wHAT ARE THE ICSD-3* CRITERIA FOR NARCOLEPSY TYPE 2?

wHAT ARE THE ICSD-3* CRITERIA FOR NARCOLEPSY TYPE 2?

How narcolepsy type 2 is diagnosed according to the American Academy of Sleep Medicine (AASM) ICSD-3 criteria.

The following criteria should be met for narcolepsy type 2 patients.1

  1. The patient has daily periods of irrepressible need to sleep or lapses into daytime sleep, occurring for at least 3 months.1
  2. A mean sleep latency of 8 minutes or less and at least 2 sleep onset rapid eye movement periods (SOREMPs) are found on a multiple sleep latency test (MSLT).1
    • A SOREMP (within 15 min of sleep onset) on the preceding nocturnal polysomnogram (PSG) may replace one of the SOREMPs on the MSLT.1
  3. Cataplexy is absent.1
    • If cataplexy develops later, then the disorder should be reclassified as narcolepsy type 1.1
  4. Cerebrospinal fluid (CSF) hypocretin-1 concentration is either not measured, or found to be either greater than 110 pg/mL, or greater than one-third of mean values obtained in normal subjects with the same standardized assay.1
    • If the CSF hypocretin-1 concentration is tested at a later stage and found to be either 110 pg/mL or less, or less than one-third of mean values obtained in normal subjects with the same assay, then the disorder should be reclassified as narcolepsy type 1.1
  5. 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.1

*ICSD-3 = International Classification of Sleep Disorders, 3rd ed.

Sleep laboratory testing should be performed according to standard techniques, and results should be carefully interpreted in the context of the patient’s clinical history in the presence of EDS. At least 1 week of actigraphy assessment with a sleep log is strongly recommended prior to MSLT to determine factors that may bias results (eg, insufficient sleep, shift work, or other circadian rhythm disorder).1

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