Chapter

Case 43. “Somebody Is Standing by My Bed When I Am Falling Asleep”…

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Abstract

Narcolepsy is a chronic disabling neurological disorder, often unrecognized and misdiagnosed. It is often confused with psychiatric conditions and not properly treated. It is a clinical syndrome consisting of classic tetrad of symptoms (often incomplete, making diagnosis challenging). It is characterized by disruption of sleep/wake cycle, where rapid eye movement physiology intrudes into wakefulness and vice versa. It is caused by loss of hypothalamic neurons producing hypocretin. Onset might be heralded by a viral illness. Continuous pharmacotherapy is as equally important as modification of behavior, sleep hygiene, education, and emotional support. This case illustrated the challenges that could represent its proper diagnosis and management.KeywordsNarcolepsy with cataplexyHypocretinExcessive daytime sleepinessMultiple sleep latency test

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Sleep Medicine is one of the fastest growing fields of medicine and of strong interest to neurologists, psychiatrists, psychologists, pulmonologists, otolaryngologists, and the technologists who perform sleep studies. In 2007, sleep medicine became an official medical subspecialty, with board examinations being administered by the American Board of Medical Specialties. This book provides a comprehensive, practical guide to managing sleep disorders, written by a major authority in the field. In addition, it includes 150 multiple choice questions with answers and explanations, to help those studying for American Board exams.