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Clinical profile of a type 1 narcoleptic population from a Brazilian tertiary outpatient clinic
Narcolepsy type 1 is a rare pleomorphic disease with generally difficult and late diagnosis, especially in emerging countries. We present a clinical profile of a sample of type 1 narcoleptic patients from a large Brazilian center and its peculiarities.
Our purposes were to identify general clinical aspects of our Brazilian narcolepsy patients and to evaluate the sleep quality of our narcoleptic patients, in addition to determine the severity of the narcoleptic symptoms. Secondarily we aimed to characterize the treatment in use (anticatapletics and stimulants).
Physical examination and evaluation of the medical records of 51 patients with a stablished diagnosis of type 1 narcolepsy. Also we applied clinical sleep scales: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Narcolepsy Severity Scale (NSS).
The majority (58,8%) of the patients was female. The mean age at the time of the evaluation was 36.74 ± 12.48, and the mean age at the beginning of follow-up in our service was 32.87 ± 12.45. Mean ESS was 15.7 + 5.4, PSQI 11.76 + 4.17 and NSS 33.92 + 11.32. Despite an unfavorable treatment profile, with only 31.4% using both stimulant and anti-catapletic antidepressant, the severity of the patients was not directly corelated with the use of medications or not. We observed high index of overweight 27.3% and obesity 56.8%, with the mean body mass index (BMI) of 32.87 + 12.34 and abdominal circumference 98.3 + 18.89. There was a correlation of BMI with the PSQI (Pearson 0.384), but there was no correlation with ESS (Pearson 0.008) and NSS (Pearson 0.056). Of our patients, 56.9% experienced bad dreams or nightmares more than once a week.
Our observed narcolepsy population presents clinical severity higher than that found in the literature, but not directly related to the therapeutic regimen in use. We observed a high rate of overweight and obesity corelated with general bad sleep quality. Oniric symptoms were more frequent in narcolepitc patients than general population in our study.
Narcolepsy type 1, clinical profile, severity
Universidade Federal de São Paulo - Sao Paulo - Brasil
Lucio Huebra, Cristina Frange, Fernando Morgadinho Santos Coelho