Following is a news release based on an article published in the February issue of Neurology, the scientific journal of the American Academy of Neurology (AAN). The AAN is an association of more than 15,000 neurologists and neuroscience professionals dedicated to improving patient care through education and research. For a copy of the full article or for more information, contact Sarah Parsons at (612) 695-2732 or by e-mail [email protected].
EMBARGOED FOR RELEASE UNTIL MONDAY, FEBRUARY 23, 1998
Narcolepsy Often Underdiagnosed in People Over 40
ST. PAUL, MN (February 23, 1998) - Narcolepsy is more common in people over 40 than previously thought by physicians and the general public, according to a recent study. Narcolepsy is a sleep disorder consisting of recurring episodes of sleep during the day and often disrupted nighttime sleep.
"Narcolepsy is a disorder that can be diagnosed at any age, not just in teenagers and younger adults," said neurologist and study co-author David Rye MD, PhD, of Emory University in Atlanta, GA.
The study examined patients diagnosed with narcolepsy over three years at the Emory Sleep Disorders Center at Wesley Woods Hospital. Of the 41 narcoleptics identified, 21 were older than 40.
"This was an unexpected finding because previously it was estimated that at least 75 percent of narcoleptics were diagnosed before the age of 40," Rye said.
Several patients, despite suffering sleepiness for many years, were diagnosed with narcolepsy only after experiencing a sudden attack of severe muscle weakness, called cataplexy. Cataplexy is often precipitated by emotions such as laughter, surprise, fear or anger. "Failure to recognize cataplexy as a symptom of narcolepsy can also lead to unnecessary and expensive tests," Rye said. One patient was for evaluated for presumed fainting spells, while two others were thought to have suffered strokes.
Problems that older patients with undiagnosed narcolepsy experienced included daily sleep attacks and problems with attention and concentration at work.
Narcolepsy caused one patient to sleep intermittently in trenches during the Battle of the Bulge. In the vast majority of older patients, however, life-threatening consequences of sleepiness, such as automobile accidents, were not observed.
"Clearly, most older narcoleptics have learned to adapt to their disease and can lead fairly normal lives," said Rye. For example, many patients were self employed or could otherwise base their work schedules around scheduled naps. Others would have coworkers cover their work duties or avoid repetitive or boring stimuli to fight the recurrent attacks of sleep during the day.
"This experience leads us to believe that narcolepsy is vastly underdiagnosed," Rye said. The Emory groupÃs findings support a recent estimate that nearly 85 percent of narcoleptics go through life undiagnosed. "Until now, insights into the cause and treatment of narcolepsy have derived from only 15 percent of the whole narcoleptic population -- just the tip of the iceberg," Rye said. "Our experience with older narcoleptics begins to provide a glimpse of the larger part of this iceberg. Proper diagnosis can lead to the appropriate treatments and medications that can dramatically improve patient well-being."
Narcolepsy affects one in 1,000-2,000 people, making it as common as multiple sclerosis. The findings stress that doctors and patients should remain aware of narcolepsy as a potential cause of any complaint of excessive daytime sleepiness, with or without cataplexy.
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