ABSTRACT
Narcolepsy is a rare disorder that is frequently misdiagnosed after manifestation of first symptoms. Onset of the core symptoms excessive daytime sleepiness and cataplexy can be delayed by years (7,8 years in Germany (1), 5,3+ 9,2 years in the USA (2)). The mean delay between symptom onset and diagnosis in retrospective data in the German population has been 15.1 years (12,4-17,8 years, 95% confidence interval) but has shortened quite a bit in the past decade. Ancillary symptoms as hypnagogic hallucinations, automatic behaviour, fragmented nocturnal sleep and sleep paralysis may be misdiagnosed as nonpsychotic mental disorder, schizophrenia, disorder of the central nervous system such as epilepsy, exhaustion, collapse, vertigo, migraine etc. (3,4). Frequent co-morbid disorders may contribute to further diagnostic mismanagement and delay of diagnosis. Narcolepsy patients (np) seek help from physicians more frequently than non-affected controls (9.4 vs. 4.8) because they do not receive a satisfactory help for their main problems, eds, irresistible sleep episodes and cataplexy. They also consult more specialists (3.4 vs. 2.1) (4). Neurologists and internists most frequently diagnose narcolepsy followed by general practitioners and psychiatrists. Nowadays many narcoleptic patients find their diagnosis by publications in the media, TV and radio shows, and very often by the internet.
