There is a research study done on the mortality rates of narcolepsy, it is the first study about the “increased mortality in narcolepsy”. The data was taken from a large database of the US population known as Symphony Health Solutions from January 2002 to January 2012. Patients were diagnosed with narcolepsy according to the ICD-9 criteria. Then all-cause mortality rates were calculated for patients with and without narcolepsy for the year 2008, 2009 and 2010. (1)
Can You Die From Narcolepsy?
Here are the results and the possible causes of death associated with narcolepsy.
In the narcolepsy population, the mortality rates were 1.14%, 1.17% and 1.16% in 2008, 2009 and 2010 respectively, whereas in the non-narcolepsy population the mortality rates were 0.78%, 0.775 and 0.79% for years 2008,2009, and 2010 respectively. There was approximately 1.5 times excess mortality seen in the narcolepsy population which was significant compared to the non-narcolepsy population. In all 3 years, the mortality rates were high in the age group of more than 75 years. The peak of relative mortality risk was in the 25-34 and 35 to 44 age group and the younger groups had the highest relative mortality risk. (1)
There have been several comorbid conditions/ complications identified with narcolepsy such as:
- Obesity
- Cognitive problems
- Obstructive sleep apnea
- Diabetes mellitus
- Coronary artery disease
- Hypertension
- Hypercholesterolemia
- Psychiatric disorders – depression
The exact reason for death in narcolepsy is still not fully understood, there is no proper explanation for the increased mortality rates in narcolepsy. It can be due to a comorbid condition associated with narcolepsy, individual comorbid conditions itself has a higher mortality rate or both narcolepsy and comorbid conditions can increase the risk of mortality. It is uncertain if narcolepsy alone can cause mortality or only in the presence of medical conditions, obesity and psychiatric conditions mortality occur.
Pathological sleepiness is a symptom found in all narcolepsy patients. This symptom alone has a higher mortality risk associated with it especially in the elderly population. Excessive daytime sleepiness can be associated with an increased risk of suicide especially if depression is present. Many of the comorbid conditions mentioned-above have high mortality rates even in the absence of narcolepsy that may be the reason for the higher mortality rates seen in the elderly population. (1)
The reason for the higher relative mortality risk in the younger age group can be because narcolepsy usually occurs in early childhood or late adolescence and it takes about 7-10 years for the diagnosis of narcolepsy after the initiation of the first symptom. So, then most patients are in the younger age group. Most patients have bad health habit and poor health condition compared to the general population. The risk of psychological diseases such as depression and suicide risk are high at this time and this can be the reason for high relative mortality risk on the younger age group. With time and with the diagnosis of narcolepsy patients tend to cope up with new strategies and try to follow a healthier lifestyle. With these strategies the suicide risk and depression can reduce and that reduces the relative mortality risk as well. (1)
Summary
There has been a 1.5-fold excess mortality rate associated with narcolepsy when compared with the normal population. The mortality rates were high in the elderly populations however; the relative mortality risk was high in the younger age groups with a peak in the 25-34 and 35 to 44 age groups. The exact reason for this excess mortality rates in narcolepsy is not known but it can be due to narcolepsy itself, as excess sleeping can lead to death especially in the elderly. Narcolepsy is also associated with several comorbid conditions such as obesity, diabetes, hypertension, coronary artery disease, obstructive sleep apnoea, and psychiatric conditions such as depression and suicide. These comorbid conditions also can increase the risk of mortality even in the absence of narcolepsy.
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