NARCOLEPSY

NARCOLEPSY: A REVIEW OF CURRENT KNOWLEDGE

Abstract

Narcolepsy is a debilitating neurological disorder characterized by excessive daytime sleepiness and abnormal control of rapid eye movement (REM) sleep. This review provides an overview of narcolepsy, including the diagnosis, etiology, and current treatments. Recent research suggests that narcolepsy is caused by a combination of genetic and environmental factors. Currently, the primary treatment for narcolepsy is the use of stimulants and other medications to improve daytime alertness and reduce the frequency of cataplexy attacks. Behavioral interventions, such as cognitive behavioral therapy and lifestyle changes, also play a role in managing narcolepsy symptoms.

Introduction

Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness (EDS) and abnormal control of rapid eye movement (REM) sleep. It affects up to 0.2% of the population and is more common in males than in females. Narcolepsy is a life-long disorder that can significantly impair quality of life and functioning. The disorder is associated with increased risk of motor vehicle accidents, falls, and other injuries, as well as problems with concentration, memory, and mood.

Diagnosis

The diagnosis of narcolepsy is based on the international criteria for narcolepsy, which include the presence of EDS, cataplexy, sleep paralysis, hypnagogic hallucinations, and disturbed nocturnal sleep. The diagnosis is usually confirmed with an overnight sleep study and multiple sleep latency test.

Etiology

Recent research has suggested that narcolepsy is caused by a combination of genetic and environmental factors. Several genes have been implicated in the development of narcolepsy, including the human leukocyte antigen (HLA) gene, the orexin receptor gene, the hypocretin receptor gene, and the histamine receptor gene. In addition, environmental factors, such as infections, vaccinations, or stress, have been hypothesized to play a role in triggering the onset of narcolepsy.

Treatment

The primary treatment for narcolepsy is the use of stimulants and other medications to improve daytime alertness and reduce the frequency of cataplexy attacks. Stimulants, such as methylphenidate and modafinil, are usually the first line of treatment and can improve daytime alertness, reduce EDS, and decrease the frequency of cataplexy attacks. Other medications, such as tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and sodium oxybate, can also be used to manage narcolepsy symptoms. Behavioral interventions, such as cognitive behavioral therapy and lifestyle changes, also play a role in managing narcolepsy symptoms.

Conclusion

Narcolepsy is a life-long disorder that can significantly impair quality of life and functioning. Recent research suggests that narcolepsy is caused by a combination of genetic and environmental factors. Currently, the primary treatment for narcolepsy is the use of stimulants and other medications to improve daytime alertness and reduce the frequency of cataplexy attacks. Behavioral interventions, such as cognitive behavioral therapy and lifestyle changes, also play a role in managing narcolepsy symptoms.

References

American Academy of Sleep Medicine. (2020). International classification of sleep disorders: Diagnostic and coding manual. Darien, IL: American Academy of Sleep Medicine.

Mignot, E., Lammers, G. J., Ripley, B., Okun, M., Nevsimalova, S., Overeem, S., . . . Plazzi, G. (2002). The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Archives of Neurology, 59(10), 1553-1562.

National Institute of Neurological Disorders and Stroke. (2017). Narcolepsy. Retrieved from https://www.ninds.nih.gov/Disorders/All-Disorders/Narcolepsy-Information-Page

Scammell, T. E. (2015). Narcolepsy. The New England Journal of Medicine, 373(15), 1451-1458.

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