Hypersomnolence Disorder KHicks
Narcolepsy is a chronic sleep condition that causes overwhelming daytime drowsiness, while OSAHS is a medical condition associated with major comorbidities. OSAHS results in breathing difficulties during napping because of a collapse in the airways. OSAHS symptoms include heavy snoring, impaired functioning, excessive daytime sleep, gasping for air, and choking. (“American Psychiatric Association,” 2013). These symptoms may take years to show, making easy diagnosis much more difficult. During care, specialists expose patients to in passive situations and monotonous activities such as watching TV or reading books to test their energy to stay alert. Since most OSAHS have trouble sleeping at night, most of them suffer from fatigue and low energy that interferes with their ability to stay alert during the daytime. On the other hand, Narcolepsy is characterized by lapsing into sleep, sleep disruptions, excessive daytime sleepiness, hallucination, and sleep paralysis (Bhattarai& Sumerall,2017).
OSAHS and narcolepsy main difference is that people suffering from OSAHS experience excessive breathing difficulties while sleeping while those with Narcolepsy recurrently lapse into sleep during the daytime. Additionally, narrowing of the UA and obesity are the most prominent sign of OSAHS during diagnosis using a physical exam. (Dauvilliers et al., 2017). On the other, a person with Narcolepsy suffers from cataplexy where there is an abrupt bilateral loss of muscle tenor, which is not the case with OSAHS. Two DSM-5 diagnostic criteria for OSAHS can be used. The first is observing the presence of a minimum of 5obtrusive Apnea or hypopneas in every hour of slumber accompanied by other sleep symptoms. The second criterion is observing a minimum of fifteen obtrusive apneas or hypopneas in every hour of napping regardless of associated symptoms. This is opposed to the two DSM-5 diagnostic criterion for Narcolepsy that requires evidence of daytime nap lapses happening at least thrice in a week for three months. The second criterion is evidence of either cataplexy episodes hypocretin deficit or REM nap latency. Other clinical diagnoses for OSAHS focus on obesity, gasping for air, snoring, and enlarged neck circumference.
Although numerous signs and symptoms can suggest the presence of OSAHS, overnight polysomnography is the main standard diagnostic test for OSAHS. The diagnosis of OSAHS is based on the presence or absence of associated symptoms and the frequency of respiratory events during napping (Dauvilliers et al., 2017). Screening questionnaires are also used to assess for sleep apnea. Increased neck circumference, high body mass index, retrognathia, and narrow oropharyngeal features also indicate the presence of OSAHS. For OSAHS, Apnea’s presence indicates complete obstruction of airflow while the presence of Hypopnea indicates partial blockage of airflow.
For Narcolepsy, there two assessments considered vital in confirming the presence of the condition. One is PSG, and the other is multiple MSLT. PSG is conducted in a sleep laboratory; it automatically conveys and records specific physical activities of the body, such as muscle faction, breathing, and brain functions during napping. Unstable body functions during sleep indicate the presence of the sleep disorder ((Bhattarai& Sumerall, 2017). MSLT monitors the time taken for a one to fall asleep. In most cases, persons with regular nap patterns and alertness will take about ten to twenty minutes to asleep while a person with Narcolepsy takes a short time to fall asleep. While Narcolepsy affects how someone can control their sleep, OSAHS occurs when there are repeated pauses and gasps in breathing during napping. It is, therefore, easy to distinguish the two conditions based on the sign and symptoms.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed).
Bhattarai,J., & Sumerall,S(2017).Current and Future Treatment Options for Narcolepsy: A Review.Sleep Sci. 2017 Jan-Mar; 10(1): 19–27.
Dauvilliers, Y., Roth, T., Guinta, D., Alvarez-Horine, S., Dynin, E.,& Black, J.(2017).Effect of sodium oxybate, modafinil, and their combination of disrupted nighttime sleep in Narcolepsy.InSleep Medicine December 2017 40:53-57