Narcolepsy may be a risk factor for cardiovascular disease and adverse cardiac events, study finds

Two new studies to be presented at the SLEEP 2024 annual meeting showed that narcolepsy is an independent risk factor for cardiovascular disease and adverse cardiac events.

According to the American Academy of Sleep Medicine, narcolepsy is a central disorder of hypersomnolence primarily characterized by repeated daily episodes of an irrepressible need to sleep or lapses into drowsiness or sleep. In some cases, sleepiness manifests as sudden, irresistible sleep “attacks” that may occur in unusual situations such as eating or walking. People who have narcolepsy also may experience episodes of cataplexy, which involve the sudden loss of muscle tone with retained consciousness, along with hallucinations or sleep paralysis during the transition from wake to sleep.

The cohort studies used the 2005-2021 Commercial and Medicare Supplemental databases to identify people with a first diagnosis of narcolepsy and a comparison cohort of people without narcolepsy. Both study samples comprised 34,562 people with narcolepsy and 1,00,405 matched controls. The researchers controlled for the use of stimulants, oxybates, and other wake-promoting agents because these medications are commonly used to treat excessive daytime sleepiness associated with narcolepsy.

Results showed that people who have narcolepsy, compared with those without narcolepsy, had a 77% increased risk of any cardiovascular disease and an 82% increased risk of major adverse cardiovascular events.

Their risk of stroke was two times higher, and they also had a 64% increased risk of heart failure or myocardial infarction, and a 58% increased risk of atrial fibrillation.

In another analysis of the same study population that controlled for the use of stimulants, oxybates, and wake-promoting agents at baseline, as well as time-varying stimulant use, people who have narcolepsy had an 89% higher risk of cardiovascular disease and a 95% higher risk of major adverse cardiac events.

“Our investigation revealed a significant finding: the connection between narcolepsy and cardiovascular disease persisted even after accounting for stimulant use. This suggests a direct correlation between cardiovascular disease and narcolepsy. Understanding the positive relationship between narcolepsy and cardiovascular disease independent of stimulants is meaningful for health care providers, especially when determining treatment options for patients,” said lead author Munaza Riaz.

Reference: Christopher Kaufmann, Munaza Riaz, Haesuk Park, Wei-Hsuan Lo-Ciganic, Debbie Wilson, Atul Malhotra, Emerson Wickwire, R Bhattacharjee, 0857 Evidence for an Independent Association of Cardiovascular Disease in Patients with Narcolepsy, Sleep, Volume 47, Issue Supplement_1, May 2024, Page A368, https://doi.org/10.1093/sleep/zsae067.0857