Narcolepsy is a disorder characterized by symptoms of sleepiness, together with features of blurring of the boundary between wake and sleep. These manifest as dream imagery on waking or drifting off to sleep, waking with a transient feeling of paralysis, and sudden loss of muscle tone often triggered by strong positive emotions.
This loss of muscle tone is called cataplexy and it is one of the symptoms of narcolepsy. Cataplexy can be triggered by strong, usually positive, emotion and also becomes more frequent if people are more tired or sleepy.
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Are men or women more prone to sleep apnea? Similarly, children and adolescents with narcolepsy may be able to work with school administrators to accommodate special needs, like taking medications during the school day, modifying class schedules to fit in a nap, and other strategies. Additionally, support groups can be extremely beneficial for people with narcolepsy who want to develop better coping strategies or feel socially isolated due to embarrassment about their symptoms.
Support groups also provide individuals with a network of social contacts who can offer practical help and emotional support. In the past few decades, scientists have made considerable progress in understanding narcolepsy and identifying genes strongly associated with the disorder.
Groups of neurons in several parts of the brain interact to control sleep, and the activity of these neurons is controlled by a large number of genes.
The loss of hypocretin-producing neurons in the hypothalamus is the primary cause of type 1 narcolepsy. These neurons are important for stabilizing sleep and wake states. This results in the sleep fragmentation and daytime symptoms that people with narcolepsy experience. It remains unclear exactly why hypocretin neurons die. However, research increasingly points to immune system abnormalities. HLA—human leukocyte antigen—genes play an important role in regulating the immune system.
Most people with narcolepsy have this gene variation and may also have specific versions of closely related HLA genes. This indicates that other genetic and environmental factors are important in determining if an individual will develop the disorder. Narcolepsy follows a seasonal pattern and is more likely to develop in the spring and early summer after the winter season, a time when people are more likely to get sick.
By studying people soon after they develop the disorder, scientists have discovered that individuals with narcolepsy have high levels of anti-streptolysin O antibodies, indicating an immune response to a recent bacterial infection such as strep throat. Also, the H1N1 influenza epidemic in resulted in a large increase in the number of new cases of narcolepsy.
The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. Genetics and biochemicals NINDS-sponsored researchers are conducting studies devoted to further clarifying the wide range of genetic —both HLA genes and non-HLA genes—and environmental factors that may cause narcolepsy. Other investigators are using animal models to better understand hypocretin and other chemicals such as glutamate that may play a key role in regulating sleep and wakefulness.
Researchers are also investigating wake-promoting compounds to widen the range of available therapeutic options and create treatment options that reduce undesired side effects and decrease the potential for abuse. A greater understanding of the complex genetic and biochemical bases of narcolepsy will eventually lead to new therapies to control symptoms and may lead to a cure.
Immune system Abnormalities in the immune system may play an important role in the development of narcolepsy. NINDS-sponsored scientists have demonstrated the presence of unusual immune system activity in people with narcolepsy. Further, strep throat and certain varieties of influenza are now thought to be triggers in some at-risk individuals.
For a one-page summary of narcolepsy and its symptoms, causes, and treatments, download What Is Narcolepsy? Types of narcolepsy Clinicians now recognize two major types of narcolepsy: narcolepsy with cataplexy muscle weakness triggered by strong emotions and narcolepsy without cataplexy. People who have narcolepsy without cataplexy have sleepiness but no emotionally triggered muscle weakness, and generally have less severe symptoms.
There also exists another, very rare type known as secondary narcolepsy , which occurs with injury to a deep part of the brain called the hypothalamus. Sleep basics To understand the symptoms of narcolepsy, it helps to first understand how sleep happens normally. REM sleep is characterized by dreams, quick eye movements, and paralysis of the limbs and trunk that prevents someone from acting out dreams and getting injured during sleep. J Clin Sleep Med.
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Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Sleep Medicine. International Classification of Sleep Disorders , 3rd ed.
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