But I Need Marijuana to Function as a Mother!

Abstract

Polysomnography and multiple sleep latency testing (MSLT), along with detailed history and sleep logs and actigraphy, are essential for the diagnosis of narcolepsy with cataplexy (narcolepsy type 1). Interpreting polysomnography and MSLT data is challenging in patients with substance abuse. This chapter presents the case of a young woman with a history of substance abuse and confounding MSLT results due to covert use of recreational drugs. Recreational drugs affect sleep architecture, and the results of urine drug screening become a critical part of diagnostic evaluation in patients with substance abuse. Patients undergoing MSLT to characterize and confirm central hypersomnia need proper preparation to reduce false-positive, false-negative, and confounding results. Unexpected positive urine toxicology results are common in adolescents and adults undergoing MSLT and maintenance of wakefulness testing.