Sleep apnoea-hypopnoea syndrome and narcolepsy. Description of a series of hospital patients
*Correspondencia: Dra. María José Abenza Abildúa. Centro de Medicina del Sueño. Hospital Universitario Infanta Sofía. Paseo de Europa, 34. E-20702 San Sebastián de los Reyes (Madrid).
E-mail: mjose.abenza@salud.madrid.org
Introduction: Sleep disorders are highly prevalent among the general population, although very few cases of sleep apnoea-hypopnoea syndrome (SAHS) have been reported in patients with narcolepsy. This study reviews the sleep disorders found in patients with narcolepsy, the prevalence of SAHS associated with these patients and their response to the different treatments.
Patients and methods: We conducted an observation-based retrospective descriptive analysis of 25 patients diagnosed with narcolepsy, who were treated in our centre between October 2012 and December 2016.
Results: Of 470 patients evaluated in the specialised neurology consultation unit, 25 patients were diagnosed with narcolepsy (5.31%); 65% were males and the remaining 35% were females; the mean age at the time of diagnosis was 40 years. 60% presented other associated sleep disorders, the most frequent being SAHS (36%). The efficacy rate of treatment with continuous positive airway pressure (CPAP) is 66% in patients with SAHS with an indication of CPAP.
Conclusions: Altogether, 60% of patients with narcolepsy have a second associated sleep disorder (greater than the incidence of coexistence in the general population, of 20-25% of patients), and those reported are also the most frequent among the general population (SAHS, restless legs syndrome, periodic limb movement disorder). 36% of patients with narcolepsy have SAHS as an associated condition. Of these, 78% have reached a suitable degree of control over respiratory events; 57% have achieved control with CPAP, and the remaining 43% did not require CPAP for event correction with other methods.
Pacientes y métodos Análisis descriptivo retrospectivo observacional de 25 pacientes, con diagnóstico de narcolepsia, atendidos en nuestro centro desde octubre de 2012 hasta diciembre de 2016.
Resultados De 470 pacientes valorados en la consulta monográfica de neurología, hemos diagnosticado a 25 pacientes con narcolepsia (5,31%); el 65% eran hombres, y el 35%, mujeres. Edad media en el momento del diagnóstico: 40 años. El 60% presenta otros trastornos del sueño asociados, el más frecuente es el SAHS (36%). La eficacia del tratamiento con presión aérea positiva continua nasal (CPAP) es del 66% en los pacientes con SAHS con indicación de CPAP.
Conclusiones El 60% de los pacientes con narcolepsia asocia un segundo trastorno del sueño (mayor que la incidencia de coexistencia en la población general, del 20-25% de los pacientes), y los descritos también son los más frecuentes en la población general (SAHS, síndrome de piernas inquietas, movimientos periódicos de las piernas). El 36% de los pacientes con narcolepsia asocia SAHS. De ellos, en el 78% se ha conseguido un control de eventos respiratorios adecuado; el 57% se ha controlado con CPAP y el 43% restante no ha precisado CPAP por corrección de eventos con otros métodos.