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Narcolepsy

The narcolepsy , also called syndrome Gélineau or narcolepsy-cataplexy syndrome is a disorder of sleep, specifically a hypersomnia, characterized mainly by the presence of daytime sleepiness, accompanied by bouts of uncontrollable sleep lasting a few minutes, as well as by crisis of cataplexy.

Sleep paralysis and hallucinations may also appear.

It appears equally in women and men, generally young.

It has a significant hereditary burden, with a family history being very frequent.

Why is it produced?

Narcolepsy is a disease of unknown cause, although there is much evidence of its relationship with genetic factors, as we have already mentioned.

Thus, in many patients an association is detected between this pathology and the presence of certain genes (DR2 and DQw1) in the HLA (histocompatibility antigen, located on chromosome 6), especially in whites (almost 100% of the cases).

Sometimes it appears after a stressful situation.

Like the causes, the mechanism of production of this disorder remains unknown (despite the genetic association).

Symptoms of narcolepsy

The symptoms that can appear in narcolepsy are the following:

  • Hypersomnia or daytime sleepiness, with unstoppable sleep attacks lasting a few minutes. These attacks, as the disease progresses, go from occurring in more or less “flattering” situations (being at the cinema, after eating, etc.), to appearing in moments of activity (walking, driving, etc.); They are usually REM sleep (phase in which you dream) from the beginning. This situation is related to poor quality of nighttime sleep, and can lead to accidents, decreased academic or work performance, and so on. It is the most frequent symptom.
  • Cataplexy It is a sudden loss of muscle tone (atony), which can become paralysis, without affecting the extraocular or respiratory muscles; This has the consequence that the patient cannot move normally or falls to the ground. There is no loss of consciousness; that is, the patient realizes what is happening. It usually lasts a few seconds.Cataplexy is actually another manifestation of the emergence of a REM phenomenon in full wakefulness, and it is usually triggered as a result of intense emotions ( anger , joy) or rapid movements.

    It is the second most frequent symptom of this disease, and is associated with hypersomnia in 70% of cases.

  • Sleep paralysis. During drowsiness or upon awakening, the patient has a perception similar to cataplexy; that is, it cannot be moved. Unlike sleep paralysis, it does not need emotional stimuli. It is a few minutes long.
  • Hallucinations They are usually visual, and can occur at the beginning of sleep (hypnogogic), or upon waking (hypnopompic). They are also a REM phenomenon, and when associated with sleep paralysis, they cause great anxiety.

The complete four only occur in 14% of cases.

It is not uncommon for narcolepsy to co-occur with other illnesses, such as depression, anxiety disorders, or other sleep disturbances.

It is currently being investigated whether, in these cases, these anomalies are a consequence of the psychosocial problems that this pathology causes, or if they are the result of its own pathophysiological mechanism.

How is it diagnosed?

The diagnosis of narcolepsy can be deduced in many cases from the medical history and physical examination.

Polysomnographic studies can be done to confirm this.

In the polysomnographic record of nocturnal sleep, the duration of superficial sleep appears increased (phases 1 and 2) and that of deep sleep decreased (phases 3 and 4). The REM phase is also prolonged, and there is a shortening of its latency, to the point that, in some patients, sleep is REM from the beginning (SOREM phenomenon).

Daytime sleep crises can also be recorded, verifying that they almost always have a REM onset.

The multiple sleep latency test (MSLT) is very useful for the diagnosis of daytime hypersomnia, showing periods of sleep latency of less than 5 minutes.

Treatment for narcolepsy

Unfortunately, complete healing is very difficult.

In some cases, thanks to drug therapy, it is possible to control some symptoms separately.

Thus, for daytime hypersomnia, amphetamine stimulants are used, such as methylphenidate or amphetamines; for REM phenomena (especially cataplexy), tricyclic antidepressants, such as clomipramine, or monoamine oxidase inhibitors (MAOIs), and for both types of symptoms, modafinil (alpha 1 adrenergic agonist).

Controlled naps during the day can also help.

In addition, to cope with the family and social problems that this disease usually produces, treatment must be completed with supportive, personal and family psychotherapy.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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