Introduction
Narcolepsy is a neurological
sleep disorder that causes a potentially disabling level of daytime sleepiness.
This sleepiness may occur in the form of repeated and irresistible “sleep
attacks.” In these episodes a person suddenly falls asleep in unusual situations,
such as while eating, walking or driving. Narcolepsy as a most common causes of
chronic sleepiness, affects about 1 in 2000 people.
Despite
the frequency of narcolepsy, the average time from the onset of symptoms to
diagnosis is 5 to 15 years, and narcolepsy may remain undiagnosed in as many as
half of all affected people with narcolepsy, since many clinicians are
unfamiliar with this disorder. It can be characterized by disordered regulation
of rapid-eye-movement (REM) sleep.
REM
sleep normally occurs only during the usual sleep period and includes vivid,
story like dreams, rapid (saccadic) eye movements, and paralysis of nearly all
skeletal muscles, except the muscle of respiration. Narcolepsy usually begins
between the ages of 10 and 20 years with the sudden onset of persistent daytime
sleepiness, although it can also develop gradually.
Clinical
Features
Narcolepsy
is characterized by instability of sleep-wake transitions.
·
Daytime
sleepiness
Clinically, narcolepsy manifests with excessive daytime sleepiness that can be personally and socially disabling.
Cataplexy
Cataplexy transient muscle weakness triggered by emotion is a specific feature of narcolepsy type 1. It often begins in the facial muscles and can manifest with slackening of the jaw or brief dropping of the head.
·
Sleep
paralysis; hallucinations
Sleep
paralysis and hallucinations are other features of narcolepsy that reflect this
REM dissociation from sleep.
·
Fragmented
sleep
Although
they are very sleepy, people with narcolepsy generally cannot stay asleep for
very long. Their sleep tends to be extremely fragmented, and they often wake up
several times a night.
·
Weight gain,
obstructive sleep apnea
Weight
gain is common, particularly after symptom onset, and especially in children.
As a result, obesity is a frequent comorbidity.
Psycosocial Consequences
Narcolepsy
has significant psychosocial consequences.
Additionally,
their risk of a motor vehicle accident is 3 to 4 times higher than in the
general population, and more than one-third of patients have been in an
accident due to sleepiness. There is some evidence to show that
treatment eliminates this risk.
Few
systematic studies have examined mood disorders in narcolepsy. However, studies
tend to show a higher prevalence of psychiatric disorders than in the general
population, with depression and anxiety the most common.
Conclusion
Hence,
narcolepsy is a neurological disorder manifested by sleeping disorder due to
reduced hypocretin that can be treated by amphetamine, methamphetamine and
medonafil like drugs.
https://pubmed.ncbi.nlm.nih.gov/30526757/
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