Hidden In Plain Sight: Expert Strategies for Eliciting a History of and Effectively Managing Cataplexy in Patients with Narcolepsy Type-1


Narcolepsy type 1 (NT-1) has been presumed to be among the easier of the causes of excessive daytime sleepiness (EDS) to diagnose as it is the only condition that presents with the pathognomonic symptom of cataplexy. However, not only does cataplexy typically occur later than other symptoms of narcolepsy, it is also often significantly more subtle and variable than textbooks might indicate. Beyond the complexity of cataplexy’s identification, it is also poorly treated by many of the common medications used for narcolepsy more broadly. To help guide clinicians through optimal techniques, this activity utilizes discussion of several clinical scenarios and pearls from the practices of the invited faculty alongside supporting evidence to deconstruct common barriers to cataplexy identification and treatment.

Target Audience

The target audience for this activity includes sleep specialists, general neurologists, nurse practitioners, physician assistants, registered nurses, and other healthcare professionals involved in the diagnosis and long-term management of patients with sleep disorders.

Learning Objectives

Upon completion of the educational activity, participants should be able to:

  • Review available assessment tools and clinical interview strategies employed by sleep specialists to better elicit a history of cataplexy in patients of variable profiles and presentations
  • Discuss which available EDS therapies are specifically indicated for and effective in managing cataplexy and which lack supporting data to ensure patients affected by this symptom are treated appropriately and successfully


Course summary
Available credit: 
  • 0.75 AAPA Category I CME
  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 ANCC
  • 0.75 Attendance
Course opens: 
Course expires: 
   Russell Rosenberg, PhD, DABSM (Moderator)
   Founder & Director
   Atlanta School of Sleep Medicine and Technology
   Director & CEO
   NeuroTrials Research, Inc
   Atlanta, GA
   Phyllis Zee, MD, PhD
   Director, Center for Circadian and Sleep Medicine
   Chief, Division of Sleep Medicine
   Feinberg School of Medicine
   Northwestern University
   Chicago, IL
   Asim Roy, MD
   Medical Director
   Ohio Sleep Medicine Institute
   Clinical Assistant Professor
   Northeast Ohio Medical University
   Dublin, OH

This activity is jointly provided by Medical Education Resources (MER) and Efficient LLC.

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Joint Accreditation Statement


In support of improving patient care, this activity has been planned and implemented by MER and Efficient, LLC. MER is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Designation Statement

MER will provide up to 0.75 AMA PRA Category 1 Credit™ to learners for their completion of the activity and associated assesments.
MER designates this enduring activity for a maximum of .75 ANCC nursing contact hours. Nurses will be awarded contact hours upon successful completion of the activity.
Physician Assistants
MER has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.75 AAPA Category 1 CME credit.

Disclosure of Relevant Financial Relationships

MER insures balance, independence, objectivity, and scientific rigor in all our educational activities. In accordance with this policy, MER identifies relevant financial relationships with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Reported relevant financial relationships are mitigated by MER to ensure that all scientific research referred to, reported, or used in a CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing learners with high-quality CE activities that promote improvements or quality in health care and not the business interest of an ineligible company.

Planners' and Managers' Disclosure
MER planners and managers have nothing to disclose. Efficient LLC planners and managers have nothing to disclose.

Faculty Disclosures

Dr. Rosenberg reported the following financial relationships:

  • Grants/Research Support: Axsome, Jazz Pharmaceuticals, Suven, Takeda, Vanda

Dr. Zee reported the following financial relationships:

  • Grants/Research Support: Vanda
  • Consulting Fees: CVS Caremark, Eisai, Harmony Biosciences, Jazz Pharmaceuticals, KemPharm, Merck, Sanofi-Aventis, Takeda
  • Ownership Interest/Shareholder: Teva Pharmaceuticals
  • Royalty/Patent Holder: US20180357360A1 (Pending); US20170304587A1 (Issued)

Dr. Roy reported the following financial relationships:

  • Grants/Research Support: Avadel, Harmony Biosciences, Jazz Pharmaceuticals, NLS Pharmaceuticals, Takeda
  • Consulting Fees: Avadel, Axsome, Harmony Biosciences, Jazz Pharmaceuticals, Takeda
  • Speakers Bureau: Axsome, Harmony Biosciences, Jazz Pharmaceuticals

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Commercial Support

This activity is supported by an educational grant from Harmony Biosciences.

Available Credit

  • 0.75 AAPA Category I CME
  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 ANCC
  • 0.75 Attendance


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