SLEEP - Narcolepsy with Cataplexy Associated with Nocturnal Compulsive Behaviors: A Case-Control Study

VOLUME 34, ISSUE 10

NARCOLEPSY WITH CATAPLEXY AND NOCTURNAL COMPULSIVE BEHAVIORS
Narcolepsy with Cataplexy Associated with Nocturnal Compulsive Behaviors: A Case-Control Study

http://dx.doi.org/10.5665/sleep.1280

Vincenzo Palaia, MD¹; Francesca Poli, MD, PhD¹; Fabio Pizza, MD¹; Elena Antelmi, MD¹; Christian Franceschini, PsyD, PhD¹; Keivan Kaveh Moghadam, MD¹; Frederica Provini, MD, PhD¹; Uberto Pagotto, MD²; Pasquale Montagna, MD¹; Carlos H. Schenck, MD³; Emmanuel Mignot, MD⁴; Giuseppe Plazzi, MD¹

¹Department of Neurological Sciences University of Bologna, Bologna, Italy; ²Endocrinology Unit and Centre of Applied Biomedical Research, Department of Clinical Medicine, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Italy; ³Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN; ⁴Center for Narcolepsy, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA

Table of Contents

Text size:

Study Objectives:

To assess the prevalence of sleep related-eating disorder (SRED) and nocturnal smoking (NS) in patients with narcolepsy with cataplexy (NC).

Design:

Case-control study.

Setting:

University hospital.

Patients or Participants:

65 consecutive adult NC patients (33 men; mean age 43.9 ± 19.2 years) and 65 age-, sex-, and geographical origin-matched controls.

Interventions:

Validated questionnaires were used to investigate SRED, NS, restless legs syndrome (RLS), and psychopathological traits (using Eating Disorder Inventory-2 [EDI-2]; Maudsley Obsessive-Compulsive Inventory [MOCI]; and Beck Depression Inventory [BDI]).

Measurements and Results:

NC patients showed a higher prevalence of SRED (32% vs 3%, P = 0.00001), NS (21% vs 0%, P = 0.00006), and RLS (18% vs 5%, P = 0.013) than controls. Moreover, NC patients presented more frequently with an eating-related pathological profile on the EDI-2 (80% vs 46%, P = 0.00006) and had a higher prevalence of depressed mood on the BDI (41% vs 18%, P = 0.004). In comparison to patients without SRED, NC patients with SRED were more frequently women (71% vs 39%, P = 0.013), had higher “bulimic” (29% vs 2%, P = 0.004) and “social insecurity” (48% vs 18%, P = 0.013) traits on the EDI-2, had higher obsessive-compulsiveness on the MOCI (29% vs 4%, P = 0.009), and were more depressed on the BDI (67% vs 29%, P = 0.005). NC patients with NS showed more frequent pathological profiles on the EDI-2 (100% vs 75%, P = 0.035), including the “bulimic” (29% vs 6%, P = 0.015), “perfectionism” (43% vs 14%, P = 0.016), and “social insecurity” (50% vs 22, P = 0.035) profiles.

Conclusion:

Our study shows a strong association of the compulsive nocturnal behaviors SRED and NS with adult NC.

Citation:

Palaia V; Poli F; Pizza F; Antelmi E; Franceschini C; Moghadam KK; Provini F; Pagotto U; Montagna P; Schenck CH; Mignot E; Plazzi G. Narcolepsy with cataplexy associated with nocturnal compulsive behaviors: a case-control study. SLEEP 2011;34(10):1365-1371.