Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy

Catherine A McCall,1,2 Nathaniel F Watson3 1Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Seattle, WA, USA; 2Department of Psychiatry and Behavioral Sciences, University of Washington Sleep Medicine Center, Seattle, WA, USA; 3Department of Neurology,...

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Autores principales:	McCall CA, Watson NF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	narcolepsy cataplexy driving safety Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/4cf6b665b22d4c05ab537c2476f43dc4
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spelling	oai:doaj.org-article:4cf6b665b22d4c05ab537c2476f43dc42021-12-02T16:03:53ZTherapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy1178-203Xhttps://doaj.org/article/4cf6b665b22d4c05ab537c2476f43dc42020-11-01T00:00:00Zhttps://www.dovepress.com/therapeutic-strategies-for-mitigating-driving-risk-in-patients-with-na-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XCatherine A McCall,1,2 Nathaniel F Watson3 1Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Seattle, WA, USA; 2Department of Psychiatry and Behavioral Sciences, University of Washington Sleep Medicine Center, Seattle, WA, USA; 3Department of Neurology, University of Washington Sleep Medicine Center, Seattle, WA, USACorrespondence: Catherine A McCallVA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USAEmail cmccall1@uw.eduAbstract: Narcolepsy is a central nervous system hypersomnia disorder characterized by uncontrollable episodes of daytime sleep, sleep state instability, and cataplexy (sudden loss of muscle tone precipitated by emotion). Individuals with narcolepsy report more frequent sleep-related crashes, near crashes, and drowsy driving than drivers with other sleep disorders. As such, evaluating risk of sleep-related crashes is of great importance for this patient population. There are no established guidelines for ensuring driving safety in patients with narcolepsy; however, many providers currently use a combination of subjective report, report of prior crashes or near-misses, report of previously falling asleep while driving, sleepiness screening tools, and maintenance of wakefulness testing (MWT) to determine risk. Driving simulator tests, though often unavailable to the clinician, provide data to support the use of MWT for evaluation of alertness in drivers with narcolepsy. Treatments such as modafinil may improve driving performance; however, the impact of other treatments such as stimulants and sodium oxybate on driving has not been extensively studied. Behavioral and lifestyle modifications may also reduce risk, including scheduled naps, driving only short distances, and avoiding driving after meals, sedating medications, and alcohol intake. Even with effective treatment, alertness in patients with narcolepsy may never reach that of normal drivers; however, studies have suggested that narcolepsy patients may be able to drive safely with appropriate limitations.Keywords: narcolepsy, cataplexy, driving, safetyMcCall CAWatson NFDove Medical PressarticlenarcolepsycataplexydrivingsafetyTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 1099-1108 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	narcolepsy cataplexy driving safety Therapeutics. Pharmacology RM1-950
spellingShingle	narcolepsy cataplexy driving safety Therapeutics. Pharmacology RM1-950 McCall CA Watson NF Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
description	Catherine A McCall,1,2 Nathaniel F Watson3 1Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Seattle, WA, USA; 2Department of Psychiatry and Behavioral Sciences, University of Washington Sleep Medicine Center, Seattle, WA, USA; 3Department of Neurology, University of Washington Sleep Medicine Center, Seattle, WA, USACorrespondence: Catherine A McCallVA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USAEmail cmccall1@uw.eduAbstract: Narcolepsy is a central nervous system hypersomnia disorder characterized by uncontrollable episodes of daytime sleep, sleep state instability, and cataplexy (sudden loss of muscle tone precipitated by emotion). Individuals with narcolepsy report more frequent sleep-related crashes, near crashes, and drowsy driving than drivers with other sleep disorders. As such, evaluating risk of sleep-related crashes is of great importance for this patient population. There are no established guidelines for ensuring driving safety in patients with narcolepsy; however, many providers currently use a combination of subjective report, report of prior crashes or near-misses, report of previously falling asleep while driving, sleepiness screening tools, and maintenance of wakefulness testing (MWT) to determine risk. Driving simulator tests, though often unavailable to the clinician, provide data to support the use of MWT for evaluation of alertness in drivers with narcolepsy. Treatments such as modafinil may improve driving performance; however, the impact of other treatments such as stimulants and sodium oxybate on driving has not been extensively studied. Behavioral and lifestyle modifications may also reduce risk, including scheduled naps, driving only short distances, and avoiding driving after meals, sedating medications, and alcohol intake. Even with effective treatment, alertness in patients with narcolepsy may never reach that of normal drivers; however, studies have suggested that narcolepsy patients may be able to drive safely with appropriate limitations.Keywords: narcolepsy, cataplexy, driving, safety
format	article
author	McCall CA Watson NF
author_facet	McCall CA Watson NF
author_sort	McCall CA
title	Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
title_short	Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
title_full	Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
title_fullStr	Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
title_full_unstemmed	Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy
title_sort	therapeutic strategies for mitigating driving risk in patients with narcolepsy
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/4cf6b665b22d4c05ab537c2476f43dc4
work_keys_str_mv	AT mccallca therapeuticstrategiesformitigatingdrivingriskinpatientswithnarcolepsy AT watsonnf therapeuticstrategiesformitigatingdrivingriskinpatientswithnarcolepsy
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Therapeutic Strategies for Mitigating Driving Risk in Patients with Narcolepsy

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