Narcolepsy is a rare disease that affects 1 in every 2,000 people worldwide 1. Narcolepsy is characterized by symptoms of excessive daytime sleepiness, hallucinations upon falling asleep and waking up, insomnia, sleep paralysis, and falling quickly into the rapid eye movement (REM) stage upon falling asleep 1,2. Narcolepsy is divided into two subtypes: Narcolepsy type 1 (N1) and type 2 (N2) 1,3. N1 is well understood and is thought to be autoimmune in nature 1,3,4. In addition to classic symptoms of narcolepsy, those with N1 almost always experience cataplexy – a phenomenon where a patient loses muscle control upon experiencing strong emotion. Those with N2 do not typically present with cataplexy, however, these patients can potentially experience cataplexy later in life, and their diagnosis will be changed accordingly 1,3.
Narcolepsy is a lifelong disorder presenting anywhere from childhood to young adulthood, however, an official diagnosis, which is confirmed by a sleep study completed in a sleep lab, may be delayed until adulthood 1,3,5. Misdiagnosis and comorbidities, as well as a lack of effective symptom recognition and awareness, may all lead to the average amount of time between symptom presentation and diagnosis being between 8-22 years 4,6. Treatment for narcolepsy is typically a combination of stimulants, wake-promoting medications, and sleep agents to help with insomnia and fragmented sleep patterns 1. Antidepressants and some sleep medications may also be used to treat cataplexy 1,2. Newer medications are being developed that promote wakefulness through more specific pathways, however, there is still no cure developed 1,2,3. There is also the question of reliability in sleep study results and subsequent diagnosis 5. These medication and diagnostic challenges point to a need for further research and development to create more effective medications and diagnostic tools for those affected by narcolepsy.
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- Burgess CR, Scammell TE. Narcolepsy: neural mechanisms of sleepiness and cataplexy. J Neurosci. 2012;32(36):12305-12311.
- Barateau L, Dauvilliers Y. Recent advances in treatment for narcolepsy. Therapeutic Advances in Neurological Disorders. 2019;12:1756286419875622.
- Golden EC, Lipford MC. Narcolepsy: Diagnosis and management. Cleveland Clinic Journal of Medicine. 2018;85(12):959.
- Lopez R, Doukkali A, Barateau L, et al. Test–Retest Reliability of the Multiple Sleep Latency Test in Central Disorders of Hypersomnolence. Sleep. 2017;40(12).
- Morse AM. Narcolepsy in Children and Adults: A Guide to Improved Recognition, Diagnosis and Management. Med Sci (Basel). 2019;7(12).
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