Increased incidence of pediatric narcolepsy following the 2009 H1N1 pandemic: a report from the pediatric working group of the sleep research network

Narong Simakajornboon, Emmanuel Mignot, Kiran Maski, Judith Owens, Carol Rosen, Sally Ibrahim, Fauziya Hassan, Ronald D. Chervin, Gayln Perry, Lee Brooks, Leila Kheirandish-Gozal, David Gozal, Thornton Mason, Althea Robinson, Beth Malow, Kamal Naqvi, Maida L. Chen, Supriya Jambhekar, Ann Halbower, Katharina Graw-PanzerEhab Dayyat, Jenny Lew, Cecilia Melendres, Suresh Kotagal, Sejal Jain, Elizabeth Super, Thomas Dye, Md Monir Hossain, Dawit Tadesse

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

This study was aimed to evaluate the yearly incidence of pediatric narcolepsy prior to and following the 2009 H1N1 pandemic and to evaluate seasonal patterns of narcolepsy onset and associations with H1N1 influenza infection in the United States. This was a multicenter retrospective study with prospective follow-up. Participants were recruited from members of the Pediatric Working Group of the Sleep Research Network including 22 sites across the United States. The main outcomes were monthly and yearly incident cases of childhood narcolepsy in the United States, and its relationship to historical H1N1 influenza data. A total of 950 participants were included in the analysis; 487 participants were male (51.3%). The mean age at onset of excessive daytime sleepiness (EDS) was 9.6  ±  3.9 years. Significant trend changes in pediatric narcolepsy incidence based on EDS onset (p  <  .0001) occurred over the 1998-2016 period, peaking in 2010, reflecting a 1.6-fold increase in narcolepsy incidence. In addition, there was significant seasonal variation in narcolepsy incident cases, with increased cases in spring (p  <  .05). Cross-correlation analysis demonstrated a significant correlation between monthly H1N1 infection and monthly narcolepsy incident cases (p  =  .397, p  <  .0001) with a lag time of 8 months. We conclude that there is a significant increase in pediatric narcolepsy incidence after the 2009 H1N1 pandemic in the United States. However, the magnitude of increase is lower than reported in European countries and in China. The temporal correlation between monthly H1N1 infection and monthly narcolepsy incidence, suggests that H1N1 infection may be a contributing factor to the increased pediatric narcolepsy incidence after the 2009 H1N1 pandemics.

Original languageEnglish (US)
JournalSleep
Volume45
Issue number9
DOIs
StatePublished - Sep 8 2022
Externally publishedYes

Keywords

  • 2009 H1N1 pandemics
  • narcolepsy incidence
  • pediatric narcolepsy
  • risk factors for narcolepsy
  • seasonal variation of narcolepsy incidence

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

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