Cardiovascular disorders in narcolepsy: Review of associations and determinants
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Cardiovascular disorders in narcolepsy : Review of associations and determinants. / Jennum, Poul Jørgen; Plazzi, Giuseppe; Silvani, Alessandro; Surkin, Lee A.; Dauvilliers, Yves.
In: Sleep Medicine Reviews, Vol. 58, 101440, 2021.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Cardiovascular disorders in narcolepsy
T2 - Review of associations and determinants
AU - Jennum, Poul Jørgen
AU - Plazzi, Giuseppe
AU - Silvani, Alessandro
AU - Surkin, Lee A.
AU - Dauvilliers, Yves
N1 - Publisher Copyright: © 2021 The Authors
PY - 2021
Y1 - 2021
N2 - Narcolepsy type 1 (NT1) is a lifelong disorder of sleep-wake dysregulation defined by clinical symptoms, neurophysiological findings, and low hypocretin levels. Besides a role in sleep, hypocretins are also involved in regulation of heart rate and blood pressure. This literature review examines data on the autonomic effects of hypocretin deficiency and evidence about how narcolepsy is associated with multiple cardiovascular risk factors and comorbidities, including cardiovascular disease. An important impact in NT1 is lack of nocturnal blood pressure dipping, which has been associated with mortality in the general population. Hypertension is also prevalent in NT1. Furthermore, disrupted nighttime sleep and excessive daytime sleepiness, which are characteristic of narcolepsy, may increase cardiovascular risk. Patients with narcolepsy also often present with other comorbidities (eg, obesity, diabetes, depression, other sleep disorders) that may contribute to increased cardiovascular risk. Management of multimorbidity in patients with narcolepsy should include regular assessment of cardiovascular health (including ambulatory blood pressure monitoring), mitigation of cardiovascular risk factors (eg, cessation of smoking and other lifestyle changes, sleep hygiene, and pharmacotherapy), and prescription of a regimen of narcolepsy medications that balances symptomatic benefits with cardiovascular safety.
AB - Narcolepsy type 1 (NT1) is a lifelong disorder of sleep-wake dysregulation defined by clinical symptoms, neurophysiological findings, and low hypocretin levels. Besides a role in sleep, hypocretins are also involved in regulation of heart rate and blood pressure. This literature review examines data on the autonomic effects of hypocretin deficiency and evidence about how narcolepsy is associated with multiple cardiovascular risk factors and comorbidities, including cardiovascular disease. An important impact in NT1 is lack of nocturnal blood pressure dipping, which has been associated with mortality in the general population. Hypertension is also prevalent in NT1. Furthermore, disrupted nighttime sleep and excessive daytime sleepiness, which are characteristic of narcolepsy, may increase cardiovascular risk. Patients with narcolepsy also often present with other comorbidities (eg, obesity, diabetes, depression, other sleep disorders) that may contribute to increased cardiovascular risk. Management of multimorbidity in patients with narcolepsy should include regular assessment of cardiovascular health (including ambulatory blood pressure monitoring), mitigation of cardiovascular risk factors (eg, cessation of smoking and other lifestyle changes, sleep hygiene, and pharmacotherapy), and prescription of a regimen of narcolepsy medications that balances symptomatic benefits with cardiovascular safety.
KW - Autonomic
KW - Blood pressure
KW - Cardiovascular
KW - Comorbidity
KW - Endothelial
KW - Hypocretin
KW - Mortality
KW - Narcolepsy
KW - Risk factor
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=85100707832&partnerID=8YFLogxK
U2 - 10.1016/j.smrv.2021.101440
DO - 10.1016/j.smrv.2021.101440
M3 - Review
C2 - 33582582
AN - SCOPUS:85100707832
VL - 58
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
SN - 1087-0792
M1 - 101440
ER -
ID: 305108519