Harvard medical schools division of sleep medicine and its sleep and health education program assume no. Despite the classic tetrad of clinical features that typify it, narcolepsy remains much underdiagnosed, in part, because of the wide spectrum of clinical phenotypes, but also because of its. Narcoleptic sleep cycles for a person with narcolepsy, these sleep cycles are completely different. About one in 2,000 people have some form of narcolepsy. Selfhelp for sleep disorders while some sleep disorders may require a visit to the doctor, you can improve many sleeping problems on your own. Increased daytime sleepiness may be the only sign at the disease onset, with attacks of sleep. The mslt is done the day after the polysomnogram so a doctor can determine whether the prior nights. Narcolepsy can usually be diagnosed by observing how you sleep and ruling out other conditions. The diagnosis of narcolepsy is usually supported by test results from a. Multiple sleep latency test mslt is a type of polysomnogram that can help with identification of patients with narcolepsy.
Keeping a sleep diary will let you learn about your sleep patterns and habits. Narcolepsy is a condition that can cause people to fall asleep suddenly, while also preventing them from getting the sleep they need. It is characterised by severe, irresistible daytime sleepiness and sudden loss of muscle tone cataplexy, and can be associated with sleep onset or sleep offset paralysis and hallucinations, frequent movement and awakening during sleep. If you suspect you have narcolepsy, discuss your concerns with a medical professional familiar with narcolepsy and other sleep disorders. People with narcolepsy feel sleepy and can fall asleep quickly, but they do not stay asleep for long. Narcolepsy is a chronic neurological sleep disorder with potentially disabling symptoms. How to use the national sleep foundation sleep diary our sleep diary. Symptoms often include periods of excessive daytime sleepiness and brief involuntary sleep.
Other associated symptoms of the condition can potentially have a. Regardless of your sleep problems, sticking to a consistent sleep. Narcolepsy is a lifelong sleep disorder that makes you feel overwhelmingly tired, and in severe cases, have sudden uncontrollable sleep. Narcolepsy is a neurologic disorder characterized by a decreased ability to regulate sleep wake cycles. Use these spaces to record what each letter or symbol. Because cataplexy is the most specific symptom of narcolepsy. How many times you woke up during the night and how long it took you to fall back.
Chapter 38 management of n arolepsy c in a dults m. This sleepiness may occur in the form of repeated and irresistible sleep attacks. Characterize disrupted nighttime sleep dns in narcolepsy, an important. While a person with narcolepsy may sleep the same amount of hours as anyone else, it will likely be spread. Narcolepsy needtoknow guide how is narcolepsy diagnosed. Narcolepsy is a longterm neurological disorder that involves a decreased ability to regulate sleep wake cycles. Narcolepsy is a neurological sleep disorder that causes a potentially disabling level of daytime sleepiness. A 12month, openlabel, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. Using this sleep diary takes just a few minutes each. Narcolepsy symptoms, diagnosis and treatment bmj best. The classic tetrad of narcolepsy, seen in only 10% to 15% of cases, includes excessive daytime sleepiness, cataplexy, sleep. National sleep foundation sleep diary complete in morning complete at end of day i went to bed last night at. To validate the narcolepsy severity scale nss, a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 nt1. Every two hours, the patient is given an opportunity to sleep for 20 minutes or more.
A sleep log is one of the best ways to provide the accurate and objective information a doctor needs to know to make important decisions about treatment. The role of the hypocretin system in normal sleep regulation is more uncertain. People with symptoms of narcolepsy often do not receive a definite diagnosis of the condition until several years after their symptoms first. Patterns of sleep and wakefulness in treated narcoleptic subjects. Franco, md associate professor of pulmonary, critical care. Sleep and cataplexy diary recording sleep times and any disturbances can help your doctor determine whether your sleepiness is caused by insufficient sleep or something else, such as narcolepsy. The national sleep foundation has a downloadable sleep diary to help you track your nighttime sleep patterns, naps, feelings of sleepiness, and more. A pilot study on the effects of sodium oxybate on sleep architecture and daytime alertness in narcolepsy. Print and use this sleep diary to record the quality and quantity of your sleep. Daytime sleepiness and sleep attacks were evaluated by comparing sleep diary data before and after treatment. Using this sleep diary takes just a few minutes each day. Record number of times when i woke up for the day, i felt. The diagnosis and treatment of pediatric narcolepsy.
The cardinal symptom of narcolepsy is excessive daytime sleepiness that leads to an irrepressible need to sleep and daytime lapses into sleep. Harvard medical schools division of sleep medicine and its sleep and health education program assume no responsibility for content on external sites, nor does listing here indicate any editorial endorsement or approval of the content of these sites. Narcolepsy is a chronic condition characterized by a disruption of the sleep wake cycle and rapid eye movement rem sleep intrusion. The functional significance of the hypocretin system is rapidly emerging in both animals and humans.
Sleep onset rem is recorded if rem sleep appears within 15 minutes after sleep. Quality measures for the care of patients with narcolepsy aasm. In narcolepsy without cataplexy, the mean sleep latency. American academy of sleep medicine provider fact sheet narcolepsy quick facts.
American sleep association 100 cambridge street, ste. Narcolepsy is a chronic neurological sleep disorder, the diagnosis of which is based upon clinical evaluation and additional paraclinical assessments. We believe hypocretin cells drive cholinergic and monoaminergic activity across the sleep. How to use the national sleep foundation sleep diary our sleep diary only takes a few minutes each day to complete. A 15item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep.
Sleep and wake times, naps, triggers and duration of cataplectic events. Testing narcolepsy healthy sleep harvard university. Narcolepsy with cataplexy is a disabling sleep disorder affecting 002% of adults worldwide. Cognitive behavioral therapy for insomnia cbti virginia runko, phd, cbsm behavioral sleep medicine specialist licensed psychologist the ross center for anxiety and related disorders, washington dc. The sleep diary is very useful to share with your doctor to describe your sleep habits. The aim of this study was to examine the prevalence of sdb in narcoleptics referred to a tertiary sleep disorders clinic and assess the effectiveness of cpap as adjunctive therapy. There was wide variation in the amount of daytime sleep among narcoleptics. Diagnosis of a sleep disorder narcolepsy parasomnias. Scheduled daytime naps called the multiple sleep latency test at a sleep laboratory can help with the diagnosis of narcolepsy, where there are rem sleep onsets in at least 2 out of 4 nap opportunities. Narcolepsy is a chronic condition characterised by a disruption of the sleep wake cycle and rapid eye movement rem sleep intrusion. Provides information about mental health problems including sleep problems. In these episodes a person suddenly falls asleep in unusual situations, such as while eating, walking or driving. Sleep diary, sleep questionnaire, sleep referral form. Narcolepsy in children is a serious disorder marked by a chronic course and lifelong handicap in school performance and choice of employment, by free time activity limitation, and by behavior and personality changes, all of which constitute a major influence on the quality of life.
See the finding a doctor section of this website for more information on finding a sleep. Download and print out our sleep log form or use a simple notebook to record the most common and useful data. This page lists resources of potential interest for people seeking to learn more about narcolepsy. Put the letter c in the box when you have coffee, cola or tea. Sleep diary national heart, lung, and blood institute. Hypocretin abnormalities cause narcolepsy in dogs, human and mice. Narcolepsy is a lifelong sleep disorder characterized by a classic tetrad of excessive daytime sleepiness with irresistible sleep attacks, cataplexy sudden bilateral loss of muscle tone, hypnagogic hallucination, and sleep. Rem sleep is the phase of sleep characterized by muscle atonia and intense dream content. Features of narcolepsy include daytime sleepiness, sleep attacks, cataplexy in narcolepsy type 1, sleep paralysis, and sleep related hallucinations. Mark the times that you take medications with a different letter or symbols for each medication or dosage. Characterized by excessive and overwhelming daytime sleepiness, even after getting a good nights sleep, narcolepsy can make someone fall asleep at.
Sleep paralysis usually only lasts for a brief period of time but can be distressing. The center for narcolepsy, stanford university school of medicine. People without narcolepsy can also experience sleep paralysis. The multiple sleep latency test is often the most important test for diagnosing narcolepsy. It is a series of five scheduled naps spread across the day. People with narcolepsy may enter rem sleep more quickly than usual and during the day.
Before your appointment, you may find it useful to record your symptoms in a diary. Download the printable sleep diary pdf to track your sleeping patterns. Print out the ullanlinna narcolepsy scale pdf to assess your symptoms. They go into rapid eye movement sleep soon after falling asleep. Objective narcolepsy is a sleep disorder characterized in humans by excessive daytime sleepiness and cataplexy. In this test, the patient is allowed to go to sleep during the five scheduled naps.