scholarly journals Drug Testing in Children with Excessive Daytime Sleepiness During Multiple Sleep Latency Testing

2014 ◽  
Vol 10 (08) ◽  
pp. 897-901 ◽  
Author(s):  
Eliot S. Katz ◽  
Kiran Maski ◽  
Amanda J. Jenkins
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Drug Testing ◽  
Sleep Latency ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

scholarly journals Cancer-related fatigue presenting with excessive daytime sleepiness

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774886
Author(s):  
Diwakar D Balachandran ◽  
Saadia A Faiz ◽  
Lara Bashoura ◽  
Ellen Manzullo
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Excessive Daytime Sleepiness ◽  
Breast Cancer Survivor ◽  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Common Symptom ◽  
Cancer Related Fatigue ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Cancer-related fatigue is a common symptom in cancer patients which commonly occurs in relation to sleep disturbance. We report a case of a 35-year-old breast cancer survivor, in whom polysomnography and multiple sleep latency testing were utilized to objectively quantify the contribution of excessive daytime sleepiness to the patient’s cancer-related fatigue.

scholarly journals Late-Onset Narcolepsy: A Case Report with Brief Review of the Literature

2021 ◽  
Author(s):  
Jeny Jacob ◽  
Rajesh Venkataram ◽  
Nandakishore Baikunje ◽  
Rashmi Soori
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Late Onset ◽  
Sleep Latency ◽  
Early Adulthood ◽  
Review Of The Literature ◽  
Multiple Sleep Latency ◽  
Overnight Polysomnography

AbstractNarcolepsy, a sleep disorder, has its onset in childhood and early adulthood but rarely in older adults. This case report focuses on a man in his late fifties who was noticed to have excessive daytime sleepiness during his stay in our hospital for an unrelated medical ailment. He was further evaluated with overnight polysomnography and next day multiple sleep latency test which confirmed the diagnosis of narcolepsy.

scholarly journals Excessive daytime sleepiness in man: Multiple sleep latency measurement in narcoleptic and control subjects

1978 ◽  
Vol 45 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Gary S Richardson ◽  
Mary A Carskadon ◽  
Wayne Flagg ◽  
Johanna Van den Hoed ◽  
William C Dement ◽  
...  
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Control Subjects ◽  
And Control ◽  
Multiple Sleep Latency

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

scholarly journals Practice Parameters for the Non-Respiratory Indications for Polysomnography and Multiple Sleep Latency Testing for Children

SLEEP ◽  
2012 ◽  
Vol 35 (11) ◽  
pp. 1467-1473 ◽  
Author(s):  
R. Nisha Aurora ◽  
Carin I. Lamm ◽  
Rochelle S. Zak ◽  
David A. Kristo ◽  
Sabin R. Bista ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Practice Parameters ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Narcolepsy with cataplexy

2017 ◽  
Author(s):  
Gert Jan Lammers
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Pharmacological Treatment ◽  
Clinical Symptoms ◽  
Sleep Latency ◽  
Daily Life ◽  
Sleep Stages ◽  
Nocturnal Sleep ◽  
Practical Guidelines ◽  
Multiple Sleep Latency ◽  
Hypnagogic Hallucinations

Narcolepsy with cataplexy is caused by disturbed cerebral hypocretin (also called orexin) transmission. It results in impaired physiological boundaries of wake and sleep stages and their specific components, leading to clinical symptoms such as excessive daytime sleepiness (EDS), impaired sustained attention, disturbed nocturnal sleep, cataplexy, and hypnagogic hallucinations. This chapter discusses the consequences for daily life of the disorder, the diagnostic challenges, particularly the interpretation of the results of the multiple sleep latency test (MSLT), the presumed cause and pathophysiology, the frequent comorbidities such as obesity, and practical guidelines for optimal nonpharmacological as well as pharmacological treatment.

scholarly journals 1231 Slurred Speech- Unusual Presentation of Cataplexy in Childhood Narcolepsy

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A470-A470
Author(s):  
Abhishek Reddy ◽  
Mary Halsey Maddox
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Social Life ◽  
Speech Therapy ◽  
Sleep Latency ◽  
Muscle Tone ◽  
Brain Mri ◽  
Hla Typing ◽  
Specific Symptom ◽  
The Impact

Abstract Introduction Narcolepsy, a chronic neurological disorder of excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations, frequently presents in late childhood/early adolescence. Cataplexy, the most specific symptom, presents as transient loss of muscle tone causing weakness. Approximately 80% of children with narcolepsy present with cataplexy1. Report of Case Eight year old African American boy presented to sleep clinic with concerns for excessive daytime sleepiness and slurred speech. Teachers initially referred to speech therapy because of slurred speech. There, speech got noticeably worse with frustration. Subsequently, sleepiness developed, and his pediatrician referred him for polysomnogram (PSG) and Mean Sleep Latency test (MSLT). After unremarkable PSG, MSLT demonstrated mean sleep latency of 10 minutes with no SOREM sleep. Patient came for evaluation in Sleep Medicine clinic where family reported worsening speech with extreme emotions and profound sleepiness, Epworth of 20. Because of the presentation and lack of REM sleep on MSLT, brain MRI was ordered and was normal. HLA typing for narcolepsy positively showed HLA haplotype associated with narcolepsy. Patient was diagnosed with narcolepsy with cataplexy and started on Modafinil 50 mg. Modafinil was progressively increased to 200 mg in a.m. and 100 mg at noon. To address cataplexy symptoms, he started Venlafaxine 12.5 mg and increased to 25 mg. Epworth score improved on Modafinil, his cataplexy symptoms, including speech difficulties, subsided on Venlafaxine. Patient’s communication improved, as did school performance and social life, and patient is currently thriving in 10th grade. Current Epworth is 5 and current medications include Modafinil 200 mg in the morning, 100 mg at noon and Venlaflaxine 25 mg at night. Conclusion This case report highlights the importance of recognizing unusual presentations of cataplexy and the impact of treatment. These symptoms can be easily missed and erroneously attributed to developmental delay or behavioral issues.

scholarly journals 0738 Advance Taper of Antidepressants Prior to Multiple Sleep Latency Testing Increases the Number of Sleep-Onset Rapid Eye Movement Periods and Reduces Mean Sleep Latency

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A281-A281
Author(s):  
B Kolla ◽  
M Jahani Kondori ◽  
M Silber ◽  
H Samman ◽  
S Dhankikar ◽  
...  
Keyword(s):  
Eye Movement ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Initial Assessment ◽  
Rapid Eye Movement ◽  
Regression Analyses ◽  
Practice Parameters ◽  
The Impact ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Abstract Introduction Patients presenting with excessive sleepiness are frequently on antidepressant medication(s). While practice parameters recommend discontinuation of antidepressants prior to multiple sleep latency testing (MSLT), data examining the impact of tapering these medications on MSLT results are limited. Methods Adult patients who underwent MSLT at Mayo Clinic Rochester, Minnesota, between 2014-2018 were included. Clinical and demographic characteristics, medications, including use of rapid eye movement suppressing antidepressants (REMS-AD) at assessment and during testing, actigraphy and polysomnography data were manually abstracted. The difference in number of sleep-onset rapid eye movement periods (SOREMS), proportion with ≥2 SOREMS and mean sleep latency (MSL) in patients who were on REMS-AD and discontinued prior to testing versus those who remained on REMS-AD were examined. At our center, all antidepressants are discontinued 2 weeks prior to MSLT wherever feasible; fluoxetine is stopped 4 weeks prior. Regression analyses accounting for demographic, clinical and other medication-related confounders were performed. Results A total of 502 patients (age=38.18±15.90 years; 67% female) underwent MSLT; 178 (35%) were on REMS-AD at the time of assessment. REMS-AD were discontinued prior to testing in 121/178 (70%) patients. Patients tapered off REMS-AD were more likely to have ≥2 SOREMS (OR-12.20; 95%CI=1.60-92.94) compared to patients who remained on REMS-AD at the time of the MSLT. They also had shorter MSL (8.77±0.46 vs 10.21±0.28; p>0.009) and higher odds of having ≥2 SOREMS (OR=2.22; 95%CI=1.23-3.98) compared to patients not on REMS-AD at initial assessment. These differences persisted after regression analyses accounting for confounders. Conclusion Patients who taper off REMS-AD prior to MSLT are more likely to demonstrate ≥2SOREMs and have a shorter MSL. Pending further prospective investigations, clinicians should preferably withdraw REMs-AD before an MSLT. If this is not done, the test interpretation should include a statement regarding the potential effect of the drugs on the results. Support None

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