I could never sleep long enough to even do a night study, so I had the lumbar puncture last year and found that I was Type 1. The puncture itself wasn't a big deal and I had no pain during the procedure or after. I did take it very easy for the next couple of days just to make sure I didn't get a headache.

MSLT and the overnight test I fell into REM within 2 min every session. So that was enough.

My doctor says that he doesn't bother with MSLTs anymore because sometimes it has taken up to a series of five before people demonstrate narcolepsy because sleeping in a strange place is not that conducive to the demonstration so he treats symptomatically (which is fantastic for me) since I show all the symptoms for narcolepsy and cataplexy.

Hey, I didn't have a lumbar puncture as my consultant decided that my symptoms were enough, alongside my overnight study & MSLT even though it didn't "scientifically" show narcolepsy (as I didn't go into REM sleep during the day). He chose not to do the lumbar puncture because my symptoms were so textbook and the presence of cataplexy makes a diagnosis easier.

Your symptoms do sound very textbook type 1 narcolepsy, so if your doctor won't diagnose you based just on your MSLT it may be worth asking for one. I've heard that they aren't too bad and most people are fine with them.