man narcolepsy

“How have actual patients experienced treatment with XYREM?”

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.


  • 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 >


  • 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).


  • 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).
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Find out about counseling adult patients on how to take XYREM.