73 Incidence Peaks and the Role of Influenza with NT2/IH could only be replicated in 64.1% of the iterations of the same permutation testing, suggesting this peak could be a false positive finding. Similar results were also found in NT2/IH excluding those with clinical diagnoses that had clear central disorder of hypersomnolence phenotype but did not strictly adhere to the ICSD-3 criteria (Appendix B, Supplementary Figure 8 and Figures 13-14). Figure 3. Narcolepsy type 2 and idiopathic hypersomnia incidence rates excluding HLA DQB1*06:02 positive subjects. The changes in narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) all individuals (A), children (B) and adults (C). The predicted incidence rates and their 95% predictive confidence intervals are marked as green circles/lines and the actual values are in black circles. EDS = excessive daytime sleepiness. NT1 incidence and preceding influenza season severity We identified a significantly positive relationship between type A H1N1 influenza season severity and NT1 incidence in children and adults when combining data from the four largest countries in linear mixed model analysis (Table 2). A significantly negative relationship was found between type A H3N2 influenza season severity and NT1 incidence in both age groups. Similar results were also found in NT1 excluding those with clinical diagnoses that had clear central disorder of hypersomnolence phenotype but did not strictly adhere to the ICSD-3 criteria (Appendix B, Supplementary Figure 15). 3
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