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Study Objectives: <p>This multicenter comparative cross-sectional study aimed to describe educational and occupational pathways, quantify effort/reward imbalance at work, and identify factors associated with professional prognosis in patients with narcolepsy type 1.</p> Methods: <p>Adult patients with narcolepsy type 1 and controls answered online questionnaires (Epworth Sleepiness Scale, Beck Depression Inventory II, Siegrist questionnaire, adult self-report, and a questionnaire on academic and professional trajectories) and were compared using sex- and age-adjusted logistic regressions. Clinical, demographic, and psycho-social factors associated with patients’ professional prognosis, as assessed by a composite score based on occupational-related outcomes, were explored with a generalized linear model.</p> Results: <p>We included 235 patients (63.8% females, 36.4 ± 14.7 years, 86.5% treated, 66.4% with childhood onset) and 166 controls (69.9% females, 40.3 ± 14.4 years). No difference was observed between patients and controls for graduation, but patients reported more interruptions, absenteeism, and lateness during schooling. No difference was observed for employment rate (69.5% vs 77.0%), but income was lower in patients who reported more unwanted changes in position and part-time work, with increased effort-reward imbalance (odds ratio = 2.28 95% confidence interval [1.20–4.33], <i>P</i> = .01). Impaired professional prognosis was associated with depression (<i>P</i> &lt; .0001) and attention disorders (<i>P</i> = .03), while being a person with narcolepsy during schooling was a protective factor (<i>P</i> = .02).</p> Conclusions: <p>Most patients with narcolepsy type 1 manage to achieve their careers goals, but at the cost of an effort/reward imbalance. Early diagnosis might allow a better adjustment to the disease. The strong impact of psycho-cognitive comorbidities on professional outcomes stresses the need to consider psycho-cognitive-social dimensions in patient care.</p> <p><b>Clinical Trial Registration:</b> Registry: ClinicalTrials.gov; Name: NARCOSCOL-NARCOVITAE; URL: <a href="https://clinicaltrials.gov/study/NCT03765892">https://clinicaltrials.gov/study/NCT03765892</a>; Identifier: NCT03765892.</p> Citation: <p>Peter-Derex L, Fort E, Putois B, et&#xa0;al. Effort/reward imbalance and comorbidities burden in academic and professional careers of patients with narcolepsy type 1. <i>J Clin Sleep Med</i>. 2025;21(6):983–997.</p>

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Effort/reward imbalance and comorbidities burden in academic and professional careers of patients with narcolepsy type 1

  • 期刊论文

  • 发表日期：

    2025年6月1日

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  • Laure Peter-Derex,
  • Emmanuel Fort,
  • Benjamin Putois,
  • Nora Martel,
  • François Ricordeau,
  • Hélène Bastuji,
  • Isabelle Arnulf,
  • Lucie Barateau,
  • Patrice Bourgin,
  • Yves Dauvilliers,
  • Rachel Debs,
  • Pauline Dodet,
  • Benjamin Dudoignon,
  • Patricia Franco,
  • Sarah Hartley,
  • Isabelle Lambert,
  • Michel Lecendreux,
  • Laurene Leclair-Visonneau,
  • Damien Léger,
  • Martine Lemesle-Martin,
  • Antoine Léotard,
  • Smaranda Leu-Semenescu,
  • Nadège Limousin,
  • Régis Lopez,
  • Nicole Meslier,
  • Jean-Arthur Micoulaud-Franchi,
  • Christelle Charley-Mocana,
  • Marie-Pia d’Ortho,
  • Pierre Philip,
  • Elisabeth Ruppert,
  • Sylvie de La Tullaye,
  • Manon Brigandet,
  • Jennnifer Margier,
  • Benjamin Rolland,
  • Barbara Charbotel,
  • Stéphanie Mazza

摘要

Study Objectives:

This multicenter comparative cross-sectional study aimed to describe educational and occupational pathways, quantify effort/reward imbalance at work, and identify factors associated with professional prognosis in patients with narcolepsy type 1.

Methods:

Adult patients with narcolepsy type 1 and controls answered online questionnaires (Epworth Sleepiness Scale, Beck Depression Inventory II, Siegrist questionnaire, adult self-report, and a questionnaire on academic and professional trajectories) and were compared using sex- and age-adjusted logistic regressions. Clinical, demographic, and psycho-social factors associated with patients’ professional prognosis, as assessed by a composite score based on occupational-related outcomes, were explored with a generalized linear model.

Results:

We included 235 patients (63.8% females, 36.4 ± 14.7 years, 86.5% treated, 66.4% with childhood onset) and 166 controls (69.9% females, 40.3 ± 14.4 years). No difference was observed between patients and controls for graduation, but patients reported more interruptions, absenteeism, and lateness during schooling. No difference was observed for employment rate (69.5% vs 77.0%), but income was lower in patients who reported more unwanted changes in position and part-time work, with increased effort-reward imbalance (odds ratio = 2.28 95% confidence interval [1.20–4.33], P = .01). Impaired professional prognosis was associated with depression (P < .0001) and attention disorders (P = .03), while being a person with narcolepsy during schooling was a protective factor (P = .02).

Conclusions:

Most patients with narcolepsy type 1 manage to achieve their careers goals, but at the cost of an effort/reward imbalance. Early diagnosis might allow a better adjustment to the disease. The strong impact of psycho-cognitive comorbidities on professional outcomes stresses the need to consider psycho-cognitive-social dimensions in patient care.

Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: NARCOSCOL-NARCOVITAE; URL: https://clinicaltrials.gov/study/NCT03765892; Identifier: NCT03765892.

Citation:

Peter-Derex L, Fort E, Putois B, et al. Effort/reward imbalance and comorbidities burden in academic and professional careers of patients with narcolepsy type 1. J Clin Sleep Med. 2025;21(6):983–997.