Clinical and socioeconomic burden among people with narcolepsy or idiopathic hypersomnia: A retrospective cohort analysis of the Danish National Patient Registry

OBJECTIVE/BACKGROUND: To assess the clinical and socioeconomic burden of narcolepsy and idiopathic hypersomnia (IH) in Denmark.

PATIENTS/METHODS: This retrospective cohort study using Danish National Patient Registry data included individuals diagnosed with narcolepsy or IH (1/1/2005-12/31/2017). Individuals with narcolepsy were matched 1:4 with controls without narcolepsy; matching was repeated for individuals with IH. Comorbidities, employment, income, and healthcare costs were assessed in the 3 years before and after diagnosis using logistic regression and generalized linear models.

RESULTS: 1183 individuals with narcolepsy (4728 controls) and 1801 individuals with IH (7204 controls) were assessed. Before diagnosis, individuals with narcolepsy had higher odds (odds ratio [OR]; 95 % confidence interval [CI]) of having nervous system (7.92 [6.46, 9.71]) or circulatory system diseases (2.45 [1.95, 3.07]) than controls, in addition to higher unemployment (2.30 [1.79, 2.96]). Individuals with narcolepsy had lower mean income before (€22,076 vs €26,538) and after (€21,786 vs €27,090) diagnosis and higher mean healthcare costs before (€4547 vs €1909) and after (€7411 vs €2178) diagnosis. Before diagnosis, individuals with IH had higher odds (OR [95 % CI]) of having nervous system (9.37 [7.93, 11.08]) or circulatory system diseases (1.80 [1.49, 2.16]) than controls, in addition to higher unemployment (1.73 [1.42, 2.10]). Individuals with IH had lower mean income before (€31,947 vs €34,503) and after (€30,262 vs €35,139) diagnosis and higher mean healthcare costs before (€4050 vs €1840) and after (€5124 vs €2106) diagnosis.

CONCLUSIONS: Danish individuals with narcolepsy or IH had a greater clinical and socioeconomic burden than controls.