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Narcolepsy

What's new

Updated 2023 BTS, 2021 AASM, and 2021 EAN guidelines for the diagnosis and management of narcolepsy in pediatric patients.

Guidelines

Key sources

The following summarized guidelines for the management of narcolepsy are prepared by our editorial team based on guidelines from the British Thoracic Society (BTS 2023), the American Academy of Sleep Medicine (AASM 2021), and the European Academy of Neurology (EAN 2021).
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2
3

Medical management

Management of excessive daytime sleepiness
As per AASM 2021 guidelines:
Offer the following medications for the treatment of excessive daytime sleepiness in adult patients with narcolepsy:
modafinil
pitolisant
sodium oxybate
solriamfetol
A
Consider offering the following medications for the treatment of excessive daytime sleepiness in adult patients with narcolepsy:
armodafinil
dextroamphetamine
methylphenidate
C
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More topics in this section

  • Management of cataplexy

  • Management of disturbed nighttime sleep

  • Management of sleep paralysis and sleep-related hallucinations

  • Agents with no evidence for benefit

Nonpharmacologic interventions

Scheduled naps: as per EAN 2021 guidelines, offer planned daytime naps to improve immediate subjective and objective sleepiness both in drug-naïve patients and in patients taking stimulant medication, at any age.
B

Therapeutic procedures

Plasmapheresis: as per EAN 2021 guidelines, do not perform plasmapheresis in patients with narcolepsy, at any age.
D

Specific circumstances

Pediatric patients, evaluation: as per BTS 2023 guidelines, suspect other diagnoses, including narcolepsy, with possible coexistent cataplexy, sleep paralysis, hypnagogic and hypnopompic hallucinations, and circadian rhythm disorders, in pediatric patients with persisting excessive daytime sleepiness despite exclusion or effective treatment of sleep-disordered breathing.
B
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More topics in this section

  • Pediatric patients (management)

  • Patients with other sleep disorders