303 Therapeutic Potential of Opioids in Narcolepsy Type 1 sleepiness and cataplexy; we therefore expected these symptom domains to be most frequently mentioned in the current study. Material and methods We conducted a systematic literature review, and used a cross-sectional questionnaire and semi-structured interviews for this study, to investigate to what extent opioid use could influence symptom severity in people with narcolepsy type 1. Systematic literature review The systematic literature review included previously conducted clinical trials, case series and case reports on opioid use in people with narcolepsy type 1. A PICO and matching search strategy (Appendix A) were composed according to the Peer Review of Electronic Search Strategies (PRESS) checklist [370]. The search strategy was conducted in PubMed/MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL, Cochrane Library). Reference lists of relevant studies were also manually scrutinised, and the ‘Related articles’ function in PubMed was used. Grey literature searches were additionally performed in Google Scholar and all registered clinical trials on narcolepsy were screened in ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). Literature was included when published between inception of the respective platform and 1 January 2022. Resulting publications were screened based on the title and abstract (by EMH) and the following eligibility criteria to be included: original research, any form of opioid use (full list in the search strategy in Appendix A), people with narcolepsy type 1 (or narcolepsy with cataplexy), written in English. Each publication that met the inclusion criteria was subsequently reviewed in full by two independent reviewers (JKG and EMH). Resulting publications were individually summarised in a table with the descriptions of the study population, the opioid details (type, indication and duration of use, dosage and frequency), control condition (if available) and the possible effects on narcolepsy symptom severity. Questionnaire and interviews A questionnaire was designed with two goals. We aimed to investigate the prevalence of recent opioid use in people with narcolepsy type 1 and, when there was use reported, whether the opioid influenced narcolepsy symptom 10
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