title: Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study.
abstract: OBJECTIVE
  Narcolepsy is a disabling disease with a delayed diagnosis. At least 3 years before the disorder identification, several comorbidities can be observed in patients with narcolepsy. The early recognition of narcolepsy symptoms may improve long-term prognosis of the patients. Thus, we aimed to investigate the prevalence of the symptoms associated with narcolepsy and its social and psychological association in a sample of Sao Paulo city inhabitants.
  
  
  METHODS
  We performed a cross-sectional evaluation with 1,008 individuals from the Sao Paulo Epidemiologic Sleep Study (EPISONO). Excessive daytime sleepiness (EDS) was assessed by the Epworth Sleepiness Scale. Volunteers were also asked about the occurrence of cataplectic-like, hypnagogic or hypnopompic hallucinations, and sleep paralysis symptoms. The participants underwent a full-night polysomnography and completed questionnaires about psychological, demographic, and quality of life parameters.
  
  
  RESULTS
  We observed a prevalence of 39.2% of EDS, 15.0% of cataplectic-like symptom, 9.2% of hypnagogic or hypnopompic hallucinations, and 14.9% of sleep paralysis in Sao Paulo city inhabitants. A frequency of 6.9% was observed when EDS and cataplectic-like symptoms were grouped. The other associations were EDS + hallucinations (4.7%) and EDS + sleep paralysis (7.5%). Symptomatic participants were predominantly women and younger compared with patients without any narcolepsy symptom (n = 451). Narcolepsy symptomatology was also associated with a poor quality of life and symptoms of depression, anxiety, and fatigue.
  
  
  CONCLUSIONS
  Narcolepsy-related symptoms are associated with poor quality of life and worse psychological parameters.
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Lenise Jihe
authors.initials: LJ
authors.lastname: Kim
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.|Neurologia e Neurocirurgia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Fernando Morgadinho
authors.initials: FM
authors.lastname: Coelho
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Hirotsu
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Paula
authors.initials: P
authors.lastname: Araujo
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Lia
authors.initials: L
authors.lastname: Bittencourt
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.affiliation: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Monica Levy
authors.initials: ML
authors.lastname: Andersen
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006212:Hallucinations / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009290:Narcolepsy / Q000453:epidemiology*; D017286:Polysomnography; D015995:Prevalence; D020188:Sleep Paralysis / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: epidemiological; narcolepsy; symptomatology