Narcolepsy in a pediatric population
D. Young, F. Zorick, R. Wittig, T. Roehrs and T. Roth
Henry Ford Hospital Sleep Disorders Center, Detroit, MI 48202.
Narcolepsy, a sleep-wake disorder of unknown cause, has been reported as
occurring in the pediatric population, but only two reports of cases in the
literature have included polysomnographic data on children with narcolepsy.
We compared the clinical and polysomnographic data on a series of eight
patients 15 years of age or younger and an adult comparison group with
narcolepsy. All patients presented with excessive daytime sleepiness, and
no significant difference was found between groups for the incidence of
cataplexy, hypnagogic hallucinations, and sleep paralysis. On
polysomnographic evaluation the pediatric group had increased total sleep
time, percent-stage 3/4 sleep, percent rapid eye movement sleep, and
decreased stage 1 sleep, which all are expected age-related differences.
The pediatric group also showed a greater degree of daytime sleepiness and
an increased frequency of sleep-onset rapid eye movement periods. While
pediatric patients with narcolepsy resemble adults in their mode of
presentation and the incidence of accessory symptoms, the increase in
severity of sleepiness highlights the importance of diagnosing narcolepsy
in children as early as possible so that treatment can be initiated.
