The impact of the coronavirus-2019 (COVID-19) on people’s daily lives has resulted in altered sleep patterns and an increase in narcolepsy symptoms, according to results of a study published in the Journal of Clinical Sleep Medicine.

The social isolation and interruption of daily routines resulting from COVID-19 precautions may impact individuals’ exposure to the light-dark cycle that regulates the circadian system, and thereby exacerbate existing narcolepsy symptoms. Though a recent study showed that COVID-19 quarantining has led to people going to bed later, getting up earlier, and getting lower quality sleep, the impact of the COVID-19 pandemic on patients with narcolepsy has not yet been determined.

To evaluate the impact of the COVID-19 pandemic on the sleep schedules, symptoms, and the need for medication of individuals with narcolepsy, questionnaire data from 76 patients (68.4% women) diagnosed with idiopathic hypersomnia were analyzed. Patients were 36.9 years of age on average, and 68.7% were diagnosed with narcolepsy type 1 (NT1). No patients were diagnosed with COVID-19, though 14.5% experienced COVID-19-like symptoms. Excessive daytime sleepiness was evaluated using the Epworth Sleepiness Scale, which scores severity of sleepiness from 0 to 24.

More patients reported going to be later or had no fixed bedtime during the pandemic (P <.05) as well as waking up later or had no fixed wake-up time (P <.01). There was a significant increase in reported excessive daytime sleepiness (EDS) (P <.01). Changes in bedtime schedules was significantly associated with increased EDS (P <.01), and a decrease in hallucinations (P <.01). An increase in the use of stimulants by patients using monotherapy and a decrease in the use of antidepressants, stimulants associated with antidepressants, or L-carnitine was observed (P =.014).

Limitations to this study include the lack of a sleep diary and the failure to capture some narcolepsy symptoms and quality of life data. Future research including these observations is warranted.

The results of this study showed that the coronavirus pandemic has significantly impacted the sleep of individuals with narcolepsy. The altered bedtime schedules were associated with an increase in excessive daytime sleepiness, which may in turn explain the increase in the use of stimulants. Reinforcing the importance of daily routines and exposure to sunlight for patients with narcolepsy may help to alleviate this observed change.

Reference

Rodrigues Aguilar AC, Frange C, Huebra L, Dias Gomes AC, Tufik S, Morgadinho Santos Coelho F. The effects of COVID-19 pandemic on patients with narcolepsy. [published online October 30, 2020]. J Clin Sleep Med. doi: 10.5664/jcsm.8952