Many people with narcolepsy take short, regularly scheduled naps at times when they tend to feel sleepiest. Drug therapy should be supplemented by behavioral strategies. Two classes of antidepressant drugs - tricyclic antidepressants and selective serotonin reuptake inhibitors - have proved effective in controlling cataplexy in many patients. Food and Drug Administration has approved a drug called modafinil for the treatment of excessive daytime sleepiness. Two or three short naps during the day may help control sleepiness and maintain alertness. Antidepressants may help with muscle control. Central nervous system stimulants are usually prescribed for excessive sleepiness. Ideally, this can be done using a minimal amount of medicine. It's also important to reduce times when you lose muscle control. The goal of treatment of narcolepsy is to help you remain as alert as possible during the day. Your tolerance for specific medicines, procedures, or therapiesĮxpectations for the course of the disease Your age, overall health, and medical history Specific treatment will be determined by your healthcare provider based on: Narcolepsy is not definitively diagnosed in most patients until 10 to 15 years after the first symptoms appear.
To test for a genetic mutation often found in people who tend to have narcolepsy. This test measures when you fall asleep and how quickly rapid eye movement (REM) sleep occurs. A sleep specialist will monitor you during an entire night of sleep. In addition to a complete medical history and physical exam, lab tests to confirm diagnosis and plan treatment may include:
Many older patients find that some daytime symptoms decrease in severity after age 60. Whatever the age of onset, patients find that the symptoms tend to get worse over the two to three decades after the first symptoms appear. You may have other difficulties as you cope with this condition including:įeelings of intense fatigue and continual lack of energyĭifficulty in concentrating and memorizing Performing routine tasks without conscious awareness of doing so, and often without memory of it.ĭisrupted nighttime sleep and waking up often Vivid and often scary dreams and sounds reported when falling asleep.Īutomatic behavior. Being unable to talk or move for about one minute when falling asleep or waking up. A sudden loss of muscle control ranging from slight weakness to total collapse. An overwhelming desire to sleep at inappropriate times.Ĭataplexy. Symptoms may include:Įxcessive daytime sleepiness (EDS). However, people may experience symptoms differently. The following are the most common symptoms of narcolepsy. It is caused by a deficiency in the production of a brain chemical that helps neurons talk to each other. It involves the body's central nervous system, which includes the brain and spinal cord. “These results suggest that immunotherapy might be used to treat narcolepsy-cataplexy, and they identify a potential cellular target for this therapeutic strategy,” concludes Rolan Liblau, who conducted this work.The cause of narcolepsy is not known. This neuronal loss led to cataplexy and sleep disorders in these mice, mimicking human narcolepsy. The mice were injected with effector T cells specific for this autoantigen.ĬD4 T cells infiltrated the hypothalamus and triggered local inflammation, but did not induce destruction of the orexinergic neurons, in contrast to cytotoxic CD8 T cells. They thus generated mice expressing an autoantigen, haemagglutinin, specifically in the orexinergic neurons (Orex-HA mice). In order to study the potential autoimmune aetiology, Inserm researchers at Unit 1043, the “Toulouse Purpan Pathophysiology Center” (Inserm/University of Toulouse/CNRS), have developed a mouse model that mimics narcolepsy. The aetiology of the disorder remains poorly known, although the genetic and environmental factors associated with narcolepsy, together with serological data, all point to a probable autoimmune origin. These neurons secrete a neurotransmitter, orexin, which stimulates the appetite and waking state.
It is due to the loss of a population of neurons, known as the orexinergic neurons, located in the lateral hypothalamus. © Fotolia Narcolepsy-cataplexy is a rare and serious sleep disorder characterised by excessive daytime drowsiness and sudden loss of muscle tone.
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