2021
DOI: 10.2147/nss.s278046
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Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review

Abstract: Narcolepsy is a chronic sleep disorder with a strong negative impact on quality of life, especially when untreated. Diagnostic delay is a persistent problem, with obvious detrimental effects on patients. A diagnosis of narcolepsy may be delayed because of its broad symptom presentation which is much more encompassing than the classical "tetrad" of sleepiness, cataplexy, hallucinations, and sleep paralysis. Furthermore, symptoms can vary over time. Presentation of symptoms can also be markedly different between… Show more

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Cited by 13 publications
(11 citation statements)
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“…44–48 EDS can also be easily mislabeled as laziness and inattention, leading to a misdiagnosis of behavioral conditions, and also to attention deficit hyperactivity disorder (ADHD) in children. 48 , 49 These results are in line with our result that pediatric patients have longer diagnostic delays than patients with EDS onset during adulthood, which has been recently reported in a US narcolepsy cohort. 18 , 20 It is not surprising that the severity of symptoms (eg, the frequency of cataplexy, duration of episodes of irresistible daytime sleep) negatively contributes to the diagnostic delay, because frequent cataplexy attacks and irresistible daytime sleep can interrupt patients’ daytime functioning and lead to accidents.…”
Section: Discussionsupporting
confidence: 91%
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“…44–48 EDS can also be easily mislabeled as laziness and inattention, leading to a misdiagnosis of behavioral conditions, and also to attention deficit hyperactivity disorder (ADHD) in children. 48 , 49 These results are in line with our result that pediatric patients have longer diagnostic delays than patients with EDS onset during adulthood, which has been recently reported in a US narcolepsy cohort. 18 , 20 It is not surprising that the severity of symptoms (eg, the frequency of cataplexy, duration of episodes of irresistible daytime sleep) negatively contributes to the diagnostic delay, because frequent cataplexy attacks and irresistible daytime sleep can interrupt patients’ daytime functioning and lead to accidents.…”
Section: Discussionsupporting
confidence: 91%
“… 18 , 20 It is not surprising that the severity of symptoms (eg, the frequency of cataplexy, duration of episodes of irresistible daytime sleep) negatively contributes to the diagnostic delay, because frequent cataplexy attacks and irresistible daytime sleep can interrupt patients’ daytime functioning and lead to accidents. 48 Thus, those patients are likely to seek clinical help earlier or be correctly diagnosed more quickly. The narcolepsy severity scales (NSS) for adults 50 and children 51 have been recently developed.…”
Section: Discussionmentioning
confidence: 99%
“…Excessive daytime sleepiness can also present as an increase in irritability, social withdrawal, and shyness 103 . Excessive daytime sleepiness in adolescents may be perceived as laziness; more than one-half of their day is spent in a classroom setting, and excessive daytime sleepiness during a passive activity like sitting can be interpreted as misbehavior by teachers 104 …”
Section: Central Disorders Of Hypersomnolencementioning
confidence: 99%
“…REM sleep intrusions can also present differently in children. The bizarre nature of sleep-related hallucinations and sleep paralysis may confuse children, and they may be embarrassed to discuss the nocturnal phenomena 104 …”
Section: Central Disorders Of Hypersomnolencementioning
confidence: 99%
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