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Narcolepsy is a rare, chronic sleep disorder with significant impacts on the quality of life of people affected by the disorder. People with narcolepsy (PWN) are a diverse patient population with evolving symptoms, comorbidities, and perspectives. As PWN have varying needs, clinicians should consider a more personalized approach to therapy, including active participation of PWN in their care and shared decision-making between patient and clinician to achieve optimal outcomes. In this review, we discuss the various characteristics and challenges of PWN, present illustrative clinical case scenarios of PWN, provide clinicians with a proposed framework to best address therapy for PWN, and demystify concerns with sodium oxybate.
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http://dx.doi.org/10.1007/s40263-024-01144-6 | DOI Listing |
Clin Ther
September 2025
Avadel Pharmaceuticals, Chesterfield, Missouri.
Purpose: Narcolepsy is a chronic neurologic disorder characterized by excessive daytime sleepiness (EDS) and can occur with or without cataplexy. Once-nightly sodium oxybate (ON-SXB) is approved for the treatment of cataplexy or EDS in patients 7 years of age or older with narcolepsy. ON-SXB contains both immediate-release and pH-dependent, controlled-release granules designed to be reconstituted in water and administered orally once at bedtime.
View Article and Find Full Text PDFJ Sleep Res
August 2025
Sleep-Wake Disorders Center, Department of Neurology, Gui-De-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France.
Data from the REST-ON trial were not available before the 2021 American Academy of Sleep Medicine (AASM) clinical practice guideline update, which included a literature review through August 2020. This post hoc analysis from REST-ON assessed participants who achieved clinically significant improvements on individual AASM clinical significance thresholds (CSTs). Composites of the coprimary endpoints and a secondary endpoint were also analysed.
View Article and Find Full Text PDFLaryngoscope
August 2025
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, USA.
Background: Laryngeal dystonia (LD) is a task-specific focal dystonia marked by involuntary spasms in the laryngeal muscles during speech production. Sodium oxybate has recently been demonstrated as a new treatment option for alcohol-responsive (EtOH+) LD patients.
Objective: The objective of this study is to evaluate the long-term use of sodium oxybate for the treatment of LD.
Arch Bronconeumol
August 2025
Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. Electronic address:
Excessive daytime sleepiness is one of the most important symptoms in obstructive sleep apnoea and it is often used to decide whether the latter should be diagnosed as a syndrome or considered a priority in diagnosis and treatment, and whether the treatment is effective. Beyond this, one concept of enormous clinical significance has emerged: "residual excessive daytime sleepiness", defined as excessive daytime sleepiness in the context of a diagnosed obstructive sleep apnea that is treatable with continuous positive airway pressure (CPAP) or alternatives to it; it appears as a consequence of poor adaptation to, or refusal of treatment, or even sometimes in situations of good tolerance. Given the direct relationship between excessive daytime sleepiness (usually defined by an Epworth Sleepiness Scale [ESS] value of more than 10 points) and cardiovascular, neurocognitive and quality-of-life disorders, attempts have been made for years to alleviate it with drugs (modafinil, armodafinil, sodium oxybate or amphetamines), to little effect and with a large number of adverse effects.
View Article and Find Full Text PDFEmerg Med Australas
August 2025
Emergency Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
Introduction: Gamma-hydroxybutyrate (GHB) is a commonly used recreational substance. It has a narrow therapeutic index. The management of GHB overdose in the emergency department (ED) is labour and resource intensive.
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