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Seeing a Physician
Everyone gets sleepy during the day now and then. While the occasional bout of post-meal drowsiness is normal, feeling the urge to nod off in the daytime could signal health problems. It may be that you're simply not allowing yourself enough time for sleep at night. However, if you are often very sleepy during the day and it is affecting your home and work life, talk to a doctor.
Below are some suggestions to help prepare you for your first doctor visit and some information on what to expect during your appointment. You can also view and print some questions to ask your physician and note any additional ones that you would like to ask your doctor.
Track Your Symptoms
The doctor will want to know what symptoms you have and when they started. It might be a good idea to track them for a week or two because it can be difficult to remember your daily experiences over time. Many sleep centers offer a form for a sleep diary you can fill out. You'll want to note down when you go to sleep and wake up and how many times you wake up at night. You might rate how well rested you feel in the morning. You could also keep track of your daytime sleepiness and any episodes of muscle weakness, vivid dreams while falling asleep or waking up, or an inability to move or speak when falling asleep or waking up.
It will also be important for the doctor to know other factors that can affect sleep, such as whether you smoke, drink caffeine or alcohol, or exercise.
Think ahead about your health history, recalling when your symptoms began and when they might have gotten worse or better over time. Many people with narcolepsy are not diagnosed for many years because they blame other problems for their symptoms. The doctor will want to know how your symptoms impact your life, such as at home, work, in your relationships and carrying out tasks such as driving.
The doctor will want to know about your family's health history and if you have relatives with sleep problems or narcolepsy. It might be worthwhile to ask relatives about this before your medical visit.
The doctor will also want to know about any medications you are currently taking. You might want to write these down or bring in the prescriptions if you are currently taking any medications.
During the Visit
A diagnosis of narcolepsy also usually involves some tests that take place in the sleep clinic overnight. Often the overnight polysomnogram, which monitors your body while you sleep, is followed by a daytime multiple sleep latency test, or nap study, that measures how easily you fall asleep during the day. Another narcolepsy test determines the levels of a substance called hypocretin in the fluid surrounding your spinal cord; a low level is often associated with a diagnosis of narcolepsy.
These are in addition to a physical exam that may look for other possible diagnoses that can cause similar symptoms.
Important Safety Information
1. XYREM® is a controlled substance. Controlled substances are medicines that, if abused, may lead to varying degrees of physical or psychological dependence. XYREM is a Schedule III drug — which means that it has a moderate dependence liability. If you sell, distribute, or give your XYREM to anyone else or use it for purposes other than what it was prescribed for, you may be punished under federal and state law by jail and fines.
2. It is very important to keep XYREM out of reach of children and pets.
3. XYREM can cause serious side effects including trouble breathing while asleep, confusion, abnormal thinking, depression and loss of consciousness. Tell your doctor if you have any of these problems while taking XYREM.
BOXED WARNING:
!Warning
Central Nervous System Depressant with Abuse Potential. Should not be used with alcohol or other CNS depressants. Sodium oxybate is a form of GHB, a known drug of abuse. Abuse has been associated with some important central nervous system (CNS) adverse events (including death). Even at recommended doses, use has been associated with confusion, depression, and other neuropsychiatric events. Reports of respiratory depression occurred in clinical trials. Almost all of the patients who received sodium oxybate during clinical trials were receiving CNS stimulants.
Important CNS adverse events associated with abuse of GHB include seizure, respiratory depression and profound decreases in level of consciousness, with instances of coma and death. For events that occurred outside of clinical trials, in people taking GHB for recreational purposes, the circumstances surrounding the events are often unclear (e.g., dose of GHB taken, the nature and amount of alcohol or any concomitant drugs).
XYREM is available through the XYREM Success Program®, using a centralized pharmacy 1-866-XYREM88® (1-866-997-3688). The Success Program provides educational materials to the prescriber and the patient explaining the risks and proper use of sodium oxybate, and the required prescription form. Once it is documented that the patient has read and/or understood the materials, the drug will be shipped to the patient. The XYREM Success Program also recommends patient follow-up every 3 months. Physicians are expected to report all serious adverse events to the manufacturer.
