Lucie Barateau1, Régis Lopez1, Isabelle Arnulf1, Michel Lecendreux1, Patricia Franco1, Xavier Drouot1, Smaranda Leu-Semenescu1, Isabelle Jaussent1, Yves Dauvilliers2. 1. From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France. 2. From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France. ydauvilliers@yahoo.fr.
Abstract
OBJECTIVE: To assess and compare the frequencies of personal and family history of autoimmune diseases (AID), autoinflammatory disorders (ID), and allergies in a population of patients, adults and children, with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), 3 central hypersomnia disorders, and healthy controls. METHODS: Personal and family history of AID, ID, and allergies were assessed by questionnaire and medical interview in a large cohort of 450 consecutive adult patients (206 NT1, 106 NT2, 138 IH) and 95 pediatric patients (80 NT1) diagnosed according to the third International Classification of Sleep Disorders criteria in national reference centers for narcolepsy in France and 751 controls (700 adults, 51 children) from the general population. RESULTS: Ten adults with NT1 (4.9%) had a comorbid AID vs 3.4% of adult controls, without between-group differences in adjusted models. AID frequency did not differ between children with NT1 and controls. Conversely, compared with controls, AID frequency was higher in adults with NT2 (p = 0.002), whereas ID (p = 0.0002) and allergy (p = 0.003) frequencies were higher in adults with IH. A positive family history of AID was found in the NT1 group and of ID in the IH group. CONCLUSIONS: NT1 is not associated with increased risk of comorbid immune disorders, in favor of a potentially unique pathophysiology. Conversely, compared with controls, the frequency of autoimmune diseases was higher in adults with NT2, whereas allergies and autoinflammatory disorders were more common in adults with IH, suggesting an immune dysregulation mechanism in these conditions.
OBJECTIVE: To assess and compare the frequencies of personal and family history of autoimmune diseases (AID), autoinflammatory disorders (ID), and allergies in a population of patients, adults and children, with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), 3 central hypersomnia disorders, and healthy controls. METHODS: Personal and family history of AID, ID, and allergies were assessed by questionnaire and medical interview in a large cohort of 450 consecutive adult patients (206 NT1, 106 NT2, 138 IH) and 95 pediatric patients (80 NT1) diagnosed according to the third International Classification of Sleep Disorders criteria in national reference centers for narcolepsy in France and 751 controls (700 adults, 51 children) from the general population. RESULTS: Ten adults with NT1 (4.9%) had a comorbid AID vs 3.4% of adult controls, without between-group differences in adjusted models. AID frequency did not differ between children with NT1 and controls. Conversely, compared with controls, AID frequency was higher in adults with NT2 (p = 0.002), whereas ID (p = 0.0002) and allergy (p = 0.003) frequencies were higher in adults with IH. A positive family history of AID was found in the NT1 group and of ID in the IH group. CONCLUSIONS: NT1 is not associated with increased risk of comorbid immune disorders, in favor of a potentially unique pathophysiology. Conversely, compared with controls, the frequency of autoimmune diseases was higher in adults with NT2, whereas allergies and autoinflammatory disorders were more common in adults with IH, suggesting an immune dysregulation mechanism in these conditions.
Authors: Mitchell G Miglis; Logan Schneider; Paul Kim; Joseph Cheung; Lynn Marie Trotti Journal: J Clin Sleep Med Date: 2020-02-10 Impact factor: 4.062