The prevalence of sleep disorders such as narcolepsy and obstructive sleep apnea increased significantly from 2013 to 2016. It is not known whether this is due to increased awareness or increased incidence.
The prevalence of sleep disorders such as narcolepsy and obstructive sleep apnea (OSA) increased significantly from 2013 to 2016, according to study results published in the Journal of Clinical Sleep Medicine.
The evolution of sleep problems from characterization as symptoms to disorders has raised awareness of the debilitating effect they can have alone or as comorbid conditions. When evaluating possible sleep disorders, there are 3 main complaints that have contributed to preliminary diagnoses: insomnia, daytime sleepiness and sleep-associated motor phenomena. A recent review recommended that specific questions be required during history taking to ensure correct diagnosis and allow for strategic treatments.
A sleep disorder such as narcolepsy, diagnosed by multiple sleep latency tests, was seen in a previous study to have an increase in prevalence along with idiopathic hypersomnia (IH).
So, is this increase in prevalence due to greater awareness or increased incidence?
Researchers sought to further assess these trends in narcolepsy prevalence by examining data from a large insured population with harm activity (Symphony Health) from 2013 to 2016. Besides this primary objective, secondary objectives were to assess the prevalence of other sleep disorders and the frequency of diagnostic sleep tests.
The harm data were analyzed to estimate the annual prevalence per 100,000 patients with narcolepsy and other sleep disorders, including OSA, IH, rapid eye movement sleep behavior disorder, and periodic limb movement disorder. The prevalence was adjusted to the age/sex distribution of the 2016 US Census estimates, the researchers noted.
In their analysis, the researchers found that the prevalence of narcolepsy per 100,000 people increased by 14%, from 38.9 in 2013 to 44.3 in 2016. This increased prevalence was also observed in other sleep disorders studied:
- OSA prevalence increased by 41% from 2,429 to 3,420 per 100,000 over the study period
- IH prevalence increased by 32%
- Periodic limb movement disorder increased by 30%
- Rapid Eye Movement Sleep Behavior Disorder increased by 64%
“For each sleep disorder, the prevalence was higher in those with commercial insurance than Medicare/Medicaid, and a significantly lower prevalence was observed in the Northeast than in the Midwest, South, and West,” the study authors added.
For the secondary objective of assessing the frequency of diagnostic sleep tests, multiple sleep latency and maintenance of wakefulness tests decreased by 20% and polysomnography by 15%. However, home sleep apnea testing showed a significant increase of 177%.
Although the prevalence trends are increasing, the researchers emphasize that it is not yet known whether this is due to increased incidence or increased awareness, warranting further analysis.
Acquavella J, Mehra R, Bron M et al. Prevalence of Narcolepsy, Other Sleep Disorders, and Diagnostic Tests from 2013–2016: Actively Seeking Insureds. J Clin Sleep Med. Published online August 15, 2020. doi:10.5664/jcsm.8482