![]() ![]() Narcolepsy is a lifelong disorder of hypersomnolence characterized by daily periods of irrepressible need to sleep, or frequent daytime lapses into sleep. Even with effective treatment, alertness in patients with narcolepsy may never reach that of normal drivers however, studies have suggested that narcolepsy patients may be able to drive safely with appropriate limitations. Behavioral and lifestyle modifications may also reduce risk, including scheduled naps, driving only short distances, and avoiding driving after meals, sedating medications, and alcohol intake. Treatments such as modafinil may improve driving performance however, the impact of other treatments such as stimulants and sodium oxybate on driving has not been extensively studied. ![]() ![]() Driving simulator tests, though often unavailable to the clinician, provide data to support the use of MWT for evaluation of alertness in drivers with narcolepsy. There are no established guidelines for ensuring driving safety in patients with narcolepsy however, many providers currently use a combination of subjective report, report of prior crashes or near-misses, report of previously falling asleep while driving, sleepiness screening tools, and maintenance of wakefulness testing (MWT) to determine risk. As such, evaluating risk of sleep-related crashes is of great importance for this patient population. Individuals with narcolepsy report more frequent sleep-related crashes, near crashes, and drowsy driving than drivers with other sleep disorders. Narcolepsy is a central nervous system hypersomnia disorder characterized by uncontrollable episodes of daytime sleep, sleep state instability, and cataplexy (sudden loss of muscle tone precipitated by emotion). ![]()
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