My overnight sleep study showed a normal sleep pattern that cycled about every 2 hours. My MSLT revealed that at each nap I was in REM in 2-5 minutes and had reported not falling asleep for longer than 5 mins. So the diagnosis of Narcolepsy was made. Is it possible to have been misdiagnosed given those test results?
Doctors Answers (3)
Narcolepsy is a clinical diagnosis based on the medical history. There are supporting tests which include the sleep study and the MSLT. Often, the sleep study shows fragmented sleep and frequent REM cycles and sometimes, an abbreviated REM latency. The MSLT supports a diagnosis of narcolepsy if the mean sleep latency (the average amount of time it takes to fall asleep in all the naps) and at least two sleep onset REM cycles. Having four sleep onset REM periods may also be seen with narcolepsy but is reported to occur in any condition which may produce sleep deprivation. These conditions would include sleep apnea, leg movements, chronic pain disorders or anything that fragments the sleep. Other causes for both a short mean sleep latency and sleep onset REM is withdrawing from stimulant medication. Just having sleep onset REM does not make a diagnosis of narcolepsy.
Without reviewing the results and actual data, it would be difficult to confirm a diagnosis. A Board Certified Sleep Specialists should competently interpret your results.
Sleep study results do support the diagnosis of narcolepsy but this diagnosis should be based on some other criteria as well. Your sleep doctor most likely asked you about persistent excessive daytime sleepiness, hypnagogic hallucinations, sleep paralysis, cataplexy, time of onset of your condition and some other important questions to make an accurate diagnosis. And if in doubt, you can always ask for a second opinion. Accurate diagnosis is important to make decisions about treatment and your quality of life is what it is all about. Best of luck.