Jiang Rena Y, Rochart Roger, Chu Irene, Duka Shae, Vendrame Martina
Lehigh Valley Fleming Neuroscience Institute, Lehigh Valley Health Network, Allentown, Pennsylvania.
University of South Florida Morsani College of Medicine, Tampa, Florida.
J Clin Sleep Med. 2025 Mar 1;21(3):479-491. doi: 10.5664/jcsm.11430.
We aimed to characterize clinical features, comorbidities, and polysomnographic characteristics of a large cohort of patients with narcolepsy.
We undertook a retrospective chart and polysomnographic review of all patients with a diagnosis of narcolepsy type 1 (NT1) or narcolepsy type 2 (NT2) seen within the Lehigh Valley Health Network between 2000 and 2022.
We found 304 cases with a diagnosis of narcolepsy (52 NT1, 252 NT2), based on , third edition criteria. Compared to NT2, patients with NT1 had younger diagnosis age (24.5 vs 27.4 years, = .03), shorter diagnostic gap (3.0 vs 4.6 years, = .002), more frequent sleep paralysis (55.8% vs 19.4%, < .0001) and hypnagogic hallucinations (46.2% vs 25.4%, = .003), and higher Epworth Sleepiness Scale scores (17.8 vs 16.7, = .02). The most common comorbid sleep disorders were breathing disorders (17.4%) and insomnia (15.5%). Migraine was the most common neurological disorder. Depression was more common in NT2 than NT1 (12 [23.1%] vs 94 [37.3%], = .05). On the Multiple Sleep Latency Test, patients with NT1 had more sleep onset rapid eye movement periods than patients with NT2 (≥ 3 sleep onset rapid eye movement periods in 59.2% vs 26.9%, < .0001). Only in NT2, hypnagogic hallucinations and higher Epworth Sleepiness Scale scores were associated with higher numbers of sleep onset rapid eye movement periods ( = .0277 and = .0179, respectively).
This is one of the largest monocentric studies to date of patients with narcolepsy and confirms the frequent comorbidities of narcolepsy. Specific clinical characteristics and comorbidities may help differentiate NT1 from NT2.
Jiang RY, Rochart R, Chu I, Duka S, Vendrame M. The Lehigh Valley Health Network Narcolepsy Cohort: clinical and polysomnographic analysis of 304 cases. . 2025;21(3):479-491.
我们旨在描述一大群发作性睡病患者的临床特征、合并症及多导睡眠图特征。
我们对2000年至2022年期间在里海谷医疗网络就诊的所有诊断为1型发作性睡病（NT1）或2型发作性睡病（NT2）的患者进行了回顾性病历和多导睡眠图检查。
根据《国际睡眠障碍分类》第三版标准，我们发现304例发作性睡病患者（52例NT1，252例NT2）。与NT2相比，NT1患者的诊断年龄更小（24.5岁对27.4岁，P = 0.03），诊断间隔更短（3.0年对4.6年，P = 0.002），睡眠麻痹（55.8%对19.4%，P < 0.0001）和入睡前幻觉（46.2%对25.4%，P = 0.003）更频繁，埃普沃思嗜睡量表评分更高（17.8对16.7，P = 0.02）。最常见的合并睡眠障碍是呼吸障碍（17.4%）和失眠（15.5%）。偏头痛是最常见的神经系统疾病。抑郁症在NT2中比NT1中更常见（12例[23.1%]对94例[37.3%]，P = 0.05）。在多次睡眠潜伏期试验中，NT1患者比NT2患者有更多的睡眠开始快速眼动期（≥3个睡眠开始快速眼动期的比例为59.2%对26.9%，P < 0.0001）。仅在NT2中，入睡前幻觉和更高的埃普沃思嗜睡量表评分与更多的睡眠开始快速眼动期相关（分别为P = 0.0277和P = 0.0179）。
这是迄今为止关于发作性睡病患者的最大规模单中心研究之一，证实了发作性睡病常见的合并症。特定的临床特征和合并症可能有助于区分NT1和NT2。
Jiang RY, Rochart R, Chu I, Duka S, Vendrame M. 里海谷医疗网络发作性睡病队列：304例患者的临床和多导睡眠图分析。《[期刊名称未给出]》。2025；21(3):479 - 491。
