Version June 2024
| Criteria A through E must be met: | |
| A | The patient has daily periods of irrepressible need to sleep or daytime lapses into drowsiness or sleep occurring for at least three months. |
| B | A mean sleep latency of ≤8 minutes and two or more SOREMPs are found on an MSLT performed in accordance with current recommended protocols. A SOREMP (within 15 minutes of sleep onset) on the preceding nocturnal PSG may replace one of the SOREMPs on the MSLT.*¶ |
| C | Cataplexy is absent.Δ |
| D | If CSF hypocretin-1 concentration is measured by radioimmunoassay, it is either >110 pg/mL (when using a Stanford reference sample) or >1/3 of mean values obtained in normal subjects with the same standardized assay.◊ |
| E | The symptoms and signs are not better explained by chronic insufficient sleep, a circadian rhythm sleep-wake disorder or other current sleep disorder, mental disorder, or medication/substances use or withdrawal. |
CSF: cerebrospinal fluid; MSLT: multiple sleep latency test; PSG: polysomnography; SOREMPs: sleep-onset rapid eye movement periods.
* The diagnostic value of a SOREMP on nocturnal PSG in the absence of MSLT SOREMPs is not established for narcolepsy type 2. However, it may help guide clinical decision-making, such as the need to pursue repeat or alternative testing.
¶ Because the circadian clock strongly gates the propensity of REM sleep, narcolepsy type 2 should not be diagnosed in a shift worker without prior re-entrainment to a normal schedule.
Δ If cataplexy develops later, then the disorder should be reclassified as narcolepsy type 1.
◊ If the CSF hypocretin-1 (also known as orexin-A) concentration is tested at a later stage and found to be either ≤110 pg/mL or <1/3 of mean values obtained in normal subjects with the same assay, the disorder should be reclassified as narcolepsy type 1.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
