OBJECTIVES: Narcolepsy is a chronic sleep disorder characterized by excessive daytime drowsiness, sleep attacks, cataplexy, hypnagogic hallucinations and sleep paralysis. The aim of the study was to assess the economic burden of patients suffering from narcolepsy. METHODS: In a cross-sectional study, we used a standardized telephone interview and a mailed questionnaire to calculate the economic and social burden of 75 narcoleptic patients (mean age: 48.9±15.2; f:m: 29:46), who met the International Sleep Disorder Classification criteria. Health-related quality of life was assessed by using the SF-36 and the EQ-5D. From a societal perspective, we calculated all direct and indirect costs using EUR2002. RESULTS: The total annual costs amounted to 16798±18976€ per patient. Direct costs added up to 3284±3600€ and included hospital costs (1193±2202€), in-patient rehabilitation (535±1772€), ambulatory diagnostics (18±3€0), ambulatory care (88±55€) and drug costs (narcolepsy medication: 1120±1530€). Approximately 50% of narcoleptic drug costs were due to the newer wake-promoting drug Modafinil. Modafinil is known to be a potent but also more expensive treatment. Total annual indirect costs were 13,515±18,411€ per patient and are mainly caused by early retirement. Sleep attacks correlated significantly with early retirement and higher indirect costs in comparison to patients without them (p=0.012). CONCLUSIONS: The socioeconomic impact of narcolepsy on society is considerably high. As in most other neurological diseases, the indirect costs outnumber the direct medical costs. Appropriate treatment is required to help patients to continue their working life and to minimize indirect costs.