Observational study: prospective longitudinal cohort (Green)
Narcolepsy type 1 (NT1) is a chronic rare hypersomnia of central origin requiring a combination of behavioural and pharmacological treatments. During the COVID-19 pandemic in Italy, the population was forced into a lockdown. With this study, the authors aimed to describe the lockdown’s impact on NT1 symptom management, according to different patients’ working schedules. In the period between 10 April and 15 May 2020, routine follow-up visits were performed by telephone with 50 patients >18 years old (40% males) on stable long-term treatment. The authors divided patients into three groups: unchanged working schedules, forced working/studying at home, and those who lost their job (“lost occupation”). Current sleep-wake habit and symptom severity were compared with pre-lockdown assessment (six months before) in the three patient groups. At assessment, 20, 22, and eight patients belonged to the unchanged, working/studying at home, and lost occupation groups, respectively. While in the lost occupation group, there were no significant differences compared with pre-pandemic assessment, the patients with unchanged schedules reported more nocturnal awakenings, and NT1 patients working/studying at home showed an extension of nocturnal sleep time, more frequent daytime napping, improvement of daytime sleepiness, and a significant increase in their body mass index. Sleep-related paralysis/hallucinations, automatic behaviours, cataplexy, and disturbed nocturnal sleep did not differ. The authors concluded that narcolepsy type 1 patients working/studying at home showed increased nocturnal sleep time and daytime napping to ameliorate daytime sleepiness, and a slight, but significant, increase of weight.