Narcolepsy, Idiopathic Hypersomnia Tied to Lower Health-Related Quality of Life

Health-related quality of life (HRQoL) is reduced among those with narcolepsy and idiopathic hypersomnia (IH) with the greatest reductions occurring in narcolepsy type 2 (NT2) and IH. These are the findings of a study published in the journal Sleep Medicine.

Narcolepsy type 1 (NT1), NT2, and IH are considered central disorders of hypersomnolence (CDH). Of these 3 CDH, NT1 is associated with a reduction in HRQoL; however, there is limited data on the relationship between NT2, IH, and HRQoL.

Researchers in the Czech Republic conducted a cross-sectional study with 3 groups of patients with CDH (NT1, NT2, and IH) from September 2020 to July 2023 to evaluate the subjective perceptions of HRQoL in adult patients with these sleep disorders.

Participants with NT1, NT2, and IH, as well as a healthy control group, underwent sleep assessments including the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Narcolepsy Severity Scale (NSS), Hypersomnia Severity Scale (HSS), and Sleep Inertia Questionnaire (SIQ); additional assessments included the Hospital Anxiety and Depression Scale (HADS) and the Short Form Health Survey (SF-36).

All participants underwent an in-person interview with a clinical psychologist. The Shapiro-Wilk, Mann-Whitney, Kruskal-Wallis, and Dwass-Steel-Critchlow-Flinger tests, as well as the Spearman Correlation coefficient, were used for statistical analysis.

A total of 158 participants were included:

• NT1 (n=64; men, 40.6%; mean age, 36.9 years [SD, 11.0])
• NT2 (n=22; men, 36.4%; mean age, 39.7 years [SD, 12.9])
• IH (n=31; men, 35.5%; mean age, 40.3 years [SD, 31.1])
• HC (n=41; men, 46.3%; mean age, 35.9 years [SD, 9.6])

The presence of a psychiatric disorder was associated with decreased HRQoL among those with CDH (P <.001) and the highest prevalence of psychiatric disorders was observed in individuals with IH (51.6%) and NT2 (50.0%).

Among individuals with vs without CDH, scores on all scales and questionnaires were worse.

Compared with individuals with NT2 and IH, those with NT1 reported higher subjective daytime sleepiness (P <.01); narcolepsy severity was higher in individuals with NT1 vs NT2 (P <.001).

Compared with individuals with NT1, those with NT2 and IH had worse sleep inertia (P <.01 for both) and depression (P <.001; P <.05, respectively).

Individuals with vs without IH had more intense depressive symptoms (P <.01). No significant differences were observed for anxiety among the 3 CDH groups.

Individuals with NT2 and IH had a worse SF-36 mental component score (MCS) vs those with NT1 (P <.05). ESS scores correlated with SF-36 MCS in those with NT2 (P <.05) and with the SF-36 physical component score (PCS) and SF-36 MCS in IH (P <.01).

Study limitations included a heterogeneous patient population.

“Considering the specifics of the impact on the lives of patients with CDH, it is reasonable to consider a specific HRQoL assessment tool and its use in clinical practice,” the researchers concluded.