Narcolepsy

1. Administer the ESS at each visit to monitor progress with modafinil or stimulant therapy. Unfortunately, EDS in narcolepsy patients rarely is fully reversed.

2. Evaluate how sleepiness changes throughout the day to best determine how to use sustained- and immediate-release stimulants to maintain wakefulness. If the patient complains of sleep disruption from stimulant therapy, move the dosing time a few hours earlier until sleep disruption is avoided.

3. Review patient's sleep diaries to track the number of cataplexy, sleep paralysis, and hallucinatory events and when they occur.

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