Narcolepsy and Medical School

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Deucedano

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After quite a long history of sleepiness and fatigue, I was diagnosed with narcolepsy without cataplexy as of two weeks ago (previously idiopathic hypersomnia and upper airway resistance syndrome in november 07). I am now a first year medical student and I was wondering how I should go about addressing this issue with my school's administrators.

I am doing well in school (top 5%), but that is with intermittant naps during the day. I am not worried about the first two years, but the irregular and long hours of third year rotations worries me. I was wondering if any attendings have had any experience with students in my situation and how they were addressed.

I was also wondering if anyone knows of any research about a correlation between narcolepsy without cataplexy and celiac's disease/gluten intolerance or any other GI problems since the GI system and sleep/wake cycles are related to eachother by hormonal input through the hypothalamus (orexin system).

(Moderators; Im not sure if these questions violate board rules on soliciting medical advice, so if they do just delete them and I apologize)
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I'm sorry if I can't share any advice on this. But I think your post is nice. I love reading it.
 
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Modafinil is the best treatment you should go for

start to visit sleep specialist in which MSLT would be conducted for you.

happy sleeping all day:eek:
 
Bobblehead said:
Do you believe that? I avoided the Nuvigil booth at the SLEEP meeting but a couple of the posters at ATS that I viewed only demonstrated a greater biochemical half-life, but without clinical correlate vs. modafinil.
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the per pill cost of nuvigil is less. The 250 mg pill is approx equiv to 400 mg of provigil (2 pills). For people who were on provigil 400/day, nuvigil 250 daily would be less than half the cost.

For people who take provigil only once a day, the effect often doesn't last the whole day. Nuvigil once daily supposedly does.

the data I've seen makes nuvigil look marginally more or equally effective to provigil, but with a longer half life and much cheaper.

Why not use nuvigil instead of provigil, especially on patients who have never used provigil?
It will be several years before provigil goes generic.
 
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spshl k said:
Hello,

My doctor diagnosed me with "CNS hypersomlence". He advised me that dentistry is not a good fit for me. My MSLT showed a sleep latency of 6.5. I wanted to get some input from people on this. Thanks and look forward to hearing from you
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Idiopathic hypersomnia is a variable condition and probably represents a combination of several entities rather than one distinct disease. I don't know you and therefore can not contradict your doctor. However, I think that how you respond to treatment (Provigil/nuvigil or stimulants in most cases) would play a role in determining your fitness for dentistry.
 
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spshl k said:
What do you mean by "is a variable condition and probably represents a combination of several entities rather than one distinct disease"

Will something like this cause me not to get licensure? Does IH eventually turn into Narc w/o cat?
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Idiopathic hypersomnia is more of a syndrome than a distinct disease (kind of like pneumonia can be due to a virus or strep, or mycoplasma...) There are several subtypes including the classic version with long sleep time (10+ hours and EDS) as well as versions with normal nocturnal sleep time and excessive daytime sleepiness. There is some overlap between Idiopathic hypersomnia with short sleep time and narcolepsy without cataplexy and sometimes IH does develop into this (in other words, sometimes a patient with IH will after several years, develop REM periods on the MSLT and qualify for a diagnosis of narcolepsy).

If IH is reasonably well controlled with meds, it probably won't keep you from getting a license, but you will probably have to reveal that you have the condition on medical license applications.
 
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