tetano
Editor, Senior Moderator
J Sleep Res
. 2026 Nov 11:e70497.
doi: 10.1111/jsr.70497. Online ahead of print.
Zhongxing Zhang 1 , Jari K Gool 2 3 4 5 , Pavel Sirotkin 1 , Yves Dauvilliers 6 7 , Lucie Barateau 6 7 , Giuseppe Plazzi 8 9 , Fabio Pizza 9 10 , Francesco Biscarini 9 10 , Karel Sonka 11 , Karolina Galuskova 11 , Aleksandra Wierzbicka 12 , Birgit Högl 13 , Eva Feketeova 14 , Rafael Del Río Villegas 15 , Rolf Fronczek 2 3 , Gert Jan Lammers 2 3 , Ramin Khatami 1 16
Affiliations Expand
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.
Keywords: 2009 H1N1; Type B influenza; idiopathic hypersomnia; infections; narcolepsy.
. 2026 Nov 11:e70497.
doi: 10.1111/jsr.70497. Online ahead of print.
2010 and 2013 Incidence Peaks in Narcolepsy and Idiopathic Hypersomnia Linked to Type A H1N1 and Type B Victoria Influenza Strains
Zhongxing Zhang 1 , Jari K Gool 2 3 4 5 , Pavel Sirotkin 1 , Yves Dauvilliers 6 7 , Lucie Barateau 6 7 , Giuseppe Plazzi 8 9 , Fabio Pizza 9 10 , Francesco Biscarini 9 10 , Karel Sonka 11 , Karolina Galuskova 11 , Aleksandra Wierzbicka 12 , Birgit Högl 13 , Eva Feketeova 14 , Rafael Del Río Villegas 15 , Rolf Fronczek 2 3 , Gert Jan Lammers 2 3 , Ramin Khatami 1 16
Affiliations Expand
- PMID: 43012367
- DOI: 10.1111/jsr.70497
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.
Keywords: 2009 H1N1; Type B influenza; idiopathic hypersomnia; infections; narcolepsy.