Study Objectives:

We assess the yearly seasonal, environmental effects on birth pattern in Chinese patients later diagnosed with narcolepsy and cataplexy, and explored if this effect persisted in patients with symptoms onset date before, following and after 2009 H1N1 pandemic.

Methods:

A total of 1942 patients with birth data information and diagnosed narcolepsy with cataplexy were included in this study. The birth month and seasonal effect of 1064 patients born from 1970 to 2000 were compared to controls (n=2,028,714) from the general population. Furthermore, birth season effect in 1373 patients with definite disease onset month were compared among patients with onset date before (n=595), following (n=325), and after (n=453) H1N1 pandemic.

Results:

Patients with narcolepsy and cataplexy had a significantly different seasonality from the general population (p = 0.027). The monthly distribution of birth month yielded a peak in November (odds ratio = 1.23 [95%CI, 1.01-1.49], p=0.042) and a trough in April (odds ratio = 0.68 [95%CI,0.52-0.88], p=0.004). No significant difference was observed in the birth month across patients with symptoms onset dates before, following and after the 2009 H1N1 pandemic (p=0.603).

Conclusions:

This reveal across many years of seasonal effect in Chinese narcolepsy cataplexy supports a role for early-life environmental influences on disease development.