The narcolepsy is a sleep disorder characterized by sudden sleep attacks that occur in any situation and are irresistible. In addition to drowsiness, someone with this disorder experiences cataplexy while awake; a sudden loss of muscle tone.
Cataplexy can last from several seconds to several minutes, and can range from weakness of the facial muscles to complete collapse of the body. Two other main features of this disorder are sleep paralysis and hypnagogic hallucinations..
Narcolepsy usually begins between the ages of 15 and 25, but it can appear at any age. In many cases it is not diagnosed and, as a consequence, not treated.
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Daytime sleepiness is when a person with narcolepsy may suddenly become sleepy and fall asleep. These little "naps" can last from several seconds to several minutes and can occur several times a day..
This situation can occur even during a good night's rest and often occurs in inappropriate places and times. It seems that people with this disorder cannot experience the amount of deep restful sleep that normal people get..
Although the "naps" feel restorative, that feeling of rest only occurs for a few hours.
In cataplexy, there seems to be a sudden onset of REM or REM sleep (rapid eye movement sleep). Normally, before reaching REM sleep, they go through 4 previous stages. However, someone with narcolepsy goes directly to REM.
During this stage, motor neurons are not stimulated by brain activity and the muscles of the body do not move, leading to cataplexy..
Sleep paralysis is a sleep disorder that occurs when, in the transition between sleep and wakefulness, you are fully aware of dreams but it is impossible to move.
As this happens when in an intermediate state between sleep and wakefulness, it is possible to have auditory or visual hallucinations that cause an intense sensation of presence and movement around the body.
A hypnagogic hallucination is an auditory, visual, or tactile hallucination that occurs shortly before the onset of sleep..
They can be scary and very realistic. Examples are flying or the illusion of being trapped in a fire.
It is estimated that up to 40% of people with narcolepsy experience automatic behaviors during dream episodes.
It consists of the person continuing to function (talking, doing things) during sleep episodes, although upon waking they do not remember having been doing those things.
The first symptom that appears in most cases is sudden and excessive sleep during the day. The other symptoms may begin on their own or in combination a few months after daytime "naps".
About 20-25% of people with narcolepsy experience all four symptoms. Daytime sleepiness usually persists throughout life, although sleep paralysis and hypnagogic hallucinations are rarer.
In humans, narcolepsy sleep occurs when suddenly passing from an awake state to REM sleep, bypassing non-REM sleep stages.
During REM sleep, motor neurons in the spine and brainstem produce almost complete atony. This situation occurs in cataplexy.
The HLA-DQB1 allele of the human HLA-DQB1 gene has been found in 90% of patients.
A 2009 study found an association with polymorphisms in the TRAC gene locus.
Another locus associated with narcolepsy is EIF3G.
There is a correlation between these people and genetic variations in the CMH complex (major histocompatibility complex).
Variations in this complex may increase the risk of an autoimmune response to neuron-producing proteins in the brain..
People with narcolepsy usually have a reduced number of neurons that produce the protein hypocretin, which are responsible for controlling appetite and sleep patterns.
Only 10,000 to 20,000 brain cells secrete hypocretin molecules.
Narcolepsy could be an evolutionary atavism; the appearance of an ancestor behavior. According to this theory, REM sleep is the evolution of the defense mechanism known as tonic immobility..
This reflex is also known as animal hypnosis or simulation of death, and it works as a last line of defense against a predator. It consists of the total immobilization of the animal.
The neurophysiology and phenomenology of this reaction has some similarities to REM sleep, which may reveal an evolutionary resemblance: paralysis, sympathetic activation, thermoregulatory changes, brainstem control.
The diagnosis of narcolepsy may require an overnight stay in a medical facility, where a deep sleep analysis is performed..
The methods normally used are:
A) Irresistible bouts of restful sleep that appear daily for a minimum of 3 months.
B) Presence of one or both of the following symptoms:
C) The alteration is not due to the direct physiological effects of a substance or a general medical condition.
Although there is no cure for narcolepsy, treatment with medications and lifestyle changes can help control symptoms..
It is important to consult a doctor before taking any of these drugs, because interactions with other medications or other conditions such as hypertension or diabetes can occur..
Other drugs such as antihistamines or cold medication can cause drowsiness.
Treatments currently being studied include: hypocretin replacement, hypocretin gene therapy, stem cells, body temperature manipulation, and immunotherapy.
Making certain lifestyle changes can help control the symptoms of narcolepsy:
People with narcolepsy can suffer from depression, social isolation, and disruption of normal functioning. Finding a psychologist or support group can help you better cope and find social support.
Meeting other people who have the same problem reduces feelings of isolation and provides social support. Also, it can be liberating to share experiences and learn how other people cope with symptoms..
And what experiences do you have with narcolepsy?
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