Abstract
A 20-years-old man was referred to our hospital in September 2003. He complained of fatigue and headache at the time of getting up, daytime sleepiness, sudden sleep attacks and dozing off at the wheel. He became aware of insomnia at night and severe sleepiness in the daytime at the age of 13. Since he was 17 years old, he had been seized with an uncontrollable desire for sleep. The total night's sleep has often been reduced to two hours at the longest, interrupted by arousal 10 times (maximal) since he got a job. His Epworth Sleepiness Scale was 13 points. In polysomnography, the first REM period occurred immediately after onset of sleep, and the apnea-hypopnea index was 1.0 per hour. In multiple sleep latency tests, his sleep latency and REM latency were less than 2 minutes. The sleep onset REM period was found in all sessions of MSLT. HLA-DR2 and HLA-DQ1 were positive. His case was diagnosed as narcolepsy, and methylphenidate was taken in the morning and at noon, and naps were taken in the morning and in the afternoon, and the sleep diary was started. The times of daytime's naps and sleep attacks decreased, and his condition was improved.
