Narcolepsy in Child

Nurse Alexa, MSN, RN · Feb 24, 2023

I have not had a student with narcolepsy, but I would imagine they'd take medications daily to prevent episodes.

I would also speak with student about what works best for them - maybe there's a possibility for a night time clinical.

cowboysandangels, BSN · Feb 27, 2023

This is a student with multiple disabilities and cannot tell me what he needs. Not sure what a night time clinical would be for him. My concern is that sometimes he is very difficult to awaken and I worry I am missing something else going on.

k1p1ssk, BSN, RN · Feb 27, 2023

I think the above poster thought you were talking about a nursing student, not a child/adolescent...

I have never had a student with narcolepsy but I knew someone in college who had cataplexy. If she became overly excited or something was particularly funny to her, she would kinda get "stuck" with the joy to the point where it was almost like a seizure. She would go stiff and if it was a laughing episode, she would continue with the laugh, but her body and face would essentially be frozen in place. She didn't take any kind of medication to my knowledge. She let us know about it before the first time it happened and just said if it does, to just give her space and let her work through it on her own. Usually, once the stimulus was gone, she would "come to" after a minute or so. My understanding is that narcolepsy is an umbrella term, with cataplexy being one of the sub-categories.

Have you spoken with his family about what is typical for his episodes and if he is on a maintenance medication? I would want to know any known triggers that can be avoided, what a typical episode looks like, how long it lasts, and what should be done to arouse him if indicated. I would also want to know how frequently he experiences these episodes and anything else you should be looking out for, anything you should be reporting back to them / his neurologist.

GdBSN, RN · Feb 27, 2023

I have not had a student with narcolepsy, but both of my children have been diagnosed with it. They both take medication to stay awake during the day. Without the meds it is very difficult for them to stay awake. For your student, you need to communicate with the parents and get a plan from the doctor. It would be very difficult to know if the student is sleeping or experiencing something else. (When my kids are sleeping, it is very difficult to wake them up.)

kunaspud · Feb 27, 2023

I have a student with narcolepsy and cataplexy. He is on medications at home to help keep him awake, but also has a 30 minutes lunch nap written into his 504. He is difficult to awaken when he forgets his medication at home, but is aware enough to let me know that he forgot. I will let mom know. She will sometimes bring in the medication/take him home, but usually we agree to let him nap for about an hour. That will usually get him through the day, although he doesn't function at peak performance. ? I have always been able to awaken him, but sometimes two or three times before he is able to get moving.

beachynurse, ASN, BSN · Mar 7, 2023

I have had numerous students with Narcolepsy. All are on medications at home for it, and 1 takes meds at school. Some have 504's some don't. They have accommodations to be able to rest for 20 minutes in the clinic, if putting their heads down on a desk doesn't help. Some wake up pretty easily, some are sluggish and it takes a few tries. I've never had trouble waking them up. I have one student that just likes to sleep in class, no narcolepsy, and he won't wake up for the teacher, so they call me. I just bang my fist on his desk, very loudly, and very loudly call his name. He wakes up for me.. He will jump when I bang on the desk. But he gets up.

cowboysandangels, BSN · Mar 8, 2023

This student is impossible to awaken. The first time it happened I called EMS to just lay eyes on him. They could not awaken him either. It has happened several times now. I call his name, tickle him, take shoes off and tickle feet, pick him up, move him to another room, clap at him, everything! No awakening. He did not even wake up when the EMS pricked his finger to check his sugar.

arlingtonnurse · Mar 8, 2023

cowboysandangels said:

I call his name, tickle him, take shoes off and tickle feet, pick him up, move him to another room, clap at him, everything! No awakening.

Sternal rub?

cowboysandangels, BSN · Mar 9, 2023

Yep, even the sternal rub did nothing. Out cold.

beachynurse, ASN, BSN · Mar 23, 2023

My daughter used to sleep like that. Getting her up for school in the morning was torture, for me LOL. I used to put a piece of ice down her back. That usually worked, put her in a bad mood for the day, but she wasn't going to be home with me. I was going to work and she was going to school. The teachers unfortunately had to deal with the bad mood. but it was either do something and get her to school, or she would sleep all day. I voted for school!

londonflo · Apr 10, 2023

I am assuming a sleep study was done. We have problems in my town with parents "entertaining all night". The nurses offers some students respite for sleeping.