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. 2020 Aug 15;16(8):1255-1263.
doi: 10.5664/jcsm.8482.

Prevalence of narcolepsy and other sleep disorders and frequency of diagnostic tests from 2013-2016 in insured patients actively seeking care

John Acquavella  1 , Reena Mehra  2 , Morgan Bron  3 , Joanna M-H Suomi  4 , Gregory P Hess  5
Affiliations

Prevalence of narcolepsy and other sleep disorders and frequency of diagnostic tests from 2013-2016 in insured patients actively seeking care

John Acquavella et al. J Clin Sleep Med. .

Abstract

Study objectives: The primary objective was to describe trends in the 2-year limited duration prevalence of narcolepsy from 2013-2016 in a large insured population with claims activity. Secondary objectives were to assess the prevalence of other sleep disorders and the frequency of diagnostic sleep testing.

Methods: Nationwide medical/prescription claims (Symphony Health) were analyzed to estimate the annual prevalence per 100,000 persons of narcolepsy and other sleep disorders (obstructive sleep apnea, idiopathic hypersomnia, rapid eye movement sleep behavior disorder, periodic limb movement disorder) and the frequency of diagnostic sleep testing. Prevalence was adjusted to the age/sex distribution of the 2016 US census estimates.

Results: The prevalence of narcolepsy per 100,000 persons increased 14% from 38.9 in 2013 to 44.3 in 2016. Obstructive sleep apnea prevalence increased 41% over the study period from 2,429 to 3,420 per 100,000. Large increases in prevalence were also seen for idiopathic hypersomnia (32%), periodic limb movement disorder (30%), and rapid eye movement sleep behavior disorder (64%). For each sleep disorder, prevalence was higher for those with commercial insurance versus Medicare/Medicaid, and markedly lower prevalence was observed for the Northeast compared with the Midwest, South, and Western US regions. The frequency of multiple sleep latency/maintenance of wakefulness testing declined by 20%, and polysomnography declined by 15%. Conversely, home sleep apnea testing increased by 117%.

Conclusions: The prevalence of narcolepsy, obstructive sleep apnea, and the other sleep disorders increased appreciably over the 2013-2016 period. It remains to be determined whether the trends seen in our analyses are due to increased incidence or increased awareness of these conditions.

Keywords: REM sleep behavior disorder,; idiopathic hypersomnia; narcolepsy; obstructive sleep apnea; periodic limb movement disorder; prevalence; sleep testing.

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Conflict of interest statement

All authors have contributed to the development of this manuscript, have reviewed it, and have approved its contents. This study was funded by Jazz Pharmaceuticals. M.B. was an employee of Jazz Pharmaceuticals during the conduct of this research. The other authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Annual prevalence of narcolepsy by age group, 2013–2016.
Percentages are change in prevalence from 2013 to 2016.
Figure 2
Figure 2. Annual prevalence of sleep disorders from 2013-2016.
OSA prevalence is provided as an inset due to scaling considerations. IH = idiopathic hypersomnia; OSA = obstructive sleep apnea; PLMD = periodic limb movement disorder; RBD = rapid eye movement sleep behavior disorder.
See this image and copyright information in PMC

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