Abstract
The patient was a 44-year-old man with bipolar disorder (BD) type 2 and generalized anxiety disorder who presented to the sleep clinic complaining of excessive daytime sleepiness. He reported occasional hypnopompic sleep paralysis, but denied cataplexy or hallucinations. Hypersomnolence work up was obtained. Patient was diagnosed with narcolepsy without cataplexy. Hypersomnia is more common in BD and is commonly attributed to medications, obstructive sleep apnea, atypical depression, and other medical comorbidities. Diagnosing narcolepsy in patients with BD patients is often challenging because of their medications that can affect sleep architecture and is not always possible to hold off the medications prior to sleep tests. A trial of modafinil or armodafinil is an option for the management of narcolepsy. However, due to the concern for mood destabilization in BD patients, these medications are best trialed under a psychiatrist’s supervision.
| Original language | English (US) |
|---|---|
| Title of host publication | Sleepless and Sleepy |
| Subtitle of host publication | 50 Challenging Sleep Medicine Cases |
| Publisher | Springer International Publishing |
| Pages | 149-153 |
| Number of pages | 5 |
| ISBN (Electronic) | 9783031183744 |
| ISBN (Print) | 9783031183737 |
| DOIs | |
| State | Published - Jan 1 2023 |
Bibliographical note
Publisher Copyright:© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
Keywords
- Bipolar disorder
- Hypersomnia
- Medications
- Narcolepsy
- Psychiatry