Sex disparities in clinical features and burden of narcolepsy type 1

J Sleep Res. 2024 Oct;33(5):e14157. doi: 10.1111/jsr.14157. Epub 2024 Feb 6.

Abstract

To investigate potential sex-related differences in patients with narcolepsy type 1, we carried out an analysis of baseline data from 93 women and 89 men with narcolepsy type 1 who participated in the TElemedicine for NARcolepsy (TENAR) trial. The following data were considered: sociodemographics; diagnostic (disease history, polysomnography, orexin, human leukocyte antigen) and clinical features, including sleepiness (Epworth Sleepiness Scale), cataplexy and other narcolepsy symptoms; disease severity (Narcolepsy Severity Scale); pharmacological treatment; depressive symptoms (Beck Depression Inventory); and self-reported relevance of eight narcolepsy-related issues. We found that, compared with men, significantly more women reported automatic behaviours (55.4% versus 40%) and had higher Epworth Sleepiness Scale (median 10 versus 9) and Beck Depression Inventory scores (median 10.5 versus 5), and there was a trend for a higher Narcolepsy Severity Scale total score in women (median 19 versus 18, p = 0.057). More women than men were officially recognized as having a disability (38% versus 22.5%) and considered 5/8 narcolepsy-related issues investigated as a relevant problem. More severe sleepiness and a greater narcolepsy-related burden in women could mirror sex differences present in the general population, or may be related to suboptimal management of narcolepsy type 1 or to more severe depressive symptoms in women. Future studies and guidelines should address these aspects.

Keywords: depression; gender; impairment; narcolepsy; sex; sleepiness.

MeSH terms

  • Adult
  • Cost of Illness
  • Depression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Narcolepsy* / physiopathology
  • Polysomnography
  • Severity of Illness Index*
  • Sex Characteristics
  • Sex Factors
  • Telemedicine

Supplementary concepts

  • Narcolepsy 1