67 Incidence Peaks and the Role of Influenza protocol in which nocturnal polysomnography was directly followed by a MSLT. In Montpellier, the 32-hour bed rest protocol was used for diagnosing IH in case of long sleep time [164]. In our incidence rate and influenza season correlational analyses we merged the individuals with NT2/IH into one group to achieve sufficient power. Those with a clear complaint of EDS almost fulfilling ICSD-3 diagnostic criteria were included as people with a “clinical diagnosis” (for instance a person with typical cataplexy, MSLT sleep latency of four minutes and one SOREMP). Appendix B shows an overview of the clinical diagnosis groups’ definitions, number of subjects per centre, and repeated sensitivity analyses without the people with a clinical diagnosis to investigate whether this group had substantially influenced our results. Demographics and diagnostic criteria were statistically compared between NT1, NT2 and IH. Shapiro–Wilk normality tests were first used to test the distributions of the numerical variables in each subgroup, and one-way ANOVA or Kruskal-Wallis tests were used to compare the variables among the three subgroups depending on whether the data were normally distributed. All sites are members of EUNN and they provided pseudonymised data with ethical approval from their local ethics committees and institutional review boards (i.e., the Netherlands: the Medical Ethical Committee of the VU Medical Center scrutinized the study as it consisted of an analysis of previously acquired clinical data posing no risk to included individuals [reference number: 2020.109]; Montpellier, France: Comité de Protection des Personnes France [reference number: 018-A00703-52]; Bologna, Italy: Comitato Etico di Area Vasta Emilia Centro [reference number: EM539-2022-17009-EM1-OSS-AUSLBO]; Prague, Czech Republic: Etická komise Všeobecné fakultní nemocnice v Praze [reference number: 115/21 S]; Warsaw, Poland: Instytut Psychiatrii I Neurologii Komisja Bioetyczna [reference number 21/2010]; Košice, Slovak Republic: Etická komisia Univerzitnej nemocnice L. Pasteura Košice [reference number 22.05.2014]; Innsbruck, Austria: Eithikkommission der Medizinischen Universität Innsbruck [reference number: AH3368 269/4.7 389/5.13(4311a)]; Madrid, Spain: Comité Ético de Investigación Clínica del Grupo Hospital de Madrid [reference number: 15.02.748-GHM]). The clinical experiments conformed to the principles outlined by the Declaration of Helsinki. Disease onset We chose the year of EDS onset as disease onset, as it in general is the first symptom of narcolepsy or IH to develop. In case of unclear onset, for instance when an individual was unsure about onset between two years, this individual 3
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