Updated on 05/01/2024
Narcolepsy is a chronic hypersomnia disorder characterized by sudden onset of excessive sleep attacks during the day. Excessive daytime sleepiness is the most common initial symptom. Although it often occurs in inactive and relatively inactive situations, there may be uncontrollable sleep attacks while doing an active job, such as driving, eating, or watching an exciting match. Persists for seconds or minutes.
It is a rare disease that affects approximately 0.05% of the population. Onset is in adolescence, with a second increase in the thirties. It is more common in men than women.
It develops as a result of the loss of hypocretin neurons in the nuclei, which we call the hypothalamus and which provides the connection between the brain and the endocrine system, as a result of the interaction of hereditary and environmental factors, by immune-mediated mechanisms.
Cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations and disturbed night sleep may accompany narcolepsy, that is, excessive sleep attacks that occur at unexpected times and in unwanted places. There may be double and blurred vision before the sleep attack.
Cataplexy is the sudden onset of paralysis of voluntary muscles without any change in consciousness. Sometimes sudden muscle discharge can be a fall or a collapse. Respiratory muscles are never involved. Sometimes the attacks can be regional, such as drooping of the face or chin, drooping eyelids, or slurred speech. Attacks are very short, lasting 2 to 10 seconds. The frequency of attacks varies from a few per day to several per year. It can often be triggered by laughing. Autonomic symptoms may accompany.
Sleep paralysis is a paralysis of the whole body that usually occurs when awakening from sleep during the rapid eye movement phase we call REM sleep. It takes seconds to minutes and will disappear by itself. This paralysis, in which only breathing and eye movements are preserved, can be very frightening for the person. It does not necessarily have to be present for a diagnosis of narcolepsy.
Hypnagogic/hypnopompic hallucinations are vivid and frightening dreams occur during sleep or awakening. These dreams can be visual, auditory, or tactile.
There are two types of narcolepsy, Type 1 and Type 2. The most important difference between them is that Type 1 has cataplexy.
Diabetes, obesity, obstructive sleep apnea syndrome, mood disorders, anxiety and eating disorders are often observed together with narcolepsy.
Narcolepsy can cause problems in the person's social, work and family life. Therefore, diagnosis is important.
Although cataplexy is a diagnostic finding of narcolepsy, it may be not present in 30% of patients. Diagnosis is made by polysomnographic examination and multiple sleep latency test in addition to the history and examination.
In treatment, it is essential to provide non-drug approaches, that is, to provide sleep hygiene and to sleep programmed daytime sleep. It can also be treated with various drugs.
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