Narcolepsy Flashcards
Where is Narcolepsy Common and Rare?
Very rare in Israel, Common in Japan
Prevalence of Narcolepsy
One in two thousand
Sex differences in Narcolepsy
There is none: males and females are affected equally
How common are sleep hallucinations in the general population?
About 4% of population
Shat can trigger status cataplecticus - and what drug can trigger status cataplecticus
Cessation of SSRI, SNRI, TCA’s (everything that can increase serotonin, decreasing cataplexy) - Prazocin can trigger status.
What is the effect of Oxybates with Narcolepsy
Treatment of cataplexy, sleep fragmentation, and EDS with narcolepsy
Association between periodic limb movements of sleep and Narcolepsy
Periodic limb movements of sleep are associated with an increased incidence of narcolepsy
How many people have two or more SOREMS without narcolepsy
30% of people have two or more SOREMS on MSLT
How is obesity associated with Narcolepsy
Obesity rate is increased in narcolepsy
Drugs for narcolepsy with sleepiness and cataplexy
Oxybates and Pitolisant
Treatment of just cataplexy
SSRI, SNRI (especially Venlafaxine)
Treatment of narcolepsy in pregnancy
Discontinue all medications as possible: Modafinil is contraindicated.
What is measured during MSLT
The four E’s - EEG, EOG, EMG, and EKG
Change in SOREMS and sleep latency with age
Sleep latency increases while SOREMS decrease with age.
Sleep attacks in narcolepsy vs idiopathic hypersomnia
Sleep attacks only in narcolepsy
Sleep drunkenness in narcolepsy vs idiopathic hypersomnia
Sleep drunkenness only in idioparhic hypersomnia
Only treatment approved for idiopathic hyeprsomnia
Xywav (Flumazenil and Clarithromycin are less often used.
Two classes of drugs associated with sleep hallucinations
Serotonergic and anticholinergic antidepressants
When is MWT indicated
To determine whether treatment for hypersomnia is helpful
Treatment for REM sleep dysregulation (i.e., sleep paralysis and hallucinations)
SSRI’s and SNRI will work for REM sleep dysregulation (but stimulants will not work)
What is the most frequent psychiatric diagnosis associated disorder with narcolepsy
Anxiety
Status Cataplecticus associated with what drug
Prazosin
Status Cataplecticus associated with withdrawal of what medication classes?
TCA, SSRI, SRNI
Medicines that work through GABA-B receptor
GBH medications and Baclofen
Mechanism of action of Modafinil
Dopamine reuptake inhibitor - increases the amount of Dopamine and therefore awakeness
Type of headaches occurring only in REM sleep and their treatment
Hypnic headaches and treatment with Lithium
