The studies reveal that individuals with narcolepsy, compared to those without the condition, face a 77% higher risk of developing any cardiovascular disease and an 82% higher risk of experiencing major adverse cardiovascular events. Additionally, their risk of stroke is twice as high, they have a 64% increased risk of heart failure or heart attack and a 58% higher risk of atrial fibrillation.
In another part of the study, which considered the use of stimulants, oxybates, and wake-promoting agents at the start and throughout the study period, people with narcolepsy were found to have an 89% higher risk of cardiovascular disease and a 95% higher risk of major adverse cardiac events.
Christopher Kaufmann, who holds a doctorate in public mental health and is an assistant professor at the University of Florida College of Medicine, mentioned that their carefully designed study using propensity score matching provided strong evidence about the narcolepsy and cardiovascular disease link. He explained that even after considering other significant factors like obstructive sleep apnea and diabetes, the narcolepsy and cardiovascular disease connection remained evident.
Dr. Rakesh Bhattacharjee, the director of pediatric sleep medicine at Rady Children’s Hospital-San Diego and an associate professor at UC San Diego, emphasized that their findings strongly supported the significant link connecting narcolepsy to cardiovascular disease.
Narcolepsy, as defined by the American Academy of Sleep Medicine, is a central disorder of hypersomnolence characterized by frequent, overwhelming urges to sleep or sudden lapses into drowsiness or sleep. In some cases, this sleepiness can lead to sudden, uncontrollable sleep “attacks” that occur during activities like eating or walking. Individuals with narcolepsy might also experience episodes of cataplexy, where there is a sudden loss of muscle tone while remaining conscious, as well as hallucinations or sleep paralysis when transitioning from wakefulness to sleep.
The retrospective cohort studies analyzed data from the 2005–2021 IBM MarketScan Commercial and Medicare Supplemental databases to identify people with an initial diagnosis of narcolepsy and a control group without narcolepsy. Both groups included 34,562 individuals with narcolepsy and 100,405 matched controls. The average age of the participants was 40 years, and 62% were female.
The researchers accounted for the use of oxybates, stimulants, and various wake-promoting agents. These medications are typically used to treat excessive daytime sleepiness in individuals with narcolepsy.
Lead author Munaza Riaz, with a doctorate in pharmaceutical outcomes and policy and a postdoctoral associate at the University of Florida, highlighted a significant finding: the link connecting narcolepsy to cardiovascular disease remained strong even after considering stimulant use. She noted that this indicates a direct link between cardiovascular disease and narcolepsy. This understanding is important for healthcare providers, especially when deciding on treatment options for patients with narcolepsy.