{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T04:53:47Z","timestamp":1791089627164,"version":"4.1.0"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["32441101"],"award-info":[{"award-number":["32441101"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82341243"],"award-info":[{"award-number":["82341243"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82400116"],"award-info":[{"award-number":["82400116"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Sleep Medicine"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.sleep.2026.109219","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:00:56Z","timestamp":1786723256000},"page":"109219","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Sex differences in patients with narcolepsy type 1: Clinical manifestations, sleep profiles, and symptoms evolution"],"prefix":"10.1016","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6069-0264","authenticated-orcid":false,"given":"Min","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Hui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijun","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhua","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qidi","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.sleep.2026.109219_bib1","series-title":"International classification of sleep disorders \u2013 third edition (ICSD\u20103)","year":"2014"},{"issue":"9","key":"10.1016\/j.sleep.2026.109219_bib2","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1038\/79690","article-title":"A mutation in a case of early onset narcolepsy and a generalized absence of hypocretin peptides in human narcoleptic brains","volume":"6","author":"Peyron","year":"2000","journal-title":"Nat Med"},{"issue":"8","key":"10.1016\/j.sleep.2026.109219_bib3","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1093\/sleep\/32.8.979","article-title":"Elevated anti-streptococcal antibodies in patients with recent narcolepsy onset","volume":"32","author":"Aran","year":"2009","journal-title":"Sleep"},{"issue":"5","key":"10.1016\/j.sleep.2026.109219_bib4","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/jsr.12044","article-title":"Clinical, polysomnographic and genome-wide association analyses of narcolepsy with cataplexy: a European Narcolepsy Network study","volume":"22","author":"Luca","year":"2013","journal-title":"J Sleep Res"},{"issue":"September","key":"10.1016\/j.sleep.2026.109219_bib5","first-page":"1","article-title":"Daytime sleepiness and BMI exhibit gender and age differences in patients with central disorders of hypersomnolence","author":"Ferrazzini","year":"2024","journal-title":"J Sleep Res"},{"issue":"12","key":"10.1016\/j.sleep.2026.109219_bib6","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1212\/WNL.58.12.1826","article-title":"Prevalence of narcolepsy symptomatology and diagnosis in the European general population","volume":"58","author":"Ohayon","year":"2002","journal-title":"Neurology"},{"issue":"7","key":"10.1016\/j.sleep.2026.109219_bib7","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsz091","article-title":"Prevalence and incidence of narcolepsy in a US health care claims database, 2008-2010","volume":"42","author":"Scheer","year":"2019","journal-title":"Sleep"},{"issue":"1","key":"10.1016\/j.sleep.2026.109219_bib8","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5664\/jcsm.3370","article-title":"The impact of gender on timeliness of narcolepsy diagnosis","volume":"10","author":"Won","year":"2014","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.sleep.2026.109219_bib9","first-page":"1","article-title":"Sex disparities in clinical features and burden of narcolepsy type 1","author":"Ingravallo","year":"2024","journal-title":"J Sleep Res"},{"issue":"10","key":"10.1016\/j.sleep.2026.109219_bib10","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1111\/cns.13438","article-title":"Narcolepsy with cataplexy: does age at diagnosis change the clinical picture?","volume":"26","author":"Zhang","year":"2020","journal-title":"CNS Neurosci Ther"},{"issue":"7","key":"10.1016\/j.sleep.2026.109219_bib11","doi-asserted-by":"crossref","first-page":"zsaf102","DOI":"10.1093\/sleep\/zsaf102","article-title":"Sex effect on disease characteristics in patients with narcolepsy type 1","volume":"48","author":"Barateau","year":"2025","journal-title":"Sleep"},{"issue":"1","key":"10.1016\/j.sleep.2026.109219_bib12","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1093\/sleep\/25.1.50","article-title":"Severity of narcolepsy among French of different ethnic origins (south of France and Martinique)","volume":"25","author":"Dauvilliers","year":"2002","journal-title":"Sleep"},{"issue":"1","key":"10.1016\/j.sleep.2026.109219_bib13","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/sleep\/25.1.27","article-title":"Clinical aspects of narcolepsy-cataplexy across ethnic groups","volume":"25","author":"Okun","year":"2002","journal-title":"Sleep"},{"issue":"3","key":"10.1016\/j.sleep.2026.109219_bib14","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1086\/318799","article-title":"Complex HLA-DR and -DQ interactions confer risk of narcolepsy-cataplexy in three ethnic groups","volume":"68","author":"Mignot","year":"2002","journal-title":"Am J Hum Genet"},{"issue":"4","key":"10.1016\/j.sleep.2026.109219_bib15","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0198-8859(95)00106-9","article-title":"HLA class II analysis in Jewish Israeli narcoleptic patients","volume":"44","author":"Kwon","year":"1995","journal-title":"Hum Immunol"},{"issue":"3","key":"10.1016\/j.sleep.2026.109219_bib16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1093\/sleep\/24.3.321","article-title":"Childhood narcolepsy in north China","volume":"24","author":"Han","year":"2001","journal-title":"Sleep"},{"issue":"5","key":"10.1016\/j.sleep.2026.109219_bib17","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1093\/sleep\/34.5.627","article-title":"Presentations of primary hypersomnia in Chinese children","volume":"34","author":"Han","year":"2011","journal-title":"Sleep"},{"issue":"6","key":"10.1016\/j.sleep.2026.109219_bib18","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.sleep.2014.03.002","article-title":"Narcolepsy in China: when the east meets the west","volume":"15","author":"Han","year":"2014","journal-title":"Sleep Med Elsevier BV"},{"issue":"8","key":"10.1016\/j.sleep.2026.109219_bib19","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1111\/j.1440-1843.2012.02178.x","article-title":"Sleepiness that cannot be overcome: Narcolepsy and cataplexy","volume":"17","author":"Han","year":"2012","journal-title":"Respirology"},{"issue":"6","key":"10.1016\/j.sleep.2026.109219_bib20","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.sleep.2013.12.012","article-title":"Symptoms and occurrences of narcolepsy: a retrospective study of 162 patients during a 10-year period in Eastern China","volume":"15","author":"Wu","year":"2014","journal-title":"Sleep Med"},{"issue":"3","key":"10.1016\/j.sleep.2026.109219_bib21","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1002\/ana.22587","article-title":"Narcolepsy onset is seasonal and increased following the 2009 H1N1 pandemic in China","volume":"70","author":"Han","year":"2011","journal-title":"Ann Neurol"},{"issue":"3","key":"10.1016\/j.sleep.2026.109219_bib22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0033723","article-title":"Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland","volume":"7","author":"Partinen","year":"2012","journal-title":"PLoS One"},{"issue":"10","key":"10.1016\/j.sleep.2026.109219_bib23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgen.1003880","article-title":"Genome wide analysis of Narcolepsy in China implicates novel immune loci and reveals changes in association prior to versus after the 2009 H1N1 influenza pandemic","volume":"9","author":"Han","year":"2013","journal-title":"PLoS Genet"},{"issue":"1","key":"10.1016\/j.sleep.2026.109219_bib24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5665\/sleep.3300","article-title":"DQB1 Locus alone explains most of the risk and protection in narcolepsy with cataplexy in Europe","volume":"37","author":"Tafti","year":"2014","journal-title":"Sleep"},{"issue":"3","key":"10.1016\/j.sleep.2026.109219_bib25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/sleep\/zsac325","article-title":"Changed epidemiology of narcolepsy before, during, and after the 2009 H1N1 pandemic: a nationwide narcolepsy surveillance network study in mainland China, 1990-2017","volume":"46","author":"Wang","year":"2023","journal-title":"Sleep"},{"issue":"6","key":"10.1016\/j.sleep.2026.109219_bib26","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"key":"10.1016\/j.sleep.2026.109219_bib27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.sleep.2021.11.003","article-title":"Validation of the Epworth sleepiness scale for children and adolescents (ESS-CHAD) questionnaire in pediatric patients with narcolepsy with cataplexy aged 7\u201316 years","volume":"89","author":"Wang","year":"2022","journal-title":"Sleep Med"},{"issue":"8","key":"10.1016\/j.sleep.2026.109219_bib28","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1093\/sleep\/29.8.1025","article-title":"Off-label treatment of severe childhood narcolepsy-cataplexy with sodium oxybate","volume":"29","author":"Murali","year":"2006","journal-title":"Sleep"},{"issue":"11","key":"10.1016\/j.sleep.2026.109219_bib29","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1212\/WNL.57.11.2029","article-title":"Age at onset of narcolepsy in two large populations of patients in France and Quebec","volume":"57","author":"Dauvilliers","year":"2001","journal-title":"Neurology"},{"key":"10.1016\/j.sleep.2026.109219_bib30","unstructured":"Iber C, Ancoli-Israel S, Chesson A, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specification. first ed., American Academy of Sleep medicine. Westchester."},{"issue":"11","key":"10.1016\/j.sleep.2026.109219_bib31","doi-asserted-by":"crossref","first-page":"e1034","DOI":"10.1212\/WNL.0000000000008094","article-title":"Validation of Multiple sleep latency test for the diagnosis of pediatric narcolepsy type 1","volume":"93","author":"Pizza","year":"2019","journal-title":"Neurology"},{"key":"10.1016\/j.sleep.2026.109219_bib32","doi-asserted-by":"crossref","DOI":"10.1016\/j.smrv.2020.101276","article-title":"Sleep during development: sex and gender differences","volume":"51","author":"Franco","year":"2020","journal-title":"Sleep Med Rev"},{"issue":"1","key":"10.1016\/j.sleep.2026.109219_bib33","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.sleep.2013.08.787","article-title":"Prevalence of insomnia symptoms in a general population sample of young children and preadolescents: gender effects","volume":"15","author":"Calhoun","year":"2014","journal-title":"Sleep Med"},{"issue":"4","key":"10.1016\/j.sleep.2026.109219_bib34","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1089\/jwh.2017.6482","article-title":"Gender-specific differences in access to polysomnography and prevalence of sleep disorders","volume":"27","author":"Auer","year":"2018","journal-title":"J Women\u2019s Heal"},{"key":"10.1016\/j.sleep.2026.109219_bib35","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2350-9-79","article-title":"Association of narcolepsy-cataplexy with HLA-DRB1 and DQB1 in Mexican patients: a relationship between HLA and gender is suggested","volume":"9","author":"Alaez","year":"2008","journal-title":"BMC Med Genet"},{"issue":"12","key":"10.1016\/j.sleep.2026.109219_bib36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/sleep\/zsac126","article-title":"Gender differences in narcolepsy: what are recent findings telling us?","volume":"45","author":"Schmidt","year":"2022","journal-title":"Sleep"},{"issue":"9","key":"10.1016\/j.sleep.2026.109219_bib37","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/s41582-019-0226-9","article-title":"Narcolepsy \u2014 clinical spectrum, aetiopathophysiology, diagnosis and treatment","volume":"15","author":"Bassetti","year":"2019","journal-title":"Nat Rev Neurol Springer US"},{"issue":"7","key":"10.1016\/j.sleep.2026.109219_bib38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/sleep\/zsac089","article-title":"Effects of sex and estrous cycle on sleep and cataplexy in narcoleptic mice","volume":"45","author":"Arthaud","year":"2022","journal-title":"Sleep"}],"container-title":["Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945726004582?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945726004582?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T04:22:19Z","timestamp":1791087739000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1389945726004582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":38,"alternative-id":["S1389945726004582"],"URL":"https:\/\/doi.org\/10.1016\/j.sleep.2026.109219","relation":{},"ISSN":["1389-9457"],"issn-type":[{"value":"1389-9457","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sex differences in patients with narcolepsy type 1: Clinical manifestations, sleep profiles, and symptoms evolution","name":"articletitle","label":"Article Title"},{"value":"Sleep Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.sleep.2026.109219","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"109219"}}