Excessive Daytime Sleepiness in Japanese-American Male
History of Present Illness
Patient is a 22-year-old Asian-American male born in the U.S. Patient presents with symptoms of excessive daytime sleepiness (EDS), which have been present for three years, Patient states that he nearly had an automobile accident, and has difficulties at work because of symptoms. He experiences varying levels of alertness during daytime hours, occasionally falls asleep at work, and has difficulties participating in family or social activities. He also experiences disrupted nighttime sleep.
Patient’s Japanese mother, and his younger sister also experience mild degree of sleep disorder symptoms.
Medical History
No other known medical issues
Social history
Patient resides with both parents and teenage sister in a single-family home. He works full-time in a mid-level business management role.
Questions
What presenting symptoms makes you lean towards a narcolepsy diagnosis?
What would be your treatment plan for this patient?
Suggest MSLT and Narcolepsy is confirmed treatment with Xywav or Xyrem would be appropriate.
After sleep study would consider provigil to begin