Narcolepsy in Europe

First created | 06/25/2002

Last edited   | 12/11/2011

Summary by Maurice M. Ohayon, MD, DSc, PhD

Reference to cite: Ohayon MM, Priest RG, Zulley J, Smirne S, Paiva T. Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology. 2002 Jun 25;58(12):1826-33.

 

Narcolepsy was first labeled by Gelineau in 1880.

Yoss and Daly, in 1957, completed the description of the disease and described the narcolepsy tetrad, which consists of:

• sudden sleep periods
• cataplexy,
• hypnagogic hallucinations and,
• sleep paralysis.

This description still prevails today in sleep disorders classification (International Classification of Sleep Disorders and DSM-IV).

 

Most prevalences are derived from:

• clinical samples (Roth, 1980; Franceschi et al., 1982; Wilner et al., 1988; Wing et al., 1994)

• or non-representative community samples (Solomon, 1945; Dement et al., 1972. 1973; Honda et al., 1983)

According to these first studies, the prevalence varied from 20 to 67 per 100,000 inhabitants in Europe and North America (Franceschi et al., 1982; Dement et al., 1972. 1973; Hublin et al., 1994).

 

A study performed in Japan set this rate at 590 per 100,000 inhabitants (Tashiro et al., 1992).

Another Japanese study set this rate at 160 per 100,000 inhabitants (Honda, 1979).

 

In Hong Kong, this prevalence was estimated to be between 1 and 40 narcoleptics per 100,000 inhabitants (Wing et al., 1994), and in Saudi Arabia 40 per 100,000 inhabitants (al Rajeh et al., 1993).

 

 Another study performed with Jews in Israel, a population known for its low rate of human leukocyte antigen (HLA-DR2), a predisposing marker for narcolepsy, set the prevalence at 0.23 per 100,000 inhabitants (Wilner et al., 1988).

 

None of these previous studies assessed the prevalence of the diagnostic elements of the narcolepsy diagnosis in a large representative sample of the general population.

Research

 

To determine the prevalence of narcolepsy in the general population of five European countries.

Target population: 205,890,882 inhabitants.
 

Overall, 18,980 randomly selected subjects were interviewed (participation rate: 80.4%).

 

These subjects were representative of the general population of :

• the United Kingdom,

• Germany,

• Italy,

• Portugal

• and Spain.

They were interviewed by telephone using the Sleep-EVAL expert system, which provided narcolepsy diagnosis according to the International Sleep Disorders classification (ICSD) and the Psychiatric Disorders Classification (DSM-IV).

Results

 

• Excessive daytime sleepiness was reported by 15% of the sample, with a higher prevalence in the United Kingdom and Germany.
• Cataplexy (episodes of loss of muscle function related to a strong emotion), a cardinal symptom of narcolepsy, was found in 1.6% of the sample.

A narcolepsy diagnosis was found in 0.047% of the sample. The narcolepsy was severe for 0.026% of the sample and moderate in 0.021% of the sample.
This was the first epidemiological study that estimated the prevalence of narcolepsy in the general population of five European countries. Narcolepsy affects 47 individuals per 100,000 inhabitants.
 

References

 

More Information

 

Dyssomnias
Dyssomnias are sleep disorders characterized by abnormalities in the quantity, quality or timing of sleep

 

Breathing Disorders
Sleep disordered breathing encompasses a spectrum of conditions whose common feature is intermittent loss of upper airway patency associated with sleep

 

Hypersomnia (disabled)

 

Insomnia
More than fifty studies of insomnia based on data collected in various representative community-dwelling samples or populations were published with highly variable rates

Excessive Daytime Sleepiness
Prevalence of daytime sleepiness has been reported to range from 0.5% to about 40%

 

Narcolepsy
This syndrome is characterized by an imperative need to sleep suddenly and for brief periods, recurring at more or less close intervals

 

Periodic Limb Movement
This syndrome is characterized by periodic episodes of repetitive limb movements caused by contractions of the muscles during sleep

 

Restless Legs Syndrome
Restless legs syndrome, initially reported by Ekbom (1944), is characterized by disagreeable leg sensations occurring most often at sleep onset that provoke an urge to move the legs