<p>Management Of Excessive Sleepiness In Patients With Narcolepsy And OSA: Current Challenges And Future Prospects</p>

Abstract

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.

Machine learning polysomnographically-derived electroencephalography biomarkers predictive of epworth sleepiness scale

“…Clinically, EDS overlaps with other common sleep and mood disorders that are considered causal to EDS, such as obstructive sleep apnea (OSA), narcolepsy, depression, and post acute sequelae of COVID-19 15 , with an estimated prevalence of 20% of adults in the United States 16 . These causes are usually misdiagnosed or undiagnosed in the population, even when a patient performs a sleep study 7 , 17 .…”

Machine learning-Based model for prediction of Narcolepsy Type 1 in Patients with Obstructive Sleep Apnea with Excessive Daytime Sleepiness

“…EDS appears ordinarily among individuals with sleep disorders, particularly those with OSA and NT1. 1,2,4 Although several studies have identified differences between OSA and NT1 on symptomatology and objective tests, 21,22 there is still no reliable model to predict NT1 in patients with OSA. [11][12][13] Our study indicated the comorbid NT1 could be accurately predicted by certain ML models.…”

Narcolepsy

“…Drugs such as benzodiazepines or opioids that may cause sedation or drowsiness also should be discontinued. Beta-blockers, which can cause drowsiness and suppression of REM sleep, should be held for 2 weeks before the study if approved by the prescriber 21. Patients also complete a sleep log for 1 week before testing, to assess their routine sleep/wake schedule 19…”