the patients and the controls were monitored from January 1, 2002 to December 31, 2011 to identify any occurrence of a psychotic disorder. Drugs that have been approved for treating narcolepsy: immediate-release methylphenidate (IR–MPH), osmotic controlled-release formulations of methylphenidate (OROS–MPH), and modafinil, were analyzed. A multivariate logistic regression model was used to evaluate the potential comorbidity of narcolepsy with psychotic disorders.ResultsDuring the study period, 8.1% of the narcoleptic patients exhibited comorbidity with a psychotic disorder, whereas only 1.5% of the control subjects (1.5%) had psychotic disorders (aOR, 4.07; 95% CI, 2.21–7.47). Of the narcolepsy patients, 41.5, 5.4, and 13.2% were treated with MPH-IR, MPH-OROS, and modafinil, accordingly. Pharmacotherapy for narcolepsy did not significantly affect the risk of exhibiting a psychotic disorder.ConclusionsThis nationwide study revealed that narcolepsy and psychotic disorders commonly co-occur. Pharmacotherapy for narcolepsy was not associated with the risk of psychotic disorders. Our findings serve as a reminder that clinicians must consider the comorbidity of narcolepsy and psychosis.
Highlights
Narcolepsy is a chronic disabling sleep disorder with an estimated lifetime prevalence of approximately 1 in 2,000 in the general population and it can severely influence daily activities [1, 2]
The narcolepsy group was more likely than the control group to exhibit comorbidities among attention-deficit hyperactivity disorder (ADHD) (8.9%), autism spectrum disorder (ASD) (2.3%), intellectual disability (2.3%), and epilepsy (8.9%)
8.1% of the cases of narcolepsy were comorbid with a psychotic disorder
Summary
Narcolepsy is a chronic disabling sleep disorder with an estimated lifetime prevalence of approximately 1 in 2,000 in the general population and it can severely influence daily activities [1, 2]. It is characterized by excessive daytime sleepiness (EDS) with sudden sleep attacks, rapid eye movement sleep abnormalities such as cataplexy, sleep paralysis, and hypnagogic or hypnopompic hallucinations, nocturnal dyssomnia with fragmented sleep and awakenings [3]. This study investigates the relationship between narcolepsy and psychotic disorders
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