Quality of life in patients with narcolepsy with cataplexy, narcolepsy without cataplexy, and idiopathic hypersomnia without long sleep time: Comparison between patients on psychostimulants, drug-naïve patients and the general Japanese population

Ozaki, Akiko; Inoue, Yuichi; Hayashida, Kentaro; Nakajima, Toru; Honda, Masashi; Usui, Akira; Komada, Yoko; Kobayashi, Mina; Takahashi, Keiichi

doi:10.1016/j.sleep.2011.07.014

Cited by 83 publications

(42 citation statements)

References 24 publications

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“…In addition, this study corroborates previous findings that narcolepsy is strongly associated with impairment in physical and mental HRQoL. [5][6][7][8][9][10][12][13][14] To our knowledge, few prior studies have reported the societal costs that arise from the work productivity loss and healthcare resource use associated with narcolepsy in the United States. Black et al 17 did find that compared to matched controls, patients in whom narcolepsy was diagnosed had approximately twofold higher annual rates of inpatient admissions, emergency department visits (without admission), hospital outpatient visits, other outpatient services, and physician visits (all p < 0.001).…”

Section: Discussionsupporting

confidence: 90%

“…3,4 Numerous studies have found health-related quality of life (HRQoL) among narcolepsy patients to be significantly impaired in comparison with healthy controls or the general population. [5][6][7][8][9][10][11][12][13][14] Patients are impaired on several domains of HRQoL including mood, psychopathology, and other areas such as marital and work problems. [5][6][7][8][9][10][11][12][13][14] Narcolepsy has been associated with a negative impact on work productivity including increased unemployment, 15 early retirement, 16 accidents at work, 5 welfare enrollment, 11 time missed from work, general impairment at work, 8 and lower wages.…”

Section: Introductionmentioning

confidence: 99%

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The Humanistic and Economic Burden of Narcolepsy

Flores

Villa

Black

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls. Methods: This analysis was conducted on data from the NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013. Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization. Results: Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p < 0.05). Conclusions: These population-based data suggest that a narcolepsy diagnosis is associated with substantial adverse impact on mental health, HRQoL, and key economic burdens that include work impairment, resource use, and both direct and indirect costs. Although this study is cross-sectional, the results highlight the magnitude of the potential opportunity to improve mental health, lower costs, and augment work-related productivity through effective assessment and treatment of narcolepsy. I NTRO DUCTI O NNarcolepsy is a chronic disorder characterized by excessive daytime sleepiness that can be associated with significant effect on quality of life and disability. Narcolepsy is also associated with obesity, nighttime sleep disturbances, and functional impairment.1,2 Narcolepsy typically presents during teenage years or young adulthood and persists through adulthood. Prevalence estimates range between 25 and 50 per 100,000 people. 3,4 Numerous studies have found health-related quality of life (HRQoL) among narcolepsy patients to be significantly impaired in comparison with healthy controls or the general population. [5][6][7][8][9][10][11][12][13][14] Patients are impaired on several domains of HRQoL including mood, psychopathology, and other areas such as marital and work problems.5-14 Narcolepsy has been associated with a negative impact on work productivity including increased unemployment, 15

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The Humanistic and Economic Burden of Narcolepsy

Flores

Villa

Black

et al. 2016

Journal of Clinical Sleep Medicine

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“…Leisure activity is destined to decline with increasing daytime somnolence and sleep attacks. [22232425] Hence, there is a clear need to explore all these facets of the disease so that you can develop a comprehensive and holistic approach to management. A patient-based approach was followed in the management of each of our patients.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of narcolepsy in the Indian scenario

Sureshbabu

Muniem

Bhatia³

2016

Ann Indian Acad Neurol

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Introduction:The diagnosis and management of narcolepsy in the Indian context needs to be revisited especially in the wake of concerns raised by sleep medicine experts that the entity could be formidably underdiagnosed, as well as undertreated in our setting.Materials and Methods:The history, clinical records, polysomnographic/multiple sleep latency test data, and treatment records of five hundred consecutive patients attending a dedicated sleep clinic between the years 2013 and 2016 were retrospectively analyzed. The response to treatment measures and improvement in daytime functioning were periodically assessed by personal/telephonic interview and E-mail communication.Results:Thirteen patients were diagnosed with narcolepsy based on the standard criteria of which three had cataplexy. The mean age of presentation was 23.23 years and the male:female ratio was 2.25:1. The mean duration from the onset of symptoms to diagnosis was 4.2 years. Two patients responded to nonpharmacological interventions alone, and six to modafinil, while two patients remained symptomatic and required treatment with methylphenidate. One patient was lost to follow-up, while two others are due for their first follow-up.Conclusion:A refurbished outlook of the diagnostic methodology and treatment paths tailored to our clinical scenario can potentially impact the future of narcolepsy management and research in our country.

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“…Although the function of sleep is largely unknown, 'quality of sleep' is an important clinical measure for multiple reasons: complaints about diminished quality of life through impaired quality of sleep is a common reason for patients to attend their physician. 15 Patients with impaired quality of sleep suffer both physically and mentally 16 with sleep quality linked to neurological and psychological problems, 17 postoperative cognitive dysfunction, 18 impaired immune function, 19 and diseases like irritable bowel syndrome. 20 In addition, a lack of sleep quality has been shown to be directly associated with mortality.…”

Section: Discussionmentioning

confidence: 99%

Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial

Wenk

Pöpping

Chapman

et al. 2013

British Journal of Anaesthesia

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Editor's key points † Sleep quality is important to patients and can be disrupted by hospital admission for surgery. † Remifentanil was shown to have long-term effects on sleep quality in children. † This study aimed to use patient self-report measures to assess sleep quality 6 months after surgery. † Preoperative 'good sleepers' were affected most by remifentanil after 6 months.Background. Clinical and pre-clinical data agree that opioids disrupt sleep architecture.Recently, remifentanil has been suggested to cause possible long-term disturbances of sleep quality. This randomized controlled clinical trial was designed to substantiate or refute a possible long-term effect of remifentanil on the quality of sleep.Methods. One hundred patients undergoing elective surgery were randomized to receive either fentanyl or remifentanil-based anaesthesia. Before operation (T0) and 3 (T3) and 6 (T6) months after operation, the quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). Results.Overall, the quality of sleep for patients in the remifentanil or fentanyl group was not significantly different at any time point. Patients in the fentanyl group screened as good sleepers before operation showed no differences across time course of the study in PSQI scores. In contrast, good sleepers in the remifentanil group had significantly impaired sleep quality for at least 3 months after operation. Patients who were before operation screened as poor sleepers showed no significant changes in PSQI scores at T3 and T6 in both groups.Conclusions. The intraoperative use of remifentanil in a general patient population does not significantly alter the quality of sleep in the postoperative period. However, it may result in a significant reduction in the quality of sleep in patients before operation considered good sleepers. These changes were not observed in the group of patients receiving fentanyl. The relevance of these findings in terms of patient recovery and quality-of-life warrants further investigation.Trial Registration. ACTRN12610000362099.Anaesthesia causes distinct disturbances in the integrity of body functions that may extend beyond the acute postoperative period. It has multiple effects on the circadian rhythm and sleep-wake cycle but also affects other circadian rhythms such as cortisol, 1 melatonin secretion, 2 and temperature control. 3 A central circadian (24 h) pacemaker in the suprachiasmatic nuclei coordinates circadian oscillators in many cells of mammals in order to synchronize and organize daily rhythms in behaviour and physiology. Exactly how anaesthesia in general and, more specifically, which drugs affect these sensitive systems is not fully understood. Data from animal and human research suggest that opioids play a highly complex role: they inhibit the rapid eye movement (REM) phase of sleep and decrease acetylcholine (ACh) release at the cholinergic cell body region in the laterodorsal tegmental nuclei (LDT) and the terminal field in medial pontine reticular formation (mPRF) regions that cont...

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Quality of life in patients with narcolepsy with cataplexy, narcolepsy without cataplexy, and idiopathic hypersomnia without long sleep time: Comparison between patients on psychostimulants, drug-naïve patients and the general Japanese population

Cited by 83 publications

References 24 publications

The Humanistic and Economic Burden of Narcolepsy

The Humanistic and Economic Burden of Narcolepsy

Diagnosis and management of narcolepsy in the Indian scenario

Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial

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