narcolepsy in adults - NICE guidance - suspected neurological conditions - recognition and referral

Last edited 05/2019

Sleep disorders in adults

Summary points from NICE guidance relating to sleep disorders in adults are:


Offer advice on sleep hygiene to adults with insomnia.

  • do not routinely refer adults with insomnia, jerks on falling asleep or isolated brief episodes of sleep paralysis

Symptoms that suggest new-onset epileptic seizures

  • refer urgently adults with symptoms suggestive of new-onset epileptic seizures in sleep for neurological assessment

Excessive sleepiness and narcolepsy

For adults with excessive sleepiness:

  • use the Epworth score together with history of obstructive symptoms in sleep to assess the likelihood of sleep apnoea
  • refer in accordance with local policy
  • if appropriate, offer advice on weight reduction, alcohol consumption and smoking cessation

Refer adults with narcolepsy, with or without cataplexy, for neurological assessment

Sleep behaviour disorders

  • consider referring adults with persistent symptoms suggestive of sleep behaviour disorders (such as agitated or violent movements that are more complex than a simple jerking motion) for neurological assessment.