Narcolepsy on the Rise in Teens and Young Adults

Narcolepsy, a severe sleep disorder that typically emerges in adolescence, appears to be on the rise in the U.S. A new analysis of U.S. health care claims reports prevalence roughly 50% higher (1.6 per 2,000) than the upper limit cited in most prior studies (1 per 2,000), with the highest incidence in late adolescence and the early 20s. Pharmaceutical company ads that encourage readers to wonder why they are “tired all the time” and to take a “Narcolepsy Symptom Screener” test are an indication of the growing problem—and the growing market.

An uptick in narcolepsy in young people is concerning, given the lifelong social, academic, workplace and daily life challenges that the condition’s unwelcome symptoms impose. These include excessive daytime sleepiness, abnormal rapid eye movement (REM) sleep, hallucinations and—in many narcoleptics—sudden muscle weakness or paralysis triggered by strong emotions (a state called cataplexy). In adults, those with narcolepsy are more likely to suffer from anxiety and depression than individuals without the disorder.

As with many of the chronic conditions that plague today’s youth, narcolepsy researchers suspect that environmental exposures in genetically susceptible individuals are a key trigger. This perspective is compatible with recent studies proposing that narcolepsy is an autoimmune disease. Like type 1 diabetes, narcolepsy is the result of selective cell loss (beta cells in the case of diabetes and hypothalamus neurons in the case of narcolepsy)—and in both instances, autoimmune processes are key drivers of the cell loss. And among the environmental exposures capable of setting autoimmunity in motion, recent medical history provides one clearly established culprit: an H1N1 influenza vaccine widely used in Europe in 2009–2010 during the so-called swine flu “pandemic.”…

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