![]() ![]() ![]() The choice of medication depends on symptom severity, psychosocial history, and comorbidities.Patients should be treated in consultation with a sleep specialist.Medical therapy Principles of medical therapy State regulations vary on the legally required period of time that patients should be symptom-free before driving. Īs motor vehicle collisions are a concern for patients with narcolepsy, to be allowed to drive, they should be symptom-free and taking treatment. Consider scheduled naps throughout the day to reduce the urge to sleep.Avoid substances that disturb the sleep-wake cycle (e.g., alcohol, antipsychotics, opiates).Ensure regular sleep periods during the night.Human leukocyte antigen ( HLA) haplotype testing: not usually useful for diagnostic purposes.MRI brain: Consider if neurological findings suggest secondary narcolepsy.Supportive finding: decreased CSF hypocretin -1 ( orexin A) levels ( ≤ 110 pg/mL or Not routinely indicated may be used to diagnose type 1 narcolepsy.If feasible, medications affecting sleep (e.g., antidepressants and stimulants) should be paused for at least two weeks prior to a sleep study. Used to exclude other sleep disorders and may also show supportive findings for narcolepsy (e.g., SOREMP).Measures sleep duration, efficiency, and stages.Sleep-onset REM periods (SOREMPs): REM periods that occur within 15 minutes of falling asleep also referred to as shortened REM sleep latency. ![]()
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