A systematic review of cognitive function and psychosocial well-being in school-age children with narcolepsy

Introduction: Narcolepsy is a neurological sleep disorder characterised by excessive daytime sleepiness and attacks of muscle weakness which are often precipitated by strong emotions (cataplexy). In August 2010, concerns were raised about an increase in the incidence rate of narcolepsy diagnosis in children and adolescents. It is therefore timely to systematically review the current research that has investigated the consequences of this chronic disorder in childhood on cognitive function and psychosocial well-being.

Objective: The review was conducted to assess whether cognitive function and psychosocial well-being is impaired in school-age children with narcolepsy and to assess the quality of the previous research.

Data sources: Four electronic databases were searched on 27th June 2015; The Cochrane Library, EMBASE, Ovid MEDLINE and PsycINFO.

Eligibility criteria for selecting studies: Research primarily concerned with; narcolepsy (and/or cataplexy) and cognitive function and/or psychosocial well-being in children aged between 5-17 years old. Studies matching this criteria, published between 2005-2015 and written in English were included in this review.

Results: Eight studies met the inclusion criteria for the present review. Collectively the results provided evidence to suggest that children who develop narcolepsy are at significant cognitive and psychological risk. The findings suggest that narcolepsy puts children and adolescents at particular risk of cognitive impairment in at least one domain and emotional problems including depression, anxiety and low self-esteem which may consequently lead to poorer quality of life.

Conclusions: This review has highlighted that children with narcolepsy are at significant risk of cognitive and psychological impairments. However, current research is limited by small sample sizes and lack of standardised assessments, appropriate controls and longitudinal data. In order to gain further understanding about the cognitive and psychological consequences of childhood narcolepsy, future research must address these limitations so that the results can enable recommendations to be made for any extra support needed at home and at school so that children with narcolepsy are able to achieve their full potential.