Comorbid Narcolepsy and Obstructive Sleep Apnea: A Review

Purpose of Review Examine the prevalence, diagnosis, and treatment of comorbid obstructive sleep apnea and narcolepsy. Recent Findings Significant overlap between obstructive sleep apnea and narcolepsy has been identified. New pharmacotherapies have been FDA approved for excessive daytime sleepiness in both obstructive sleep apnea and narcolepsy. These pharmacotherapies may be used as an adjunct to positive airway pressure therapy in patients with comorbid obstructive sleep apnea and narcolepsy. Narcolepsy and obstructive sleep apnea may present with many of the same clinical findings, including excessive daytime sleepiness and fragmented nighttime sleep. The overlap between obstructive sleep apnea and narcolepsy should be considered when sleepiness persists despite effective treatment of sleep apnea with positive airway pressure therapy adherence. An evaluation by a sleep medicine physician may include nighttime polysomnography followed by mean sleep latency testing on positive airway pressure. Treatment often involves use of both positive airway pressure and alertness promotion pharmacotherapy.