A. Social reticence occurs due to fear of having sleep attack.
B. Sudden onset of sleep (cataplexy) can be triggered by strong emotions.
C. Often associated with mood disorders, substance abuse, and generalized anxiety disorder
III. Differential Diagnosis: Sleep deprivation, primary hypersomnia, breathing-related disorders, hypersomnia associated with mental disorder such as depression or substance abuse, medical condition
IV.Treatment: Stimulants, such as methylphenidate (Ritalin), 10 mg bid or tid, are sometimes combined with tricyclic antidepressants (Protriptyline) before bedtime. Modafinil (Provigil) is a non-amphetamine stimulant approved for treatment of excessive daytime sleepiness associated with narcolepsy. The usual dose is 200 mg given in the morning.
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