The complexities of medico-legal assessment of disability in narcolepsy

This chapter addresses the multifaceted impact of narcolepsy on patients’ functioning, primarily caused by excessive daytime sleepiness. Comorbidities and depression increase the disease burden, as do higher rates of inpatient admissions and healthcare visits. Pharmacological and behavioral therapies are effective in managing symptoms but do not fully restore the functional status or quality of life of patients, who may experience significant health-related stigma, perpetuated by misperceptions of narcolepsy. Consequently, many patients with narcolepsy meet the criteria for disability. To provide a comprehensive picture of the multifaceted impact of narcolepsy, the chapter reports the results of a pilot study using the International Classification of Functioning (ICF) Core Set for Sleep Disorders. The chapter concludes with recommendations for improving disability assessment processes, emphasizing the need for documentation from sleep experts and a holistic approach to managing narcolepsy’s impact on daily life.