Narcolepsy--master of disguise: evidence-based recommendations for management.

Full Abstract

Narcolepsy is a neurological disorder affecting the regulation of sleep and wakefulness. It is characterized by excessive daytime sleepiness, cataplexy, and other rapid eye movement (REM) sleep-associated manifestations (eg, hypnagogic hallucinations and sleep paralysis). The recognition of this disorder is usually delayed by 10 to 15 years, largely because of its protean manifestations, insidious nature, and lack of physician awareness. Delayed diagnosis is associated with poor quality of life, depression, and increased likelihood of accidents. Health care providers should include narcolepsy in the differential diagnosis of patients with excessive sleepiness, chronic fatigue, sleep-disordered breathing, depression, and attention-deficit/hyperactivity disorder. Narcolepsy is a lifelong disorder that often requires pharmacological treatments, which may include wake-promoting stimulants for excessive sleepiness and gamma-hydroxybutyrate (sodium oxybate) and antidepressants for REM sleep-associated manifestations. This article presents a case of a 47-year-old man with long-standing sleepiness and cataplexy who was eventually diagnosed with narcolepsy 30 years after the first onset of symptoms. The presenting manifestations of narcolepsy, diagnostic criteria, and its management are also discussed.

Author information

Author/s: Mohsenin, Vahid (V);

Affiliation: Center for Sleep Medicine, Yale University School of Medicine, New Haven, CT 06519, USA. vahid.mohsenin(-atsign-)yale.edu

Journal and publication information

Publication Type: Case Reports; Journal Article

Journal: Postgraduate medicine (Postgrad Med), published in United States. (Language: eng)

Reference: 2009-May; vol 121 (issue 3) : pp 99-104

Dates: Created 2009/06/03; Completed 2009/06/23;

PMID: 19491546, status: MEDLINE (last retrieval date: 6/23/2009, IMS Date: 23 Jun 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adjuvants, Anesthesia - therapeutic use
Attention Deficit and Disruptive Behavior Disorders
Benzhydryl Compounds - therapeutic use
Catalepsy - diagnosis; etiology; physiopathology
Central Nervous System Stimulants - therapeutic use
Diagnosis, Differential
Drug Therapy, Combination
Evidence-Based Medicine - methods

Follow-Up Studies
Humans
Male
Middle Aged
Narcolepsy - complications; diagnosis; drug therapy
Polysomnography
Sleep, REM - drug effects; physiology
Sodium Oxybate - therapeutic use

Associated Chemicals: Adjuvants, Anesthesia (0) ; Benzhydryl Compounds (0) ; Central Nervous System Stimulants (0) ; Sodium Oxybate (502-85-2) ; modafinil (68693-11-8)

This article has not been indexed for related articles as yet, however you can still use the live related article search links below.

See 100+ related articles.

See a large map of 100+ related articles.