Abstract Introduction Narcolepsy is a rare, chronic sleep disorder associated with decreased quality of life and multiple comorbid conditions, including sleep-related and psychiatric or mood disorders. This study used aggregate electronic health record (EHR) data to characterize the demographics and comorbidities of patients with narcolepsy. Methods An EHR-based search identified first-time Duke Health patients between January 1, 2012, and March 31, 2024. Included patients had ≥1 narcolepsy-specific ICD-9 (347.*) and ICD-10 (G47.4*) codes and ≥1 disease-supportive statement in clinical notes, identified using a natural language processing algorithm. A control cohort was propensity-matched for birth year, age at first institutional encounter, sex, race, number of diagnosis code instances, and mortality. Common comorbidities were compared and ranked between cohorts by odds ratio (OR). Statistical significance was determined using a chi-squared test; P values were corrected for multiple comparisons using Bonferroni correction. Results Within the EHR database of 2,617,188 patients, 1659 patients with a narcolepsy diagnosis were identified (mean age at first presentation, 32.4 years; white, 69%; female, 69%); the propensity-matched control cohort included 1659 patients (mean age at first presentation, 32.3 years; white, 69%; female, 69%). Comorbidities that occurred statistically significantly more frequently (all P 0.0001) among the narcolepsy vs control cohort (OR 95% CI) included sleep disorders: sleep-related movement disorders (26.26 10.71-64.40), hypersomnia (16.56 12.54-21.87), and circadian rhythm sleep disorders (15.43 6.73-35.38); psychiatric or mood disorders: posttraumatic stress disorder (3.08 2.10-4.52), attention deficit hyperactivity disorder (2.90 2.28-3.68), and depression (2.66 2.27-3.11); and pain disorders: trigeminal neuralgia (6.63 2.80-15.70), fibromyalgia (5.30 3.58-7.85), and chronic pain syndrome (3.37 2.46-4.61). Postural orthostatic tachycardia syndrome occurred statistically significantly more frequently (P 0.0001) in the narcolepsy vs control cohort (7.24 3.59-14.61). Conclusion Consistent with prior EHR research, sleep, psychiatric, mood, and pain disorders were among the most frequently reported comorbidities of patients with narcolepsy. The results of this analysis of real-world demographic and clinical information of patients with narcolepsy may further inform clinicians of the most relevant concomitant disease states to consider when evaluating potential therapies. Support (if any) Avadel Pharmaceuticals
Soltis et al. (Fri,) studied this question.