Alon Avidan, MD, MPH

An Overview of Excessive Daytime Sleepiness (EDS) 

Signs and Symptoms of Narcolepsy 

Pathophysiology and Risk Factors for Narcolepsy  

Differential Diagnosis of Patients with Narcolepsy  

Behavioral Approaches to the Management of Narcolepsy 

Pharmacological Approaches to the Management of Narcolepsy  

Recent Approvals of Pitolisant and Solriamfetol for EDS 

The Impact of COVID-19 on the Management of Narcolepsy 

Future Improvements in the Management of Narcolepsy

Videos

Phyllis Zee, MD, PhD, and Alon Avidan, MD, MPH, provide an overview of behavioral and pharmacological approaches to the management of excessive daytime sleepiness (EDS) and narcolepsy and discuss the recent approval of agents with new mechanisms of action. 

Treating Narcolepsy and Excessive Daytime Sleepiness

“We often see patients who truly have the condition but were tested incorrectly by the clinician. If it’s not done correctly, the results cannot be used to exclude or cite if a patient actually does have narcolepsy.”

Misdiagnosing narcolepsy and other sleep disorders can be attributed to clinicians labeling patients based on symptoms or common traits that other previously diagnosed patients may have experienced. Oftentimes, a lack of medical history records or proper screening tests can lead to a misdiagnosis, which can ultimately damage a patient’s future if they are prescribed incorrect treatment.

Alon Avidan, MD, director of the Sleep Disorders Center and vice chair of the department of neurology at UCLA David Geffen School of Medicine feels as though clinicians are not taking enough precautions before fully diagnosing a patient—or, in other words, they’re placing patients into a bucket. These “buckets” as Avidan calls them, are essentially used to group patients who may show those similarities but may not have the same diagnosis.

 sat down with Avidan to discuss the issues and challenges caused by placing patients into these buckets, as well as what specific symptoms clinicians may confuse with narcolepsy when making a diagnosis.

The Director of the Sleep Disorders Center and vice chair of the department of neurology at UCLA David Geffen School of Medicine describes why labeling patients can lead to a misdiagnosis of narcolepsy.

Alon Avidan, MD: Putting Patients With Suspected Narcolepsy Into Buckets

“There is a huge problem in our society in that patients are being labeled in a certain way… They may receive inappropriate treatment that goes on for decades which is very problematic..”

Narcolepsy can oftentimes go untreated, mistreated, or treated so late after onset that the comorbidities and conditions associated with it can be worsened. In some cases, time from onset of symptoms to diagnosis can take up to 10 years.

 that it seems as though the education around narcolepsy needs to be improved on both the patient and physician perspectives in order to improve rates of earlier diagnosis. Avidan, who is director of the Sleep Disorders Center and vice chair of the department of neurology at the UCLA David Geffen School of Medicine, mentioned that a number of conditions, such as laziness, attention deficit disorder, and depression, can be mistreated and confused with narcolepsy, thus compounding the problem.

In this interview, Avidan detailed why an effort to boost education can lead to a greater understanding of identifying symptoms and improving rates of early diagnosis, including the challenge of improper labels accompanying the condition.

The Director of the Sleep Disorders Center and vice chair of the department of neurology at the UCLA David Geffen School of Medicine detailed how patients and physicians can be proactive in identifying narcolepsy.

Alon Avidan, MD, MPH: Early Stage Identification of Narcolepsy

“Obesity is often related to the fact that this individual cannot maintain alertness during the day and they cannot participate in sports activities.”

While narcolepsy is commonly associated with difficulties staying awake for long periods of time, sudden loss of muscle tone, sleep paralysis, and changes in rapid eye movement, many patients have accompanying comorbidities linked to the disease which can often take an equivalent toll on a patient’s daily life.  

Among these comorbidities that patients may experience are depression, obesity, social anxieties, and schizophrenic conditions due to the effects of narcolepsy. Alon Avidan, MD, MPHD director, Sleep Disorders Center, and vice chair, department of neurology, UCLA David Geffen School of Medicine, feels as though an additional challenge for diagnosis at times can be triggered because medications can have adverse effects that trigger these comorbidities.  

In an interview with NeurologyLive, Avidan breaks down the comorbidities associated with narcolepsy, as well as the ways they can impact a patient’s daily function. Additionally, he touches on how clinicians can confuse narcolepsy with underlying schizophrenia.

The director of the Sleep Disorders Center and vice chair of the department of neurology at the UCLA David Geffen School of Medicine detailed the comorbidities related to narcolepsy.  

Alon Avidan, MD, MPH

Articles

Treating Narcolepsy and Excessive Daytime Sleepiness

Alon Avidan, MD: Putting Patients With Suspected Narcolepsy Into Buckets

Alon Avidan, MD, MPH: Early Stage Identification of Narcolepsy

Alon Avidan, MD, MPH: Comorbidities Associated With Narcolepsy