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dc.contributor.authorTrogstad, Lillen_US
dc.contributor.authorBakken, Inger Johanneen_US
dc.contributor.authorGunnes, Ninaen_US
dc.contributor.authorGhaderi, Saraen_US
dc.contributor.authorStoltenberg, Camillaen_US
dc.contributor.authorMagnus, Peren_US
dc.contributor.authorHåberg, Siri Eldeviken_US
dc.PublishedTrogstad L, Bakken IJ, Gunnes N, Ghaderi S, Stoltenberg C, Magnus P, Håberg SE. Narcolepsy and hypersomnia in Norwegian children and young adults following the influenza A(H1N1) 2009 pandemic. Vaccine. 2017;35(15):1879-1885eng
dc.description.abstractBackground: Associations between influenza infection and sleep disorders are poorly studied. We investigated if pandemic influenza infection or vaccination with Pandemrix in 2009/2010 was associated with narcolepsy or hypersomnia in children and young adults. Methods: We followed the Norwegian population under age 30 from January 2008 through December 2012 by linking national health registry data. Narcolepsy diagnoses were validated using hospital records. Risks of narcolepsy or hypersomnia were estimated as adjusted hazard ratios (HRs) in Cox regression models with influenza infection and vaccination as time-dependent exposures. Results: Among the 1,638,526 persons under age 30 in Norway in 2009, 3.6% received a physician diagnosis of influenza during the pandemic, while 41.9% were vaccinated against pandemic influenza. Between October 1st 2009 and December 31st 2012, 72 persons had onset of narcolepsy and 305 were diagnosed with hypersomnia. The risk of a sleep disorder was associated with infection during the first six months, adjusted HR 3.31 with 95% confidence interval [CI], 1.01–10.79 for narcolepsy and adjusted HR 3.13 (95% CI, 1.12–8.76) for hypersomnia. The risk of narcolepsy was strongly associated with vaccination during the first six months adjusted HR 17.21 (95% CI, 6.28–47.14), while the adjusted HR for hypersomnia was 1.54 (95% CI, 0.81–2.93). Conclusions: The study confirms an increased HR of narcolepsy following pandemic vaccination. Slightly increased HRs of narcolepsy and hypersomnia are also seen after influenza infection. However, the role of infection should be viewed with caution due to underreporting of influenza.en_US
dc.rightsAttribution CC BY-NC-NDeng
dc.subjectInfluenza A(H1N1)pdm09eng
dc.subjectPandemic vaccinationeng
dc.subjectImmunisation registryeng
dc.titleNarcolepsy and hypersomnia in Norwegian children and young adults following the influenza A(H1N1) 2009 pandemicen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2017 The Author(s)

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