Narcolepsy

Name: Narcolepsy
Author: Ahmed S. BaHammam

Integrating Basic and Clinical Knowledge

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Paperback, blz. | Engels

Elsevier Science | 2025

ISBN13: 9780443300042

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Elsevier Science e druk, 2025 9780443300042

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Narcolepsy: Integrating Basic and Clinical Knowledge provides comprehensive coverage of narcolepsy-related topics. The book offers updated, deep coverage of its diagnosis, treatment, and impact on mental health based on the latest research findings and clinical practices. Its interdisciplinary approach brings together experts from different specialties, such as sleep medicine, psychology, and neurology to offer a more holistic understanding. This allows for a more nuanced discussion of how narcolepsy interacts with various aspects of health and well-being. Researchers and clinicians will find within this book novel information on pathophysiology and neurobiology, as well as behavioral and psychosocial considerations.

Users will find this to be a resource that takes a deep dive into narcolepsy, introducing topics never before discussed in books on the topic, including COVID-19 and sleep, as well as immunotherapy and gene therapy. It’s the cutting-edge medical volume professionals need, whether narcolepsy specialists or more casual readers.

Specificaties

ISBN13:9780443300042

Taal:Engels

Bindwijze:Paperback

Uitgever:Elsevier Science

Inhoudsopgave

List of contributors About the editors Foreword Preface Acknowledgments Part I Pathophysiology and neurobiology CHAPTER 1: Understanding sleep in narcolepsy: sleep physiology, neurobiology, and cognitive impairment mechanisms Syed Shahid Habib 1.1 Introduction 1.2 Sleep physiology 1.3 Normal sleep architecture 1.4 Sleep stages and their transitions 1.4.1 N1 (Stage 1) sleep 1.4.2 N2 (Stage 2) sleep 1.4.3 N3 (Stage 3) deepest nonrapid eye movement or slow–wave sleep 1.5 Rapid eye movement sleep 1.6 Comparing sleep patterns of normal individuals with patients with narcolepsy 1.7 Brain networks regulating sleep and wakefulness 1.7.1 The concept of “flip–flop” switch 1.7.2 Sleep paralysis and cataplexy 1.8 Brain neurotransmitters in normal sleep and narcolepsy 1.8.1 Memory impairment and cognitive deficits in individuals with narcolepsy 1.9 Impact of narcolepsy on cognitive function 1.10 Conclusion References CHAPTER 2: Pathophysiology of narcolepsy: genetics and immune system Shahrad Taheri 2.1 Introduction 2.2 Human leukocyte antigen genes and narcolepsy 2.3 Narcolepsy and nonhuman leukocyte antigen immune genes 2.4 Narcolepsy and environmental factors 2.5 Narcolepsy and humoral immunity 2.6 Summary References CHAPTER 3: Neurotransmitters, genetics, and animal models in narcolepsy: a comprehensive overview Nada F. AlAhmady and Fadwa M. Alkhulaifi 3.1 The role of neurotransmitters in narcolepsy: a focus on hypocretin/orexin signaling pathways 3.2 The role of immunological and hormonal pathways in narcolepsy 3.2.1 The immune basis of narcolepsy 3.3 Genetic underpinnings of narcolepsy 3.4 The role of animal models in understanding narcolepsy 3.5 Common animal models in narcolepsy research 3.5.1 Canine narcolepsy 3.5.2 Rodent narcolepsy 3.5.3 Transgenic models 3.5.4 Zebrafish narcolepsy 3.6 Implications for treatment and future directions References CHAPTER 4: The gut–brain axis in narcolepsy: emerging research on microbiota, diet, and sleep Fulong Xiao 4.1 Introduction 4.2 The gut microbiota and sleep disorders 4.3 Trends in research about gut microbiota and narcolepsy 4.4 Conclusion References Part II Clinical aspects CHAPTER 5: Types of narcolepsy and their symptoms: differential diagnosis and misdiagnosis Renata Riha 5.1 Types of narcolepsies 5.1.1 Type 1 narcolepsy 5.1.2 Type 2 narcolepsy 5.2 Controversies in the diagnosis of type 1 and type 2 narcolepsy 5.3 Phenotyping narcolepsy 5.4 Conclusion References CHAPTER 6: Delayed diagnosis of narcolepsy: causes and implications Abdul Rouf Pirzada and Ahmed S. BaHammam 6.1 Introduction 6.2 Epidemiological insights into diagnostic delays in narcolepsy 6.2.1 Global perspective on diagnostic delay 6.2.2 Improvement in diagnostic delay in recent data 6.2.3 Access to healthcare services and diagnostic delay 6.3 Potential predictors of delayed diagnosis 6.3.1 Age 6.3.2 Cataplexy 6.3.3 Gender 6.4 Symptoms overlap with other disorders and prior misdiagnoses of patients with narcolepsy 6.4.1 Diagnostic delays and misdiagnosis trends 6.4.2 Comparative studies and misdiagnosis rates 6.4.3 Comorbidity and symptom complexity 6.4.4 Sleep disorders and narcolepsy overlap 6.4.5 Diagnostic challenges in pediatric narcolepsy 6.4.6 Logistical and diagnostic limitations 6.5 Diagnostic delay and clinical implications 6.5.1 Clinical and personal consequences of delayed diagnosis 6.5.2 Educational challenges 6.5.3 Economic and societal impacts 6.6 Conclusion References Chapter 7: Diagnostic tools for narcolepsy: sleep studies, multiple sleep latency test, and more Ahmed S. BaHammam 7.1 Introduction 7.2 Overview of American Academy of Sleep Medicine diagnostic criteria for narcolepsy 7.2.1 Narcolepsy type 1 7.2.2 Narcolepsy type 2 7.2.3 Updates in the 2024 pediatric guidelines include 7.3 Emerging roles of CSF hypocretin-1 measurement in narcolepsy diagnosis 7.4 Polysomnography 7.4.1 Role of polysomnography in narcolepsy diagnosis 7.4.2 Typical polysomnography findings in narcolepsy 7.4.3 Specific rapid eye movement sleep changes in narcolepsy 7.4.4 Limitations of polysomnography alone for diagnosis 7.5 Multiple sleep latency test 7.5.1 Purpose and procedure of multiple sleep latency test 7.5.2 Diagnostic criteria for narcolepsy based on multiple sleep latency test results 7.5.3 Pediatric considerations 7.5.4 Preparation for the multiple sleep latency test 7.5.5 Factors affecting multiple sleep latency test reliability 7.6 Daytime continuous polysomnography 7.7 Actigraphy 7.7.1 Limitations of actigraphy for narcolepsy diagnosis 7.8 Screening scales for narcolepsy 7.8.1 Ullanlinna Narcolepsy Scale 7.8.2 Swiss Narcolepsy Scale 7.8.3 Epworth Sleepiness Scale 7.8.4 Narcolepsy Severity Scale 7.8.5 The Pediatric Hypersomnolence Survey 7.8.6 Challenges and opportunities in the use of Narcolepsy Screening Scales 7.9 Emerging technologies and artificial intelligence 7.9.1 Wearables 7.9.2 Pupillometry as a potential biomarker for sleepiness 7.9.3 Home sleep testing for narcolepsy diagnosis: current limitations 7.9.4 Machine learning in narcolepsy diagnosis 7.9.5 Utilizing AI in phenotyping narcolepsy and hypersomnolence disorders 7.10 Diagnostic approach 7.11 Conclusion References Chapter 8: Narcolepsy in children and adolescents: diagnosis, management, and challenges Binal Kancherla, Sonal Malhotra, Marlene Typaldos, Aleena Wasim, and Yousaf Khan 8.1 Medical history 8.2 Physical exam 8.3 Diagnostic testing 8.3.1 Sleep diary and actigraphy 8.3.2 Overnight polysomnography 8.3.3 Multiple sleep latency test 8.4 Laboratory testing and imaging 8.4.1 Hypocretin testing 8.4.2 HLA typing 8.4.3 Neuroimaging 8.5 Psychological, psychiatric, and social aspects 8.6 Differential diagnosis 8.7 Management 8.7.1 Education 8.7.2 Behavioral modification 8.7.3 Pharmacological 8.7.4 Medications for excessive daytime sleepiness 8.7.5 Medications for cataplexy 8.7.6 Other medications 8.8 Summary of management Chapter 9: Narcolepsy and pregnancy: risks and strategies for management Rosa Peraita-Adrados 9.1 Introduction 9.2 Narcolepsy in women 9.3 Sleep disorders in pregnancy 9.4 Narcolepsy in pregnancy 9.5 Medication management during pregnancy for narcolepsy patients References Chapter 10: Aging with narcolepsy: understanding the unique challenges for older adults Natalie Cornay Manalo and Hrayr Attarian 10.1 Introduction 10.2 Narcolepsy onset after age 35 10.2.1 Case 1 (late onset) 10.3 Delayed diagnosis 10.3.1 Case 2 (delayed diagnosis) 10.4 Symptomatic narcolepsy 10.4.1 Case 3 (symptomatic narcolepsy) 10.5 Implications of narcolepsy in older adults and therapeutic challenges 10.5.1 Case 4 (management dilemma with age) 10.6 Conclusion References Chapter 11: Medical comorbidities of narcolepsy Nikita Jambulingam, Nathaniel Yuan, and Alon Y. Avidan 11.1 Introduction 11.2 Neurological comorbidities 11.2.1 Migraines 11.2.2 Restless leg syndrome 11.2.3 Rapid eye movement sleep behavior disorder 11.3 Cardiovascular comorbidities 11.3.1 Cardiovascular events and stroke 11.3.2 Hypertension 11.4 Metabolic comorbidities 11.4.1 Obesity 11.4.2 Type 2 diabetes 11.4.3 Dyslipidemia 11.5 Autoimmune disease comorbidities 11.5.1 Autoimmune disease and human leukocyte antigen 11.5.2 Type 1 diabetes 11.5.3 Celiac disease 11.5.4 Rheumatoid arthritis 11.5.5 System lupus erythematosus 11.5.6 Sjögren’s syndrome 11.6 Narcolepsy and comorbidities: management perspectives 11.6.1 Comorbid neurological treatment considerations 11.6.2 Comorbid cardiovascular treatment considerations 11.6.3 Comorbid metabolic treatment considerations 11.6.4 Comorbid autoimmune disease treatment considerations 11.7 Conclusion References Chapter 12: Cardiovascular disease risk and comorbidities in narcolepsy Ahmed S. BaHammam 12.1 Introduction 12.2 Epidemiological evidence of increased cardiovascular disease risk 12.3 Potential mechanisms linking narcolepsy and cardiovascular disease risk 12.3.1 Sleep disruption and autonomic dysfunction 12.3.2 The role of hypocretin 12.3.3 Metabolic dysfunction 12.3.4 Comorbid sleep disorders 12.3.5 Inflammation and endothelial dysfunction 12.4 Cardiovascular risk assessment and management in narcolepsy 12.4.1 Regular cardiovascular risk screening 12.4.2 Lifestyle modification 12.4.3 Management of comorbidities 12.4.4 Consideration of cardiovascular effects of narcolepsy medications 12.4.5 Sodium intake and cardiovascular risk in narcolepsy 12.5 Future research directions 12.6 Conclusion References Chapter 13: More than just narcolepsy: the importance of recognizing concurrent sleep disorders Antara Mallampalli, MD 13.1 Introduction: comorbid sleep disorders in narcolepsy patients 13.2 Prevalence of comorbid sleep disorders in narcolepsy patients: an overview 13.3 Sleep-related breathing disorders in narcolepsy patients 13.3.1 Pathophysiology of sleep-related breathing disorders in narcolepsy 13.3.2 Clinical impact of sleep-related breathing disorders in narcolepsy 13.3.3 Summary 13.4 Insomnia in narcolepsy patients 13.5 Restless leg syndrome and periodic limb movement disorder in narcolepsy patients 13.5.1 Pathophysiology of periodic limb movements of sleep and restless leg syndrome in narcolepsy 13.5.2 Clinical impact of restless leg syndrome in narcolepsy 13.6 REM sleep behavior disorder and other parasomnias in narcolepsy patients 13.6.1 Clinical impact of REM sleep behavior disorder in narcolepsy 13.7 Conclusion and future research directions References Chapter 14: Narcolepsy and circadian rhythm disorders: diagnosis and management Sona Nevsimalova 14.1 Introduction 14.2 Circadian and ultradian rhythms in narcolepsy 14.3 Hypocretin and circadian system 14.4 Circadian aspects of clinical manifestation in narcolepsy 14.5 Circadian rhythm disorders and narcolepsy 14.6 Recommendations for therapy, management, and future perspectives References Chapter 15: The hidden link between narcolepsy and autonomic dysfunction: a closer look Fang Han 15.1 The orexin system and narcolepsy 15.2 Orexins in autonomic regulation 15.3 Role of orexins in cardiovascular regulation 15.4 Narcolepsy and autonomic dysfunction 15.5 Cardiovascular dysfunction in narcolepsy 15.6 Nondipper profile in narcolepsy with cataplexy 15.7 Treatment of narcolepsy on cardiovascular effects References Chapter 16: Narcolepsy and metabolic rate: what do we know? Hamza O. Dhafar and Ahmed S. BaHammam 16.1 Introduction 16.2 Prevalence of obesity in patients with narcolepsy 16.3 Changes in metabolic rate in patients with narcolepsy 16.4 Exploring the possible underlying mechanisms of weight gain in narcolepsy 16.4.1 The role of orexin in metabolism 16.4.2 Orexin and eating behavior 16.4.3 Physical activity 16.4.4 Genetic factors 16.4.5 The role of leptin and ghrelin hormones 16.4.6 Metabolomics 16.4.7 The role of medications used for narcolepsy 16.5 Conclusions and future directions References Chapter 17: Narcolepsy and driving: safety issues and regulations Tha A. Saw and Catherine A. McCall 17.1 Introduction 17.2 Narcolepsy and drowsy driving 17.3 Evaluating drowsy driving risk with narcolepsy 17.4 Legal and regulatory issues 17.5 Risk mitigation 17.5.1 Pharmacologic interventions 17.5.2 Nonpharmacologic interventions 17.5.3 Patient resources 17.6 Conclusion References Chapter 18: The natural history of narcolepsy: lessons from longitudinal studies Salman A. Bahammam and Ahmed S. BaHammam 18.1 Introduction 18.2 Importance of understanding the natural history and time course of narcolepsy 18.2.1 Predicting disease progression 18.2.2 Identifying comorbidities 18.2.3 Developing targeted therapies and precision medicine 18.2.4 Enhancing patient education and support 18.3 Longitudinal studies on narcolepsy 18.3.1 Age of onset and gender differences 18.3.2 Progression of symptoms and clinical findings over time 18.3.3 Changes in sleep architecture over time based on sleep study findings 18.3.4 Longitudinal changes in orexin levels 18.3.5 Impact of narcolepsy on quality of life 18.3.6 Long-term data on safety and efficacy of narcolepsy medications 18.4 Developing targeted therapies based on natural course 18.5 Conclusion References Chapter 19: Neuroimaging in narcolepsy: advances in understanding pathophysiology and diagnosis Kyung Min Kim, Jun-Sang Sunwoo, and Seung Bong Hong 19.1 Introduction 19.2 Voxel-based morphometry, volumetry, cortical thickness studies on narcolepsy 19.3 Diffusion tensor imaging and narcolepsy 19.4 Functional magnetic resonance imaging research on narcolepsy 19.5 Magnetic resonance spectroscopy studies on narcolepsy 19.6 Single photon emission computed tomography and PET studies in narcolepsy 19.7 Future directions References Chapter 20: The distinctive characteristics of REM sleep and dreams in narcolepsy Serena Scarpelli and Luigi De Gennaro 20.1 Introduction 20.2 Rapid eye movement sleep features in narcolepsy 20.3 Dream activity in narcolepsy 20.4 Neural bases of dream recall 20.5 Lucid dreams, nightmares, and insights for treatment 20.6 Conclusions References Part III: Behavioral and psychosocial considerations Chapter 21: The hidden burden of narcolepsy: anxiety and depression among patients Berit Hjelde Hansen 21.1 Introduction 21.2 Anxiety disorders 21.3 Depressive disorders 21.4 Widening the scope—a potential role of neurodevelopmental disorders 21.5 Treatment 21.6 Importance of screening for anxiety and depression in narcolepsy 21.7 Summary References Chapter 22: Understanding psychosis and behavioral abnormalities in narcolepsy patients Cyril Hanin 22.1 Introduction 22.2 Clinical presentation of psychosis in narcolepsy 22.2.1 Psychotic symptoms in narcolepsy 22.2.2 Group 1: hallucinations in typical narcolepsy 22.2.3 Group 2: narcolepsy with atypical psychotic-like symptoms 22.2.4 Group 3: challenges in diagnosing narcolepsy in schizophrenia patients 22.3 Impulsivity, emotional dysregulation, and social behavior in narcolepsy 22.3.1 Impulsivity in narcolepsy 22.3.2 Emotional dysregulation 22.3.3 Altered social behavior 22.4 Pathophysiology: linking narcolepsy and psychosis 22.4.1 REM-sleep intrusion and psychotic-like symptoms 22.4.2 Autoimmune and genetic mechanisms 22.4.3 Hypocretin system implications 22.4.4 Early-onset narcolepsy and schizophrenia: neurodevelopmental implications 22.4.5 Medication-induced psychosis in narcolepsy patients with or without comorbid psychotic disorder 22.4.6 Classical psychostimulants: methylphenidate and amphetamines 22.4.7 Modafinil and armodafinil 22.4.8 Sodium oxybate (gamma hydroxybutyrate) 22.4.9 Pitolisant and other emerging treatments 22.5 Clinical algorithm and management strategies 22.5.1 Initial assessment and categorization 22.5.2 Assessing drug-induced psychosis 22.6 Prognosis and long-term outcomes in narcolepsy patients with psychotic symptoms AI disclosure References Chapter 23: Narcolepsy and cognitive impairment: causes and management Meteb H. Alenazi 23.1 Introduction 23.2 Cognitive impairment in narcolepsy 23.2.1 Attention 23.2.2 Memory 23.2.3 Executive functions and higher cognitive functions 23.3 Clinical pictures of excessive daytime sleepiness and cognitive impairment 23.3.1 Hypersomnolence related to major depressive disorder with atypical features 23.4 Conclusion AI disclosure References Chapter 24: Narcolepsy and relationships: navigating intimacy, family, and social life Anne Marie Morse 24.1 Introduction 24.1.1 Early childhood and adolescence 24.1.2 Adulthood 24.2 Optimizing outcomes 24.2.1 Conclusion References Chapter 25: Narcolepsy and advocacy: awareness, education, and community building Ahmed S. BaHammam 25.1 Introduction 25.2 The importance of narcolepsy advocacy 25.3 Raising awareness about narcolepsy 25.4 Educating the general public and healthcare providers about narcolepsy 25.4.1 Providing resources 25.4.2 Presentations and workshops 25.4.3 Correcting common myths 25.4.4 Importance of educating healthcare professionals 25.5 Building community and support 25.5.1 Connecting with other patients 25.5.2 Providing encouragement and sharing coping strategies 25.5.3 Advocating together for research and better treatments 25.6 Empowering patients to advocate for themselves 25.6.1 Gaining confidence to discuss narcolepsy 25.6.2 Communicating needs and challenges effectively 25.6.3 Partnering with healthcare providers 25.6.4 Understanding rights and accommodations 25.7 The impact of narcolepsy advocacy 25.8 Conclusion References Further reading Chapter 26: The complexities of medico-legal assessment of disability in narcolepsy Francesca Ingravallo and Annamaria Govi 26.1 The complexities of medico-legal assessment of disability in narcolepsy 26.2 The impact of narcolepsy on work and other major life activities 26.3 Aspects of functioning in people with narcolepsy identified by the International Classification of Functioning Core Set for Sleep Disorders 26.4 The complexity of medical-legal assessment of disability in narcolepsy 26.5 The role of sleep providers 26.6 Conclusions References Part IV: Specific management Chapter 27: Current pharmacological treatments for narcolepsy Ritwick Agrawal 27.1 Nonpharmacological interventions 27.1.1 Addressing comorbid disorders 27.1.2 Cognitive behavioral therapy and behavioral approaches to excessive daytime sleepiness 27.2 Pharmacological management 27.2.1 Primary goals of pharmacological management 27.2.2 Pretreatment considerations 27.2.3 Excessive daytime sleepiness treatment 27.2.4 Cataplexy and excessive daytime sleepiness management 27.2.5 Other narcolepsy symptoms 27.2.6 Adjustment of initial pharmacological intervention 27.3 Special populations 27.3.1 Children and young people 27.3.2 Pregnancy and lactation 27.4 Conclusion AI disclosure References Chapter 28: Exploring the potential of cognitive behavioral therapy as an adjunct to medication in narcolepsy management Sultan M. Alshahrani 28.1 Introduction 28.1.1 Cognitive behavioral therapy for narcolepsy 28.1.2 Psychotherapy and psychotherapeutic interventions 28.1.3 Education and psychoeducation 28.1.4 Conclusion 28.2 The psychosocial and psychosomatic aspects of narcolepsy 28.2.1 Introduction 28.2.2 Psychosocial aspects 28.2.3 Psychosomatic aspects 28.2.4 Summary 28.3 How can psychotherapy help cases with narcolepsy 28.3.1 Introduction 28.3.2 Mechanism of psychotherapy for individuals with narcolepsy 28.3.3 Summary 28.4 Cognitive behavioral therapy for narcolepsy 28.4.1 Introduction 28.4.2 Psychological models for narcolepsy 28.4.3 How does cognitive behavioral therapy work for narcolepsy 28.4.4 Components of cognitive behavioral therapy for narcolepsy 28.4.5 Techniques in cognitive behavioral therapy for narcolepsy patients 28.5 Diet and physical activity as components of psychotherapy in narcolepsy 28.5.1 Introduction 28.5.2 Diet applications for narcolepsy 28.5.3 Physical activity and exercise applications for narcolepsy 28.6 Other psychotherapeutic interventions for narcolepsy 28.6.1 Psychoanalysis for narcolepsy 28.6.2 Mindfulness-based interventions for narcolepsy 28.6.3 Supportive psychotherapy 28.6.4 Psychoeducational therapy (psychoeducation) References Chapter 29: Emerging therapies for narcolepsy: immunotherapy, gene therapy, and beyond Todd J. Swick 29.1 Genetics and immunology of narcolepsy 29.2 Cell/gene therapy for narcolepsy 29.3 Orexin agonists 29.4 Conclusions References Chapter 30: Exploring the role of biomarkers and epigenetics in narcolepsy: implications for diagnosis and treatment Ahmed S. BaHammam and Amir Sharafkhaneh 30.1 Introduction 30.2 Current biomarkers for narcolepsy diagnosis 30.2.1 Hypocretin-1 levels in cerebrospinal fluid 30.2.2 Genetic markers 30.2.3 Epigenetic biomarkers 30.2.4 Proteomic biomarkers 30.2.5 Other potential biomarkers 30.3 Epigenetic mechanisms in narcolepsy pathophysiology 30.3.1 Epigenetic changes in narcolepsy (histone modifications, DNA methylation) 30.3.2 Role of epigenetic alterations in narcolepsy development and progression 30.3.3 Integration of epigenetic mechanisms in narcolepsy pathophysiology 30.4 Epigenetic signatures as potential diagnostic markers 30.4.1 DNA methylation as a diagnostic biomarker 30.4.2 Potential for personalized medicine 30.5 Epigenetics in developing novel narcolepsy treatments 30.5.1 Epigenetic modulation of hypothalamic neuropeptides 30.5.2 Immunomodulatory approaches targeting epigenetic changes 30.5.3 Personalized therapy based on epigenetic profiling 30.6 Proteomics in narcolepsy pathogenesis 30.7 Proteomics in narcolepsy diagnosis 30.8 Proteomics in narcolepsy therapeutics 30.9 Challenges and limitations 30.10 Conclusions and future research directions References Chapter 31: Disease control in narcolepsy: use of telehealth and remote patient management technology Javad Razjouyan, Amir Sharafkhaneh, Antara Mallampalli, Max Hirshkowitz, and Sharam Moghtader 31.1 Introduction 31.2 Telehealth for diagnosis and management of narcolepsy 31.2.1 Diagnosis of narcolepsy 31.3 Management of narcolepsy 31.3.1 Medication management 31.3.2 Narcolepsy multidisciplinary teams 31.3.3 Remote patient monitoring 31.4 Application of telesleep for management of obstructive sleep apnea co-occurring with narcolepsy 31.5 Application of telesleep for management of insomnia co-occurring with narcolepsy 31.6 Application of telesleep for management of psychiatric conditions co-occurring with narcolepsy 31.6.1 Technical aspects of telemedicine References Chapter 32: The future of narcolepsy treatment: what role will artificial intelligence play? Arash Maghsoudi, Amin Ramezani, Javad Razjouyan, and Amir Sharafkhaneh 32.1 What is artificial intelligence? 32.2 The role of artificial intelligence in narcolepsy research 32.2.1 Artificial intelligence-driven analysis of narcolepsy: uncovering genetic markers 32.2.2 Machine learning models for predicting narcolepsy progression 32.3 Artificial intelligence in the diagnosis and management of narcolepsy 32.3.1 Enhancing diagnostic accuracy with artificial intelligence algorithms 32.3.2 Personalized medicine: artificial intelligence in developing customized treatment plans 32.4 Wearable technology and artificial intelligence monitoring 32.4.1 Smart devices and wearables: tracking sleep patterns and daytime sleepiness 32.4.2 Real-time monitoring and artificial intelligence: a new paradigm in narcolepsy management 32.5 Artificial intelligence and patient support systems 32.5.1 Chatbots and virtual assistants: providing round-the-clock support 32.5.2 Artificial intelligence-driven platforms for patient education and community building 32.6 Ethical considerations and future directions 32.6.1 Navigating the ethical landscape of artificial intelligence in healthcare 32.6.2 The future of artificial intelligence in narcolepsy treatment: innovations on the horizon 32.7 Conclusion Funding References Chapter 33: Narcolepsy and chronic pain: implications and management Zheng Liu, Man Min Zhu, and Hao Huang 33.1 Introduction 33.2 Epidemiology 33.3 Pathophysiological mechanisms 33.4 Bidirectional relationship between narcolepsy and chronic pain 33.5 Narcolepsy and chronic pain management 33.6 Future research directions References Chapter 34: Navigating the costs of narcolepsy in managed care Shafaq Mansoor, Elli Allen, and Sudha Tallavajhula 34.1 Introduction 34.2 Economic burden of narcolepsy 34.3 Insurance considerations for approval of testing in narcolepsy 34.4 Pharmacotherapy considerations 34.5 Strategies to help patients navigate the landscape 34.6 Patient access to sleep medicine specialists 34.6.1 Strategic drug utilization 34.7 Summary References Further reading Index

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