Narcolepsy, idiopathic hypersomnolence and related conditions

摘要

Narcolepsy with cataplexy is primarily a disorder of excessive daytime sleepiness (EDS) and episodic collapse. Despite a quality of life impact similar to Parkinson's disease (PD) and significant individual and societal costs it is often overlooked. A UK survey found median time from first symptom to diagnosis to be 10.5 years. The delay in diagnosis may be because it is uncommon (European prevalence 0.047%), but is no doubt exacerbated by a paucity of sleep medicine training (median 5 min in UK medical undergraduate curricula). Narcolepsy has a variety of presentations which may be wrongly attributed to more familiar disorders or lifestyle and there is an overlap with normality. EDS is reported by up to 10% of the general population and objective measures of sleepiness do not reliably differentiate narcoleptics and normal subjects. It is important for the acute care physician to be aware of the features of, and means for, diagnosing narcolepsy so that opportunities to treat this disabling condition are not missed.