Narcolepsy is a sleep disorder that specifically affects the rapid eye movement (REM) cycle. Hallmark symptoms of narcolepsy include excessive daytime sleepiness (EDS) and disruption of the sleep-wake cycle. Patients with narcolepsy enter REM sleep rapidly (within 15 minutes) and can suffer from sleep attacks, or the sudden need to sleep, often at inappropriate times. A recent study published by Christopher Kaufmann and colleagues in the Journal of the American Heart Association identified an increased risk of cardiovascular disease (CVD) in people with narcolepsy.
The study reviewed US medical claims databases from 2005 to 2021 and compared CVD outcomes in narcolepsy patients and non-narcoleptic controls. Compared to the controls, people with narcolepsy (PWN) were 1.40 times more likely to develop hypertension, 1.41 times more likely to develop hyperlipidemia, 1.50 times more likely to develop diabetes, and 1.48 times more likely to develop NAFLD/NASH (MASLD/MASH). Narcoleptic patients were also found to be at 1.69 times greater risk of major adverse cardiac events (MACE) and 1.61 times greater risk of CVD in general than non-narcoleptic controls. These results corroborate a previous correlation between narcolepsy and CVD and demonstrate the first connection between narcolepsy and an increased risk of NAFLD/NASH (MASLD/MASH).
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Researchers found that the risk of CVD outcomes in narcoleptic patients was not affected by either subtype or by pharmaceutical treatment. However, the risk of CVD factors increased more dramatically in patients under 25 years. Hypertension in PWN rose to 2.01 times greater risk, hyperlipidemia rose to 1.84 times greater risk, and diabetes rose to 2.37 times greater risk than in the control group. This is the first reporting of higher CVD risk in PWN under 25 years of age.
The two major subtypes of narcolepsy are Type 1 and Type 2. GlobalData epidemiologists predict 105,560 diagnosed prevalent cases of Type 1 and Type 2 narcolepsy in the US in 2025. Type 1, previously known as “narcolepsy with cataplexy,” is diagnosed either by low levels of REM-controlling hormone hypocretin, or the presence of cataplexy (sudden muscle weakness) along with EDS. Type 2, previously known as “narcolepsy without cataplexy,” is considered less severe. While EDS is present, cataplexy is absent and hypocretin levels are normal.
Narcolepsy can be caused by multiple factors, including family history, autoimmune disorders, and brain injury (secondary narcolepsy). Treatments for narcolepsy include lifestyle adjustments like naps, exercise, and avoiding late caffeine, as well as pharmaceutical interventions such as antidepressants, stimulants, and sodium oxybate.
Increased attention to CVD risk factors, beginning under age 25 years, has the potential to improve cardiac outcomes and decrease the overall health burden of narcolepsy.
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By GlobalData