Narcolepsy in Saudi Arabia Demographic and clinical perspective of an under-recognized disorder

Objectives: To assess the clinical and polysomnographicfeatures of narcolepsy in Saudis.Methods: All patients diagnosed to have narcolepsy inthe Sleep Disorders Center at King Khalid UniversityHospital, Riyadh, Kingdom of Saudi Arabia betweenMarch 1998 and December 2005 based on the InternationalClassifications of Sleep Disorders Diagnostic and CodingManual criteria were included. A data entry form collectingthe demographic, clinical features, medications, referringspecialty, prior diagnoses and daytime sleepiness wasused. All patients underwent polysomnography followedby multiple sleep latency.Results: Forty-seven patients with a mean age of 28.9 ± 1.9years were included. The mean age at onset of symptomswas 20.5 ± 1.4 years. The interval between symptomsABSTRACTonset and diagnosis was 8.4 ± 1.2 years. While 22 (46.8%)of the patients were referred to the sleep disorders clinicby different specialties, 25 (53.2%) patients sought anappointment in the sleep disorders clinic directly. Only 3patients were referred with the correct diagnosis. Nocturnalsleep quality was worse in narcoleptics with cataplexycompared to those without cataplexy.Conclusions: Saudi patients with narcolepsy have the sameclinical presentation as reported in the Western literature.Narcoleptics with cataplexy had disturbed quality comparedto narcoleptics without cataplexy. A long time was reportedbetween symptoms onset and diagnosis, which may reflectthe under-recognition of the problem among physicians.