Nature and Science of Sleep (Oct 2019)
Management Of Excessive Sleepiness In Patients With Narcolepsy And OSA: Current Challenges And Future Prospects
Abstract
Ashima S Sahni, Melissa Carlucci, Malik Malik, Bharati Prasad Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Ashima S SahniDivision of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago (MC 719), 909 South Wolcott Avenue, Room 3135 (MC 719), Chicago, IL 60612, USATel +1 312 355-4806Email [email protected]: Excessive daytime sleepiness (EDS) can be caused by insufficient sleep but is also a manifestation of medical or sleep disorders and a side effect of medications. It impacts quality of life and creates safety concerns in the home, at work, and on the roads. Screening questionnaires can be used to estimate EDS, but further evaluation is necessary. EDS is a common symptom of both narcolepsy and obstructive sleep apnea (OSA). Polysomnography and multiple sleep latency testing are used to diagnose these disorders. However, isolating the primary etiology of EDS can be challenging and may be multifactorial. Untreated OSA can show polysomnographic findings that are similar to narcolepsy. The effects of sleep deprivation and certain medications can also affect the polysomnographic results. These challenges can lead to misdiagnosis. In addition, narcolepsy and OSA can occur as comorbid disorders. If EDS persists despite adequate treatment for either disorder, a comorbid diagnosis should be sought. Thus, despite advances in clinical practice, appropriate management of these patients can be challenging. This review is focused on EDS due to OSA and narcolepsy and addresses some of the challenges with managing this patient population.Keywords: EDS, excessive daytime sleepiness, narcolepsy, OSA, obstructive sleep apnea
