Sleeping through a pandemic: impact of COVID-19 related restrictions on narcolepsy and idiopathic hypersomnia

Nigam, Milan; Hippolyte, Amandine; Dodet, Pauline; Gales, Ana; Maranci, Jean-Baptiste; Al-Youssef, Saba; Leu-Semenescu, Smaranda; Arnulf, Isabelle

STUDY OBJECTIVES: To assess the impact of COVID-19 related restrictions on narcolepsy type 1 (NT2), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH). METHODS: Participants with NT1, NT2 and IH followed in a university hospital completed an online 78-question survey assessing demographic, clinical and occupational features of the population during the first COVID-19 related lockdown. RESULTS: The 219 /851 (25.7%) respondents of the survey reported a mean increase of 1.2±1.9 hours (P<.001) in night sleep time, and a mean decrease of 1.0±3.4 points (P<.001) on the Epworth sleepiness scale during lockdown. Bedtime was delayed by 46.1% of participants and wakeup time was delayed by 59.6%, driven primarily by participants with IH. Teleworkers (but not in-person workers) reported a mean increase of 0.9±1.2 hours in night sleep (P <.001) and a mean decrease in sleepiness score of 1.6± 3.1 (P <.001). Cataplexy improved in 54.1% of participants with NT1. Sleepiness correlated with psychological wellness (R=0.3, P<.001). As many as 42.5% enjoyed the lockdown, thanks to reallocation of time usually spent commuting towards longer sleep time, hobbies and family time, and appreciated a freer napping schedule. Conversely, 13.2% disliked the lockdown, feeling isolation and psychological distress. CONCLUSIONS: Extended sleep time, circadian delay (in IH patients) and teleworking resulted in decreased symptoms of central hypersomnias. These findings suggest that people with IH, NT1 and NT2 may benefit from a decrease in social and professional constraints on sleep-wake habits, and support advocacy efforts aimed at facilitating workplace and schedule accommodations for this population.