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To measure your level of hypocretin, a sample of cerebrospinal fluid is removed using a needle during a procedure called a lumbar puncture. This test is increasingly being used by sleep disorder specialists to help make a diagnosis.
Diagnosis and Tests Two essential sleep studies to confirm a diagnosis of narcolepsy are the polysomnogram (PSG) and the multiple sleep latency test (MSLT). These tests are usually performed in a sleep disorders center and require an overnight stay.
The diagnosis of narcolepsy is usually supported by test results from a polysomnogram and the Multiple Sleep Latency Test (MSLT). A polysomnogram helps your physician assess brain activity during sleep, in particular, how frequently and when REM activity is occurring.
Hypocretin levels are particularly low in those who experience cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn't known, but experts suspect it's due to an autoimmune reaction. It's also likely that genetics play a role in the development of narcolepsy.
Patients with idiopathic hypersomnia fall asleep easily but do not have SOREMPS. The MSLT reveals a broad range of time in which it takes normal sleepers to fall asleep during the study. Normal sleepers tend to fall asleep in an average of about ten minutes or more during the five naps of the MSLT.
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You don't need to see a neurologist for the diagnosis or treatment of narcolepsy. But many leading neurologists do specialize in sleep disorders and work at sleep medicine practices. ENT (ear, nose, and throat) doctor. ENT doctors can address nasal and airway obstructions.
If CSF hypocretin-1 is below 110 pg/ml, the diagnosis is consistent with narcolepsy caused by hypocretin deficiency. This particular test was first developed at Stanford and is the most definitive test for narcolepsy.
Mayo Clinic has developed a widely clinically available test, reports Sleep Review. Orexin testing, a diagnostic procedure requiring a lumbar puncture, can detect type 1 narcolepsy in conjunction with sleep studies like multiple sleep latency tests and polysomnography.
Imaging studies such as MRI are useful for excluding rare causes of symptomatic narcolepsy. Structural abnormalities of the brain stem and diencephalon may present as idiopathic narcolepsy. In patients with secondary narcolepsy, MRI of the brain may show various abnormalities that correspond to the underlying cause.
The multiple sleep latency test (MSLT) is a standard tool used to diagnose narcolepsy, but it can easily give false positives and false negatives, according to an expert presenter at the SLEEP 2016 meeting.

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