Narcolepsy ; Sleep Attacks

 

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.

 Refrences

https://pubmed.ncbi.nlm.nih.gov/30526757/

 https://aasm.org/resources/factsheets/narcolepsy.pdf

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634162/