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Treatment of narcolepsy includes sleep hygiene and planned daytime naps, preferably no
longer than 15 minutes. EDS is also treated with stimulants; modafinil or amphetamine
derivates (dexamphetamine or methylphenidate). Cataplexy and other REM sleep
phenomena (sleep paralysis and hallucinations) usually respond well to treatment with
antidepressants, for example fluoxetine, clomipramine or venlafaxine. Sodium oxybate taken
in the evening to consolidate overnight sleep can be an effective treatment of both EDS and
cataplexy but due to the high cost (permission needs to be sought from local authorities)
usage in the UK is so far limited.

Summary

There are multiple links between epilepsy and sleep. Sleep and sleep deprivation may
influence IED and seizures. Primary sleep disorders such as OSA may worsen epilepsy and
treatment of these sleep disorders can lead to improved seizure control. Seizures may interfere
with night-time sleep structure and cause EDS. Correctly diagnosing paroxysmal nocturnal
events remains a challenge even using video-EEG telemetry. Identification and treatment of
both sleep disorders and epilepsy is important for optimal patient care.

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