The SLEEP 2024 Annual Meeting took place this year from June 1 to June 5 in Houston, TX. During the course of this premier sleep conference, stakeholders across the sleep space explored new clinical practices and research in sleep and circadian medicine and science. Two studies, shares the American Academy of Sleep Medicine, centered around the interconnectivity between narcolepsy and cardiovascular disease.

Discussions on narcolepsy and heart health are not new. The American Heart Association explains that narcolepsy can increase blood pressure at night, which in turn can put more strain on the heart. However, research into the relationship between narcolepsy and cardiovascular disease remains lacking. The two presented retrospective cohort studies aimed to uncover a more concrete understanding of how these conditions relate.

The study findings, published in Sleep, used data to develop two cohorts including 34,562 people with narcolepsy and 100,405 matched controls. After comparing incidences of cardiovascular health, the studies determined that people with narcolepsy saw a 77% higher risk of cardiovascular disease. Additionally, the chance of having a major adverse cardiovascular event (MACE), such as a stroke or myocardial infarction, rose by 82%. When diving deeper into the statistics, heart failure and myocardial infarction risk rose by 64%. For atrial fibrillation, the risk heightened by 58%. Finally, people with narcolepsy were twice as likely to experience a stroke.

Researchers wondered if controlling for narcolepsy treatment use would lower the risks, but the opposite occurred. Cardiovascular disease risk rose to 89%, and MACE to 95%.

Ultimately, these studies underscore a correlation between cardiovascular disease and narcolepsy. Why these conditions may coexist, or why narcolepsy so significantly impacts the risk of cardiovascular disease, is still yet to be determined. Future research should explore the underlying mechanisms connecting these conditions to identify potential therapies or interventions to mitigate risk.

Understanding Narcolepsy

Narcolepsy is a chronic neurological disorder which causes sleep-wake cycle dysregulation. People with this condition may fall asleep instantly for a few moments, a few minutes, or longer. Upon waking, people with narcolepsy may experience hallucinations. Because its primary symptom is excessive daytime sleepiness, narcolepsy can be difficult to diagnose. Some physicians may write this symptom off, but it’s important to increase physician awareness for easier identification and diagnosis.

There are two forms of narcolepsy. In type one, affected individuals also experience cataplexy, where they lose muscle control. Cataplectic attacks differ for each person. Some individuals have mild symptoms (eyelid fluttering) while others may fall over. Typically, cataplectic attacks are triggered by excitement, anger, or other strong emotions. Type 2 narcolepsy is characterized by excessive daytime sleepiness, as is type 1, but individuals do not have cataplexy.

Additional signs or characteristics of narcolepsy can include:

• Insomnia
• Sleep disruptions such as sleep apnea or vivid dreaming
• Automatic behaviors (completing known behaviors while asleep)
• Sleep paralysis

Treatment options are available. These include Xyrem, XYWAV, stimulants, and antidepressants. Speak with your doctor to determine the best treatment plan for you.