Narcolepsy in the older adult

Narcolepsy is generally considered an illness of youth because of its incidence peaks around the second to third decade of life. However, there have been a handful of cases that reported the onset of narcolepsy after age 35 and well into the seventies. In addition to the late onset of primary narcolepsy, there is a certain amount of delay in diagnosing this condition; hence, there are reports of subjects who could not be diagnosed until later in life even though their symptoms started at a more typical age. There are certain neurological conditions that lead to symptomatic narcolepsy, most of which present at a later point in life than the primary narcolepsy. This chapter discusses each of these three subpopulations, together with challenges in the diagnosis and treatment of the older individual with the small armamentarium of medications that we have for this disabling and chronic illness.