Two sides of a coin: differential response to COVID-19 distancing measures in children with narcolepsy

None: Narcolepsy is a chronic neurological sleep disorder, debuting before the age of fifteen in one-third of the cases. Narcolepsy has a negative influence on quality of life, with daily functioning being affected by concomitant cognitive, behavioral and social problems. In December 2019, a new coronavirus emerged world-wide, causing a severe a respiratory disease COVID-19. In the Netherlands, a partial lockdown was implemented which included the closure of schools. Here, we report three illustrative cases, teaching us important lessons for the treatment of pediatric narcolepsy. We observed significant consequences of the measures on daytime functioning, wellbeing and school performance, both negative but also very positive. The consequences of the lockdown led to valuable insights for further treatment, substantiating the importance of personalizing education. Involvement of specialized student counselors, flexibility in the way education is delivered and enhancing environmental factors could help in guiding young narcolepsy patients through the challenges at school.