Narcolepsy - Prevalence, Diagnosis and Treatment Options

Narcolepsy is a Debilitating and incurable neurologic disorder that disrupts the boundaries between sleep and wake states. Prevalence: ~1 in 2000 in the general US population. Up to 5% of patients who present with EDS. Underrecognized and underdiagnosed. IH is a similar condition whose etiology is unknown.

Both conditions are associated with significant morbidity. Their diagnostic evaluation involves a comprehensive office based evaluation, polysomnographic testing and serum orexin levels, among others.

A variety of treatments are available. Traditionally, stimulants and antidepressants have been utilized for control of daytime sleepiness and cataplexy. More recently, we have seen the introduction of wake promoting agents, hydroxy butyrate preparations, agents that augment histamine neurotransmission, and under development are orexin receptor agonists.