Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. Persons with excessive daytime sleepiness are at risk of motor vehicle and work-related incidents and have poorer health than comparable adults.This program will discuss the different causes of EDS as well as the objective tools that can be used to identify excessive sleepiness.
Narcolepsy is a chronic sleep-wake disorder with onset typically during the first to third decades of life, that is often associated with major impairments in school or work productivity, interpersonal relationships and increased risk for adverse health and safety outcomes. Narcolepsy is a disorder of excessive daytime sleepiness and nighttime sleep fragmentation. This lecture will review the essential clinical features of narcolepsy, assessment and diagnostic measures, and highlight the important role of narcolepsy- associated comorbidities on disease burden and overall quality of life.
Idiopathic hypersomnia (IH) is a rare central nervous system hypersomnolence disorder characterized clinically by excessive daytime sleepiness often associated with long and unrefreshing naps, prolonged and undisturbed nocturnal sleep, and great difficulty waking up and “getting going” (sleep inertia) after sleep. The pathophysiology of IH remains unclear. In the absence of a specific marker, IH is a diagnosis of exclusion with a broad differential diagnosis, including atypical forms of depression, narcolepsy type 2 (NT2; narcolepsy without cataplexy), sleep apnea syndrome, and behaviorally induced insufficient sleep syndrome.
Dr. Scammell will review the basic neural circuits that regulate normal states of wake, non-REM sleep, and REM sleep, and how the activity of these circuits is disrupted in people with narcolepsy. He will also discuss how a process of molecular mimicry may result in loss of the orexin/hypocretin neurons, and some hypotheses on the causes of sleepiness in other hypersomnia disorders.
This program presents the clinical features and burden of illness in adults and children of the main disorders of hypersomnia, narcolepsy, idiopathic hypersomnia, and Klein-Levin syndrome. The diagnostic criteria and pathophysiology of the disorders as well as the management including current and future medications will be discussed.
Kleine-Levin syndrome is a rare, remitting-relapsing disorder affecting mostly adolescents, characterized by episodes lasting one to several weeks with severe hypersomnia, as well as cognitive (confusion, mental slowness), behavioral (apathy, disinhibition) and psychiatric (derealization, anxiety, mood change, psychosis) disturbances. We will describe how to recognize the symptoms (and avoid confounding it with encephalopathy or psychiatric disturbances), what tests to do and how to manage patients.
Pediatric Narcolepsy has unique features and co-morbidities that can contribute to diagnostic delays and difficulties in management. In this talk, we will review unique cataplexy and daytime sleepiness presentations in children, discuss new ways for screening for pediatric narcolepsy and nocturnal sleep biomarkers that help confirm the condition, and review AASM Clinical Practice Guidelines for treatment of pediatric narcolepsy.