A recent large-scale study has found that individuals diagnosed with narcolepsy face a significantly higher risk of developing cardiovascular disease (CVD) and experiencing major adverse cardiovascular events (MACE) compared to those without the sleep disorder. As reported by Clinical Advisor, the findings underscore the importance of routine cardiovascular screening and proactive monitoring in this vulnerable population.
Study Overview
The study analyzed data from over 34,000 patients with newly diagnosed narcolepsy and compared them to more than 100,000 matched controls without narcolepsy or hypersomnia. Researchers used sophisticated matching techniques to account for differences in demographics, existing medical conditions, and baseline medication use, ensuring that the observed differences in cardiovascular outcomes were robust.
The average participant age was about 40 years, and women made up over 60% of the narcolepsy cohort. Many participants also had other health issues at the start, such as sleep apnea (nearly 37%) and mood disorders (almost 29%). Use of medications like SSRIs, benzodiazepines, and SNRIs was also common among those with narcolepsy.
Key Findings
Even after adjusting for the use of stimulant medications—commonly prescribed for narcolepsy—patients with the disorder were nearly twice as likely to develop CVD (adjusted hazard ratio [aHR] 1.89) and MACE (aHR 1.95) compared to controls. This elevated risk was consistent across various outcomes, including:
- Heart failure (aHR 1.90)
- Stroke (aHR 2.06)
- Myocardial infarction (heart attack) (aHR 1.93)
The heightened cardiovascular risk was observed regardless of age, sex, or additional comorbidities. Importantly, the risk was similar for both narcolepsy type 1 and type 2. Further analyses that excluded patients who had received certain narcolepsy treatments before diagnosis confirmed these results.
Study Limitations and Implications
The authors note some limitations, including reliance on insurance claims data rather than clinical confirmation of narcolepsy, and the potential for unmeasured confounding factors. Despite these limitations, the study’s large sample size and rigorous design lend strength to its findings.
Given the significant increase in cardiovascular risk, the study’s authors recommend that all patients with narcolepsy undergo routine cardiovascular screening and receive ongoing monitoring to help mitigate potential health complications.
