Screening for Excessive Daytime Sleepiness and Diagnosing Narcolepsy

Which patients need evaluation for excessive daytime sleepiness and central hypersomnias? Dr Winkelman shares his expertise in this brief CME activity.

ABSTRACT

Sleep disorders such as narcolepsy can cause excessive daytime sleepiness (EDS). However, the diagnosis of narcolepsy is often delayed by years in both children and adults, reducing their quality of life. Clinicians can improve the recognition of EDS and diagnosis of sleep disorders using screening tools such as the Epworth Sleepiness Scale, collecting sleep histories, and using sleep laboratory tests. By following up with patients who present with EDS and continuing to assess until a cause is found, clinicians can lessen the time to diagnosis and the negative impact of narcolepsy by initiating appropriate treatment.

From the Series: Recognizing and Treating Excessive Daytime Sleepiness in Patients With Narcolepsy

To cite: Winkelman JW. Screening for EDS and Diagnosing Narcolepsy. J Clin Psychiatry. 2020;81(4):HB19045BR1C.

To share: https://doi.org/10.4088/JCP.HB19045BR1C

© Copyright 2020 Physicians Postgraduate Press, Inc.

Target Audience

  • Psychiatrists, PCPs

Learning Objectives

After completing this educational activity, you should be able to:

  • Screen patients for excessive daytime sleepiness (EDS)
  • Conduct a differential diagnosis for narcolepsy in patients with EDS
Activity summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation
Activity opens: 
07/15/2020
Activity expires: 
07/31/2022
Cost:
$0.00
Rating: 
0

Support Statement

Supported by an educational grant from Harmony Biosciences, LLC.

Participants may receive credit by reading the activity, scoring 70% or higher on the posttest, and completing the evaluation.

OBJECTIVES

After completing this educational activity, you should be able to:

  • Screen patients for excessive daytime sleepiness (EDS)
  • Conduct a differential diagnosis for narcolepsy in patients with EDS

RELEASE, REVIEW, AND EXPIRATION DATES

This brief report activity was published in July 2020 and is eligible for AMA PRA Category 1 Credit™ through July 31, 2022. The latest review of this material was June 2020.

STATEMENT OF NEED AND PURPOSE

Sleep disorders such as narcolepsy can cause excessive daytime sleepiness (EDS). However, the diagnosis of narcolepsy is often delayed by years. Clinicians report that they lack knowledge about sleep disorders in general, and narcolepsy in particular, and they may not ask patients about sleep or document sleep histories. Therefore, increased awareness of the impact of EDS and narcolepsy is needed, as well as education on talking about sleep with patients and using tools to improve screening for and diagnosis of sleep disorders. Clinicians have also reported a lack of knowledge about treating sleep disorders such as narcolepsy. For patients who do receive treatment, many struggle with residual symptoms that affect work and daily living. Multiple types of health care providers need education to select pharmacologic and nonpharmacologic treatment for narcolepsy and to monitor for problems such as residual EDS. Clinicians also need education about the current understanding of the pathogenesis of narcolepsy and about emerging therapies. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on narcolepsy.

DISCLOSURE OF OFF-LABEL USAGE

Dr Winkelman has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.

REVIEW PROCESS

The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.

ACKNOWLEDGMENT

This activity is derived from the teleconference series “Recognizing and Treating Excessive Daytime Sleepiness in Patients With Narcolepsy,” which was held in February and April 2020 and supported by an educational grant from Harmony Biosciences, LLC. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.

FACULTY

John W. Winkelman, MD, PhD

Sleep Disorders Clinical Research Program and Departments of Psychiatry and Neurology, Massachusetts General Hospital; and Department of Psychiatry, Harvard Medical School, Boston

FINANCIAL DISCLOSURE

The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosures are as follows:

Dr Winkelman is a consultant for Avadel and CVS; has received grant/research support from Merck and Restless Legs Syndrome (RLS) Foundation; is a member of the speakers/advisory boards for Massachusetts General Hospital Psychiatry Academy; and has received financial or material support honoraria from Winston and Strawn and UpToDate.

The Chair for this activity, Thomas Roth, PhD, is a consultant for and has received honoraria from Merck, Idorsia, Eisai, Alarion, Takeda, Jazz, Click Therapeutics, Avadel, GlaxoSmithKline, and SEQ; and is a member of the speaker/advisory board for Eisai.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

 

 

CREDIT DESIGNATION

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.

MOC APPROVAL STATEMENT

Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification DirectoryScreening for Excessive Daytime Sleepiness and Diagnosing Narcolepsy has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

MOC PART II CME ACTIVITY

Psychiatry and Neurology

Available Credit

  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation

Price

Cost:
$0.00
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