Content area
Abstract
Abstract
The objective was to estimate the prevalence of narcolepsy and idiopathic hypersomnia (IH) and the use of diagnostic sleep tests in a large US healthcare claims database. There are no recent data in a large US population.
Nationwide medical/prescription claims (Symphony Health) were utilized to assess the prevalence of diagnosed narcolepsy and IH per 100,000 persons for each calendar year (2013-2016). Approximately 66 million persons annually were available for review. Cases were identified as having ≥2 claims with a narcolepsy (or IH) diagnosis within 6 months, or for narcolepsy, a diagnosis following multiple sleep latency testing (MSLT) or maintenance of wakefulness testing (MWT). Direct standardization was applied to narcolepsy prevalence to control for possible changes in the age-sex distribution of the database. Use of diagnostic sleep tests (polysomnography [PSG], MSLT/MWT, and home sleep apnea testing [HSAT]) was also reported as a rate per 100,000 persons tested.
Standardized narcolepsy prevalence increased from 37.0 per 100,000 persons (95% confidence interval [CI] 36.7-37.3) in 2013 to 42.1 (95% CI 41.9-42.4) in 2016. This was a 13.8% increase over the 4 years, with annual increases of 8.4%, 2.5%, and 2.4% in 2014, 2015, and 2016, respectively. Prevalence of IH increased by 33.8% from 2013 to 2016 (7.7 to 10.3 per 100,000 persons) with 13.0%, 2.3%, and 15.7% annual increases, respectively. During 2013 to 2016, use of PSG declined 13.9% (677.6 to 583.6 per 100,000 persons) and use of MSLT/MWT also declined 22.1% (17.2 to 13.4), while use of HSAT increased 118.2% (96.8 to 211.2).
The prevalence of both narcolepsy and IH increased over the study period (2013-2016), with a larger percentage change in IH than narcolepsy. The increasing prevalence of narcolepsy slowed in the latter part of the study period, while IH increased. Further research is needed to understand the changing utilization patterns for sleep testing and the etiology of changes in the prevalence of narcolepsy and IH.
Jazz Pharmaceuticals.