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Narcolepsy: New Strategies for Diagnosis and Treatment

50 to 70 million Americans, or 20% of the US population, are estimated to have a chronic sleeping or wakefulness disorder. Sleep disorders result in billions of dollars in direct health and medical costs each year an estimated $150 billion due to absenteeism, workplace accidents, and other lost productivity.

As most sleep-related disorders manifest with nonspecific symptoms such as fatigue, insomnia, or hypersomnia, a visit to the physician will often be the first encounter for the patient to address these problems. However, data demonstrate that most physicians feel unprepared to address, diagnose, and treat sleep disorders.

One of the most underdiagnosed and untreated sleep conditions is narcolepsy. Narcolepsy is a disabling neurological condition characterized by excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, and sleep paralysis. It is the second leading cause of EDS, after sleep apnea. Approximately one in every two thousand Americans are believed to have narcolepsy, although much fewer have been diagnosed and treated. Many factors are attributed to under diagnosis and misdiagnosis. Physicians need to be better prepared to suspect narcolepsy in patients, differentiate narcolepsy from other sleep disorders or medical conditions with overlapping symptoms, initiate the proper diagnostic tests, and refer to a sleep specialist when appropriate.