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Diagnostic criteria for narcolepsy type 1

Diagnostic criteria for narcolepsy type 1
Criteria A and B must be met:
  1. The patient has daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least three months.*
  1. The presence of one or both of the following:
  1. Cataplexy and a mean sleep latency of ≤8 minutes and two or more SOREMPs on an MSLT performed according to standard techniques. A SOREMP (within 15 minutes of sleep onset) on the preceding nocturnal PSG may replace one of the SOREMPs on the MSLT.
  2. CSF orexin-A concentration, measured by immunoreactivity, is either ≤110 pg/mL or <1/3 of mean values obtained in normal subjects with the same standardized assay.

CSF: cerebrospinal fluid; MSLT: multiple sleep latency test; PSG: polysomnography; SOREMPs: sleep-onset rapid eye movement periods.

* In young children, narcolepsy may sometimes present as excessively long night sleep or as resumption of previously discontinued daytime napping.

¶ If narcolepsy type 1 is strongly suspected clinically but the MSLT criteria of B1 are not met, a possible strategy is to repeat the MSLT.
Reproduced with permission from: International Classification of Sleep Disorders, 3rd ed, American Academy of Sleep Medicine, Darien, IL 2014. Copyright © 2014 American Academy of Sleep Medicine.
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