Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia.
Sleep Breath. 2019 Jun;23(2):603-609. doi: 10.1007/s11325-019-01807-5. Epub 2019 Feb 28.
Narcolepsy is an uncommon neurological disorder characterized by excessive daytime sleepiness (EDS) and multiple other symptoms. Due to the under-recognition of narcolepsy symptoms, patients are often misdiagnosed. This study aimed to assess the types of specialties visited and the diagnoses received by Saudi patients prior to their narcolepsy diagnosis.
The study included 55 consecutive patients with type-1 and type-2 narcolepsy who attended the narcolepsy clinic between August 2017 and December 2017. Narcolepsy was diagnosed according to the International Classification of Sleep Disorders-third edition criteria. We evaluated sociodemographic data, the specialties visited, and diagnoses and treatments received prior to visiting a sleep specialist.
The mean diagnostic delay was 9.1 ± 8.4 years (1-43 years). Multiple linear regression analysis identified early onset as the only predictor of a delayed diagnosis (β coefficient = - 0.262, p = 0.03). EDS was the main symptom that prompted patients to seek medical consultation, and only one patient had been (1.8%) referred with the diagnosis of narcolepsy. In the study group, 82% of the patients were misdiagnosed with a mental or neurological disorder or were thought to be afflicted by "envy," "evil eye," or "black magic" before receiving a correct diagnosis. No significant differences were detected between patients with narcolepsy type-1 and narcolepsy type-2.
Delays in diagnosing narcolepsy remain a major problem for Saudi patients with this disorder. We found that Saudi patients with narcolepsy had visited several medical specialists and faith healers and were misdiagnosed prior to visiting a sleep specialist.
发作性睡病是一种罕见的神经系统疾病，其特征是白天过度嗜睡（EDS）和多种其他症状。由于对发作性睡病症状的认识不足，患者经常被误诊。本研究旨在评估沙特患者在被诊断为发作性睡病之前就诊的专业类型和获得的诊断。
本研究纳入了 2017 年 8 月至 2017 年 12 月期间在发作性睡病诊所就诊的 55 例 1 型和 2 型发作性睡病患者。根据国际睡眠障碍分类第三版标准诊断发作性睡病。我们评估了社会人口统计学数据、就诊的专业类型以及在就诊于睡眠专家之前获得的诊断和治疗。
平均诊断延迟为 9.1±8.4 年（1-43 年）。多元线性回归分析发现，早期发病是诊断延迟的唯一预测因素（β系数=-0.262，p=0.03）。EDS 是促使患者寻求医疗咨询的主要症状，只有 1 例（1.8%）患者因发作性睡病被转诊。在研究组中，82%的患者被误诊为精神或神经系统疾病，或被认为患有“嫉妒”、“邪眼”或“黑魔法”，然后才得到正确的诊断。在 1 型发作性睡病患者和 2 型发作性睡病患者之间未发现显著差异。
延迟诊断发作性睡病仍然是沙特患者的一个主要问题。我们发现，沙特发作性睡病患者曾就诊于多个医学专家和信仰治疗师，并在就诊于睡眠专家之前被误诊。
