12 Chapter 1 Box 1 – ICSD-3 diagnostic criteria Narcolepsy type 1 (criteria A and B): A) Daily periods of irrepressible need to sleep or daytime lapses into sleep, present for at least three months. B) E ither one and/or two: (1) Cataplexy and mean sleep latency ≤ 8 minutes and two or more SOREMPs on the MSLT. REM sleep within 15 minutes of sleep onset on the preceding nocturnal polysomnogram may replace one of the SOREMPs. (2) Low CSF hypocretin-1 concentration (< 110 pg/mL or less than one-third of control values). Narcolepsy type 2 (all criteria A-E): A) Daily periods of irrepressible need to sleep or daytime lapses into sleep, present for at least three months. B) M ean sleep latency ≤ 8 minutes and two or more SOREMPs on the MSLT. REM sleep within 15 minutes of sleep onset on the preceding nocturnal polysomnogram may replace one of the SOREMPs. C) No cataplexy. D) CSF hypocretin-1 concentration has not been measured or CSF hypocretin-1 concentration is ≥ 110 pg/mL or greater than one-third of control values. E) T he hypersomnolence and/or MSLT findings are not better explained by other causes. Idiopathic hypersomnia (all criteria A-F): A) Daily periods of irrepressible need to sleep or daytime lapses into sleep, present for at least three months. B) F ewer than two SOREMPs on the MSLT (or fewer than one if nocturnal REM sleep latency was ≤ 15 minutes). C) No cataplexy. D) Either one and/or two: (1) Mean sleep latency ≤ 8 minutes on the MSLT. (2) Total 24-hour sleep time ≥ 660 minutes on 24-hour polysomnographic monitoring or wrist actigraphy (averaged over ≥ 7 days). E) Insufficient sleep syndrome is ruled out. F) T he hypersomnolence and/or MSLT findings are not better explained by other causes.
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