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Sleep Medicine NetWorkNarcolepsy and Idiopathic HypersomniaNarcolepsy and Idiopathic Hypersomnia After reading the Chapter, test your knowledge with questions from ACCP-SEEK Sleep Medicine, First Edition: 1) Which one of the following statements is true regarding narcolepsy due to medical conditions? A. The diagnosis requires the presence of reduced or absent CSF hypocretin-1 levels.
2) A 24-year-old woman presents with several years of excessive daytime sleepiness associated with bilateral lower extremity weakness precipitated by laughter. Her typical bedtime is 10:30 pm, with a subjective total sleep time of 8 h on most nights. She has no medical problems and takes no medications. Following an overnight polysomnogram with relatively normal results, an MSLT demonstrates a mean sleep latency of 3 min, with three sleep onset rapid eye movement (REM) periods out of four nap trials, supporting a diagnosis of narcolepsy. Therapy with modafinil, 200 mg taken each morning, is initiated and later increased to 400 mg taken each morning. After 4 weeks of therapy, she continues to have significant residual daytime sleepiness, as well as cataplexy. Which of the following could you recommend to better treat the patient’s symptoms? A. Increase modafinil from once-a-day to twice-a-day dosing. |
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