Table 1.
Summary of CBT modules and activities.
| Module | Key Concepts/Activities | Suggested Session |
|---|---|---|
| Education about CDH | Provide education about the prevalence and etiology of narcolepsy and/or IH (as appropriate for the patient). Discuss the patient’s experience with the emergence of symptoms, the journey to getting diagnosed, and the perception of others about having narcolepsy. Provide resources for learning more about narcolepsy or IH (as appropriate). | Session 1 |
| Self-identity and self-image | Discuss self-identity and changes that have developed as the result of CDH symptoms. This includes strategies for active acceptance and value-congruent living. | Session 2 |
| Structured daytime activities | Use of sleep/wake diaries to develop a personalized structure for scheduled naps (as appropriate) and waking activities in small segments throughout the day (Pomodoro technique). Explain the nurturing/depleting activity to evaluate energy transactions throughout the day. | Session 3 |
| Structured nighttime activities | Use of sleep/wake diaries to develop a structure for regulating bedtime and waketime and to practice good sleep hygiene. | Session 4 |
| Coping skills and emotion-regulation | Discuss problem-focused and emotion-focused coping strategies to manage the unpredictability and/or constancy of CDH symptoms. This include cognitive flexibility for dealing with limitations or setting a structured worry time to manage anxiety. | Session 5 |
| Social support | Explain the importance of support from family and friends and connecting with others through patient organizations for people with CDH. | Session 5 |
| Medical, legal, and occupational issues | Discuss disability accommodations at work/school (if applicable), disclosing CDH diagnosis at work/school, and preparing for doctor’s visits. | Session 6 |
| Other topics | Discuss topics as appropriate: (1) managing the unpredictability of cataplexy; (2) medication adherence; (3) impact of CDH symptoms on family relationships; (4) using service or emotional support animals | Optional |
This table provides a summary of the CBT modules and key concepts and activities within each module. CDH including narcolepsy type 1, narcolepsy type 2, and IH. CBT = cognitive behavioral therapy, CDH = central disorders of hypersomnolence, IH = idiopathic hypersomnia.