This chapter discusses the case of an 11-year-old Asian-American girl who was admitted for treating sleep disturbances, excessive daytime sleepiness (EDS) and paroxysmal weakness in the sleep center. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Nocturnal video-polysomnography (PSG) followed by a multiple sleep latency test (MSLT) were ordered. She went into REM sleep, without going into any other sleep stages at the beginning of the MSLT in three of the five naps. The diagnosis was narcolepsy with cataplexy. Sodium oxybate was administered and titrated twice nightly, which helped further decrease her cataplexy to once or twice daily. Cataplexy may take the form of prolonged waxing and waning, with partial or complete muscle atonia, called status cataplecticus. Schizophreniamay be co-morbid or an intrinsicmanifestation of narcolepsy. Obesity is frequently observed in association with narcolepsy, contributing to sleepiness.

The analysis of age-related changes in sleep requires the accumulation of data on a healthy population over 65 years of age. However, increased age raises the risk of cardiovascular, metabolic, cognitive, psychiatric, musculoskeletal, renal, hepatic, and hematological conditions. Structural decline in the elderly, including reduced brain mass and numbers of neurons, might lead to functional brain loss. Certain primary sleep disorders affecting sleep in the elderly includes insomnia, sleep-disordered breathing (SDB), periodic limb movement disorder and restless legs syndrome, circadian rhythm sleep disorders, and sleep in dementia. This chapter provides the clinical presentation, diagnosis and treatment for each disorder. As sleep and its restorative function become more widely recognized for their impact on both medical conditions and quality of life in the elderly, the healthcare community has ever-increasing responsibility for translating the growing knowledge of sleep medicine into clinical practice in geriatric medicine.