Meet John.

Diagnosed with narcolepsy type 1 (narcolepsy with cataplexy).

62 years old | Private investigator
Effective XYREM dosage: 7.5 g per night

Patient stories are based on actual patient experiences. Response to XYREM may be different for each individual.

Presentation

Referred to sleep specialist by primary care physician for suspected obstructive sleep apnea (OSA).
Complains of sleepiness during the day.
Reports occasional snoring while sleeping.
Clinical interview reveals manifestations of excessive daytime sleepiness (EDS):
- Struggles to stay awake throughout the day, becomes "very irritable" if he does not take a daily nap.
Epworth Sleepiness Scale (ESS) score = 18.
- Reports a high chance of falling asleep while riding as a passenger in a car, watching TV, reading.

Learn about John’s diagnosis >

Patient stories are based on actual patient experiences.

Diagnosis

Initial overnight PSG:
- Ruled out OSA and other primary sleep disorders.
- Revealed nocturnal SOREMP.
Further probing on clinical interview established history of cataplexy:
- Drooping face and sloped shoulders in response to strong emotions such as happiness, anger, stress.
- Buckling of the legs or occasional full body collapse when laughing or surprised.
- Daily cataplexy episodes.
Swiss Narcolepsy Scale (SNS) score = -42.
Repeated PSG, followed by MSLT, showed:
- Nocturnal SOREMP on PSG.
- Mean sleep latency 4.3 minutes, SOREMPs on 1 of 5 nap trials.
Diagnosis of narcolepsy type 1 established.

Learn about John’s treatment >

MSLT = multiple sleep latency test;
OSA = obstructive sleep apnea;
PSG = polysomnogram;
SOREMP = sleep onset REM period (within 15 min of sleep onset).

Patient stories are based on actual patient experiences.

Treatment

Counseled regarding XYREM therapy.
Enrolled in the XYWAV and XYREM REMS.
Initial dosage:
- 4.5 g per night in 2 equal, divided doses (2.25 g at bedtime, 2.25 g 2.5–4 hours later).
Titrated to effective dosage:
- By increasing total nightly dosage by 1.5 g per night (added 0.75 g at bedtime and 0.75 g 2.5–4 hours later) at weekly intervals.
Effective dosage:
- 7.5 g per night in 2 equal, divided doses (3.75 g at bedtime and 3.75 g 2.5–4 hours later).