Checklist for Therapeutic Use Exemption (TUE) Application:
Intrinsic Sleep Disorders
Prohibited Substances: Stimulants
This Checklist is to guide the athlete and their physician on the requirements for a TUE application that will allow the TUE Committee to assess whether the relevant ISTUE Criteria are met.
Please note that the completed TUE application form alone is not sufficient; supporting documents MUST be provided. A completed application and checklist DO NOT guarantee the granting of a TUE. Conversely, in some situations a legitimate application may not include every element on the checklist.
| • | TUE Application form must include: | |
| • | All sections completed in legible handwriting | |
| • | All information submitted in [language] | |
| • | A signature from the applying physician | |
| • | The Athlete’s signature | |
| • | Medical report should include details of: | |
| • | Medical history: include comments on history of
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| • | Findings on examination:
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| • | Interpretation of symptoms, signs and test results by a specialist physician | |
| • | Diagnosis (must differentiate between narcolepsy, idiopathic hypersomnia, sleep apnoea and hypopnea syndrome) by a medical specialist in sleep disorders | |
| • | Stimulant prescribed (prohibited in-competition) including dosage, frequency, administration route | |
| • | Use of and response to other treatments including behavioural changes, naps, CPAP, antidepressants (not essential to have trialled prior to the use of stimulants) | |
| • | Diagnostic test results should include copies of: | |
| • | Night time polysomnography | |
| • | Multiple Sleep Latency Test | |
| • | Brain imaging: not mandatory | |
| • | Additional information included | |
| • | As per ADO specification | |
