Journal of Sleep Disorders: Treatment and CareISSN: 2325-9639

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Research Article, J Sleep Disor Treat Care Vol: 2 Issue: 1

Narcolepsy-Characteristics of those in the Borderland-We Need a Better Diagnostic Tool

Mandana Mahmoudi2, Christine Won1 and Vahid Mohsenin1*
1Yale Center for Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
2Department of Sleep Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Corresponding author : Vahid Mohsenin
Yale Center for Sleep Medicine, Yale School of Medicine, 333 Cedar Street, P.O.Box 208057, New Haven, CT 06520, USA
Tel: 203-562-9901; Fax: 203-624-4950
E-mail: [email protected]
Received: December 26, 2012 Accepted: March 05, 2013 Published: March 12, 2013
Citation: Mahmoudi M, Won C, Mohsenin V (2013) Narcolepsy-Characteristics of those in the Borderland-We Need a Better Diagnostic Tool. J Sleep Disor: Treat Care 2:1. doi:10.4172/2325-9639.1000106

Abstract

Narcolepsy-Characteristics of those in the Borderland-We Need a Better Diagnostic Tool

Purpose: The criteria for the diagnosis of narcolepsy changed when the 2nd edition of the International Classification of Sleep Disorders supplanted the first edition (ICSD-1). The impact of using the updated criteria is unknown. We thus compared the characteristics of a population of patients diagnosed using ICSD- 2 with those that only met ICSD-1 criteria. Minimum criteria for narcolepsy in ICSD-1 are sleepiness with cataplexy, sleep paralysis, or hypnogogic hallucinations plus sleep latency <10 minutes or REM latency <20 min on polysomnography. ICSD-2 requires sleepiness with cataplexy or a positive MSLT (MSLT-SL ≤ 8 min and SOREMPs ≥ 2). Methods: The records of 148 subjects with suspected narcolepsy were reviewed. Seventy subjects were excluded because of other diagnoses or use of REM suppressants. 59 patients were diagnosed on the basis of cataplexy (54%) or positive MSLT (55%). The remaining 19 patients without cataplexy or positive MSLT fulfilled the minimal criteria using ICSD-1. Results: The anthropometrics, narcolepsy symptoms including refreshing naps, Epworth sleepiness scores and sleep bioparameters were comparable between patient with and without cataplexy.

Keywords: Narcolepsy; Hypersomnia; Sleepiness; Cataplexy; REM sleep; MSLT

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