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Diagnostic criteria for narcolepsy type 2

Diagnostic criteria for narcolepsy type 2
Criteria A through E 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. A mean sleep latency of ≤8 minutes and two or more SOREMPs are found 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.
  1. Cataplexy is absent.*
  1. Either CSF orexin concentration has not been measured or CSF orexin concentration measured by immunoreactivity is either >110 pg/mL or >1/3 of mean values obtained in normal subjects with the same standardized assay.
  1. The hypersomnolence and/or MSLT findings are not better explained by other causes such as insufficient sleep, obstructive sleep apnea, delayed sleep phase disorder, or the effect of medication or substances or their withdrawal.

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

* If cataplexy develops later, then the disorder should be reclassified as narcolepsy type 1.

¶ If the CSF 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, then the disorder should be reclassified as narcolepsy type 1.
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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