Background Autism spectrum disorder (ASD) is often seen alongside narcolepsy in childhood; however, little is known about the potential link between the two. Our objective was to identify any similarities or differences between children with narcolepsy who also have ASD and those who do not.

Methods A single-centre retrospective records review was undertaken of all children attending narcolepsy clinics as of 1st of August 2021. Data collected included: date and method of narcolepsy diagnosis, severity of narcolepsy at diagnosis, Revised Children’s Anxiety and Depressions Scale (RCADS) scores from parent and child, presence of autistic traits, date of ASD diagnosis and support received by the child’s family.

Results Data was collected from 83 sets of patient records. of this sample, 75 (90.4%) had a confirmed diagnosis of narcolepsy, further analysis was conducted on this group only. A total of 21 (28.0%) children were recorded to have autistic traits, 9 (12.0%) had a confirmed diagnosis of ASD; 88% of ASD diagnoses were made before investigation for narcolepsy. Children with and without ASD had similar SOL and REMSOP results on MSLT. When collecting RCADS data, 55.6% of questionnaires from children with ASD were incomplete for both parent and child, compared to 29.6% of questionnaires from cases without, there was greater discrepancy between parent and child scores in the ASD group and higher parent-rated anxiety scores. Children with ASD were also more likely to receive enhanced school support.

Discussion Descriptive analysis of this sample has shown that 40% of children with narcolepsy also have and ASD diagnosis or autistic traits. These children were more likely to be rated as anxious by their parents and went on to require enhanced support throughout school. This may suggest that ASD is could act as a clinical indicator to offer enhanced support where possible.