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Pediatric Narcolepsy: June 18, 2011

Falling asleep at school could be a symptom of a medical disorder.

Narcolepsy is a disorder of excessive sleepiness. While sufferers are usually diagnosed as adults, doctors now realize many of them had it since childhood.

“Many times, its diagnosed in 20 and 30 year olds after more than a decade of having symptoms.” says pediatric neurologist Dr. Jose Colon. He also specialized in sleep disorders.

People become accustomed to being told their sleepiness is due to depression or psychiatric symptoms.

The gold standard in diagnosing narcolepsy is a sleep study, beginning with an overnight visit to a sleep lab. It will rule out apnea or other disorders. The next day patients undergo a Multiple Sleep Latency Test.

“We do this MSLT where you have the patient take five naps,” Dr. Colon says. ‘We have norms set for a person with no sleepiness and we have norms set for a person with other sleep disorders including narcolepsy.”

The study measure REM sleep, which is a deep, dream state. Narcoleptics reach REM quickly and frequently. Meaning they can fall deeply asleep almost anywhere, anytime.

“I do have some patients that do fall asleep in school or they have fallen asleep at the wheel or at work,” Dr. Colon says. “These patients do very well with medication.”

Various medications can either suppress REM sleep during the day or stimulate alertness. Once diagnosed, some choose not to get treatment.

“They can have absolutely normal lives. Now very interesting I would say about half of my patients with narcolepsy, don’t want treatment. They want an answer.”