Sleep

Question 1

What is the magic number for ODI?

Answer 1

15-30 is moderate
>30 is severe

Question 2

What are the DVLA rules?

Answer 2

excessive sleepiness w mild OSA
should not drive- should be controlled over a 3/12 period or inform DVLA

suspected OSA
Group 1 and 2-can not drive. unitl symptoms under control for >3months

mod/severe OSA
Group 1- inform DVLA and can not drive until control, adherence and improvment with medical confirmation every 3 years
Group 2- inform DVLA and can not drive until control, adherence and improvment with medical confirmation every year

Question 3

which gene is associated with narcolepsy?

Answer 3

HLA-DQB1*06:02

Question 4

What are the criteria for narcolepsy type 1 (with hypocretin def)?

Answer 4

• daily daytime lapses of sleep >3months
• sleep latency <8mins and 2+SO REMs
  CSF hypcretin <1/3 normal value or <110

Question 5

What are the criteria for narcolepsy type 2 (without hypocretin def)?

Answer 5

must meet 5 criteria:
1. daily daytime lapses of sleep >3months
2. sleep latency <8mins and 2+SO REMs
3. cataplexy is absent
4. normal or no result of CSF hypocretin
5. hypersomnolence not better explained by other causes

Question 6

What other conditions are associated with narcolepsy type 2?

Answer 6

Neuro:
parkinsons, MS, MD

infiltrative disorders:
sarcoid, tumours involving the hypothalamus

autoimmune/paraneoplasia:
anti-Ma-2 and antiaquaporin-4

prader willi

trauma