Type II Narcolepsy Detected Through Wesper Testing
A recent Wesper user with controlled sleep apnea was diagnosed with Type II Narcolepsy through at-home sleep testing.
Abstract
Background
A 28-year-old woman with a BMI of 26.6 was previously diagnosed with mild sleep apnea via a traditional hospital PSG and is currently treated with a CPAP.
Despite successfully adapting to CPAP, the user reported that she continues to experience extreme daytime sleepiness, even on days following sufficient sleep.
Findings
Her data to date demonstrates a consistently low average breathing event score while using her CPAP.
The Wesper Sleep Expert further evaluated her sleep patterns and sleep quality data to determine if there was another obvious reason for her daytime sleepiness.
The Wesper Sleep Expert identified that the user had multiple signs and symptoms of a hypersomnia disorder and recommended that she receive further testing.
Her PSG and MSLT revealed that she has Type II Narcolepsy, which is Narcolepsy without Catalepsy.
Conclusion
A key feature of hypersomnia sleep disorders is unrefreshing sleep without other sleep disorders and health problems.
It is essential to evaluate an individual’s sleep from every angle.
While OSA treatment is essential, it is not always sufficient to improve an individual's sleep quality, health, and overall well-being.
Tracking sleep with Wesper allowed this individual to confirm that their sleep apnea was corrected, identify that there was likely another reason for their continuing symptoms, and receive additional testing for other common sleep disorders not previously screened.
Background
A 28-year-old woman with a BMI of 26.6 was previously diagnosed with mild sleep apnea via a traditional hospital PSG and is currently treated with a CPAP. Despite successfully adapting to CPAP, the user reported that she continues to experience extreme daytime sleepiness, even on days following sufficient sleep.
The patient complained of continuing to take frequent naps during the day, difficulty staying awake, even while performing tasks, and extreme body fatigue. Therefore, she purchased a Wesper device to confirm that her CPAP corrected her sleep apnea and investigate additional causes for her daytime sleepiness and fatigue.
Findings
The patient is a frequent Wesper user, having already completed multiple weekly tests, currently totaling 46 tests in a 3-month period. Her data to date demonstrates a consistently low average breathing event score while using her CPAP. Her average breathing event score per hour across the tests with CPAP was 3.1 (min, max: 1, 8), which is within a normal healthy range.
Conversely, the single night she tested without her CPAP scored a 14, which is consistent with mild OSA, demonstrating that CPAP had successfully treated her OSA.
The Wesper Sleep Expert further evaluated her sleep patterns and sleep quality data to determine if there was another obvious reason for her daytime sleepiness.
First, the Wesper Sleep Expert investigated the nightly total sleep time of the user to assess if she was short sleeping. Overall, the user achieved 7.3 hours of sleep per night on average (min, max: 6.25 hours, 9 hours), indicating no significant sleep deprivation.
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This data did not account for the daily sleep accumulation from napping, which the user reported could last anywhere from 1 to 3 hours. Napping did not appear to affect her ability to sleep at night.
Second, the expert looked for indications of restless sleep and poor sleep quality, including indicators of frequent nighttime awakenings. Her average number of nighttime awakenings was 4 (min, max: 1, 9), with most of her nights having 3 or fewer awakenings.
While it is normal to have a “bad night” a few times a month, most of her tests showed that she slept soundly through the night with only brief awakenings that lasted less than 5 minutes. Her sleep efficiency, which was consistently at or greater than 85%, further confirmed the soundness of sleep.
Meeting With the Wesper Sleep Expert
During the consultation with the Wesper Sleep Expert, the user was asked about her full sleep and medical history. The following information was revealed:
Based on the above information, the Wesper Sleep Expert identified that the user had multiple signs and symptoms of a hypersomnia disorder and recommended that she go back to her sleep specialist for further testing.
Two months after the Wesper Sleep Expert consultation, the user reported that she underwent a second sleep study, which also included a Multiple Sleep Latency Test (MSLT), which is essential for the diagnosis of idiopathic hypersomnia and narcolepsy.
Her PSG and MSLT revealed that she has Type II Narcolepsy, which is Narcolepsy without Catalepsy. She is currently taking prescription stimulant medication while continuing to use her CPAP.
Conclusion
A key feature of hypersomnia sleep disorders is unrefreshing sleep without other sleep disorders and health problems. This means that an individual can seemingly achieve sufficient sleep but still experience excessive daytime sleepiness and fatigue.
Other common symptoms include falling asleep at inappropriate times and sleep paralysis [1]. Narcolepsy is hypothesized to be caused by the autoimmune destruction of cells in the brain that are important for regulating sleep. Therefore, individuals with a family history of autoimmune disorders may be at increased risk for developing the sleep disorder [1].
Population studies have difficulty determining the percentage of individuals with the sleep disorder, however, it’s estimated that approximately 1 in 2,000 people have narcolepsy [1]. Narcolepsy, while not rare, is underdiagnosed, with testing focusing more on common sleep disorders like insomnia and sleep apnea.
Interestingly, studies have shown that 25% of narcoleptic patients also have obstructive sleep apnea, which means that many patients are misdiagnosed as only having OSA or their diagnosis of narcolepsy is delayed, often by years [2]
It is, therefore, essential to evaluate an individual’s sleep from every angle. While OSA treatment is essential, it is not always sufficient to improve an individual's sleep quality, health, and overall well-being.
Tracking sleep with Wesper allowed this individual to confirm that their sleep apnea was corrected, identify that there was likely another reason for their continuing symptoms, and receive additional testing for other common sleep disorders not previously screened.
Explanation of metrics:
Breathing events—Moments of increased respiratory effort, which include reduced airflow and prolonged breathing stoppages.
Total sleep time - Total accumulation of sleep in minutes.
Sleep efficiency - The percentage of time asleep during the testing period.
Awakenings - The total number of awakenings during the testing period.
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