2010 and 2013 Incidence Peaks in Narcolepsy and Idiopathic Hypersomnia Linked to Type A H1N1 and Type B Victoria Influenza Strains

ABSTRACT Increased narcolepsy type‐1 (NT1) incidence rates were reported globally in 2010, linked to the H1N1 2009–2010 influenza pandemic and Pandemrix vaccination. A child‐specific NT1 peak was observed in Europe in 2013, further raising questions about the relationship between NT1 and influenza infections. This study analysed annual European incidence patterns of central disorders of hypersomnolence (CDH) in relation to influenza severity. All NT1 ( N = 981) and a combined group of narcolepsy type‐2 (NT2) and idiopathic hypersomnia (IH) ( N = 545) cases from eight European centers were studied from 1995 to 2019. Linear mixed models and Spearman correlations were applied to investigate the relationships between CDH incidence and the severity of preceding influenza seasons, including H1N1, H3N2, and for the Netherlands, influenza Type B Victoria and Yamagata. Peaks in NT1 incidence were present in 2010 and 2013, while a 2010 child‐specific peak was identified in NT2 and IH. Both groups showed a significantly positive correlation with H1N1 influenza severity and a negative correlation with H3N2. NT1 was also significantly associated with influenza Type B Victoria in the Netherlands, particularly in children. These findings suggest that, beyond H1N1, influenza Type B Victoria may be a novel trigger for NT1. Similar to NT1, the 2010 children peak in NT2 and IH may indicate possible immune‐related pathophysiologies linked to the 2009–2010 H1N1 pandemic. Further immunological studies are warranted to unravel the complexities of these relationships and their implications for CDH.

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Publication Details

Journal
Journal of Sleep Research
Published
2026-11-11
DOI
https://doi.org/10.1111/jsr.70497
Primary Topic
Sleep and Wakefulness Research
Type
article
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article

2010 and 2013 Incidence Peaks in Narcolepsy and Idiopathic Hypersomnia Linked to Type A H1N1 and Type B Victoria Influenza Strains

Gert Jan Lammers, Karel Šonka, Pavel Sirotkin, Zhongxing Zhang et al.
Journal of Sleep Research
Sleep and Wakefulness Research
article

2010 and 2013 Incidence Peaks in Narcolepsy and Idiopathic Hypersomnia Linked to Type A H1N1 and Type B Victoria Influenza Strains

Gert Jan Lammers, Karel Šonka, Pavel Sirotkin, Zhongxing Zhang, Fabio Pizza, Eva Feketeová, Ramin Khatami, Birgit Högl, Rafael del Río Villegas, Karolína Galušková, Jari K. Gool, Lucie Barateau, Rolf Fronczek, Francesco Biscarini, Yves A Dauvilliers, Aleksandra Wierzbicka, Giuseppe Plazzi
article en

Abstract

ABSTRACT Increased narcolepsy type‐1 (NT1) incidence rates were reported globally in 2010, linked to the H1N1 2009–2010 influenza pandemic and Pandemrix vaccination. A child‐specific NT1 peak was observed in Europe in 2013, further raising questions about the relationship between NT1 and influenza infections. This study analysed annual European incidence patterns of central disorders of hypersomnolence (CDH) in relation to influenza severity. All NT1 ( N = 981) and a combined group of narcolepsy type‐2 (NT2) and idiopathic hypersomnia (IH) ( N = 545) cases from eight European centers were studied from 1995 to 2019. Linear mixed models and Spearman correlations were applied to investigate the relationships between CDH incidence and the severity of preceding influenza seasons, including H1N1, H3N2, and for the Netherlands, influenza Type B Victoria and Yamagata. Peaks in NT1 incidence were present in 2010 and 2013, while a 2010 child‐specific peak was identified in NT2 and IH. Both groups showed a significantly positive correlation with H1N1 influenza severity and a negative correlation with H3N2. NT1 was also significantly associated with influenza Type B Victoria in the Netherlands, particularly in children. These findings suggest that, beyond H1N1, influenza Type B Victoria may be a novel trigger for NT1. Similar to NT1, the 2010 children peak in NT2 and IH may indicate possible immune‐related pathophysiologies linked to the 2009–2010 H1N1 pandemic. Further immunological studies are warranted to unravel the complexities of these relationships and their implications for CDH.

Journal of Sleep Research
Universidad San Pablo CEU (ES), University of Bern (CH), University of Modena and Reggio Emilia (IT), Innsbruck Medical University (AT), Inserm (FR), Université de Montpellier (FR), University of Pavol Jozef Šafárik (SK), Charles University (CZ), Leiden University Medical Center (NL), University Hospital of Bern (CH), Amsterdam Neuroscience (NL), Univerzitná Nemocnica Louisa Pasteura (SK), Hôpital Gui de Chauliac (FR), Istituto delle Scienze Neurologiche di Bologna (IT), Institute for Neurosciences of Montpellier (FR), Klinik Barmelweid (CH), Institute of Psychiatry and Neurology (PL), Stichting Epilepsie Instellingen Nederland (NL), General University Hospital in Prague (CZ), Amsterdam UMC Location Vrije Universiteit Amsterdam (NL), University of Bologna (IT)
Good health and well-being
Sleep and Wakefulness Research
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