0694 Polysomnographic Findings in Pediatric Patients with Narcolepsy Type 1 and Narcolepsy Type 2: A Retrospective Review

Abstract Introduction There are few large polysomnographic datasets for children and adolescents with narcolepsy type 1 (NT1) and 2 (NT2). This analysis aims to characterize daytime and nighttime sleep features in pediatric patients with NT1 and NT2. Methods A retrospective review of Pulse Infoframe registry data of patients aged ≤18 years with a diagnosis of NT1 or NT2 from 22 US hospitals between 2009 and 2017 was performed. All included patients underwent a clinical evaluation, Multiple Sleep Latency Test (MSLT), and overnight polysomnography (PSG). Data were analyzed descriptively. Results In total, 471 patients were identified (NT1, 70%; NT2, 30%; male, 52%; white, 48%). MSLT: median (IQR) sleep latency was 2.1 (1.0-3.9) minutes for patients with NT1 (n=308) and 3.5 (1.7-5.6) minutes for those with NT2 (n=136). Median (IQR) sleep-onset rapid eye movement (REM) periods (SOREMPs) were 4.0 (3.0-4.0) for patients with NT1 and 4.0 (3.0-4.0) for those with NT2. PSG: respective median (range) N1 percentage and time were 8% (0%-44%) and 35.9 (0-188.3) minutes for patients with NT1 and 7% (0%-32%) and 32.5 (0-152.6) minutes for those with NT2. Respective median (range) N2 percentage and time were 49% (19%-82%) and 218.7 (3.2-427.3) minutes for patients with NT1 and 50% (16%-80%) and 237.0 (69.1-426.1) minutes for those with NT2. Respective median (range) N3 percentage and time were 21% (1%-63%) and 98.6 (2.5-354.2) minutes for patients with NT1 and 20% (2%-54%) and 98.7 (6.5-240.8) minutes for those with NT2. Respective median (range) REM percentage and latency were 19% (0%-41%) and 90.1 (0-234.2) minutes for patients with NT1 and 22% (2%-40%) and 100.0 (7.2-226.0) minutes for those with NT2. Median (range) arousals per hour were 12.6 (0-65.0) for patients with NT1 and 11.0 (0.1-38.4) for those with NT2. Conclusion Treatment of narcolepsy is often solely focused on daytime symptoms; however, sleep latency and SOREMP data point to NT1 and NT2 ultimately being disorders of both sleep and wake. Future research and patient care should consider the 24/7 nature of narcolepsy. Support (if any) Avadel Pharmaceuticals