Introduction: Narcolepsy is a chronic brain disease with the cerebral dysfunction in modulating the mechanism of sleep and awakening. Previous studies showed the disease burden of narcolepsy can be high. Besides the medical cost, impairment and economic loss related to narcolepsy, both medical and psychiatric comorbidities are common in patients with narcolepsy. In this study, we used a clinical narcolepsy cohort conducted in Chang Gung Memorial Hospital to validate data of the Taiwan's National Health Insurance Research Database. This study aims to investigate the prevalence and incidence of narcolepsy in Taiwan, as well as its disease burden including medical and psychiatric comorbidities.
Subject: (1) To assess the incidence and prevalence of patients with narcolepsy type 1(NT1), narcolepsy type 2(NT2), and idiopathic hypersonic(IH) in Taiwan. (2) Characterize and assess the patient journey among those with NT1 and NT2; (3) Assess treatment patterns and burden of illness among patients with NT1 and NT2, and to explore the long-term outcomes of narcolepsy and IH patients in Taiwan.
Results: The cohort database collected 404 patients’ information. The distribution of patients in this database are 68 patients with IH (17.00%), 209 patients with NT1 (52.25%), and 121 patients with NT2 (30.50%), respectively. A total of 26,780 patients with IH, NT1 and NT2 were retrieved from in the NHIRD by ICD9/ICD10 code between 2009-2019. With a total of 1009 patients with NT1 and NT2, considering that the calculated precision of narcolepsy by NHIRD is 47.7%, estimated prevalence of narcolepsy in Taiwan is around 0.91 per 10,000 people. Most common psychiatric comorbidities include anxiety disorder in group NHIRD and clinical database (12% and 30%) and depression ( 13% and 19%). Obstructive sleep apnea is common ( 25% and 27% ). Common physical comorbidities include diabetes mellitus (5%), hypertension (11%), and cardiovascular disease (6% and 5%).
Discussion: Consider the precision rate of validation, estimated prevalence of narcolepsy in Taiwan is lower than that in Hong Kong. The result indicates that narcolepsy can be under-diagnosed or treated inadequately in Taiwan. But the disease burden including medical and psychiatric comorbidities should be reminded.
Support: Taiwan National Science and Technology Council and Takeda Pharmaceutical Company
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