Table of Contents

What is Narcolepsy?
Who Gets Narcolepsy?
What are the symptoms?
When do the symptoms appear?
What causes Narcolepsy?
How is Narcolepsy Diagnosed?
What Treatments are Available?
What Behavioural Strategies Help People Cope With Symptoms?
What research is being done?



What is Narcolepsy?
Narcolepsy is a chronic neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. At various times throughout the day, people with narcolepsy experience fleeting urges to sleep. If the urge becomes overwhelming, patients fall asleep for periods lasting from a few seconds to several minutes. In rare cases, some people may remain asleep for an hour or longer.
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Who Gets Narcolepsy?
Narcolepsy is not rare, but it is an under-recognised and under-diagnosed condition. The disorder is estimated to affect about one in every 2,000 Americans. But the exact prevalence rate remains uncerntain, and the disorder may affect a larger segment of the population.
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What are the Symptoms?
People with narcolepsy experience highly individualized patterns of REM sleep disturbances that tend to begin subtly and may change dramatically over time. The most common major symptom, other than excessive daytime sleepiness (EDS), is cataplexy, which occurs in about 70 percent of all patients. Sleep paralysis and hallucinations are somewhat less common. Only 10 to 25 percent of patients, however, display all four of these major symptoms during the course of their illness.
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When Do Symptoms Appear?
In most cases, symptoms first appear when people are between the ages of 10 and 25 but narcolepsy can become clinically apparent at virtually any age. Many patients first experience symptoms between the ages of 35 and 45. A smaller number initially manifest the disorder around the ages of 50 to 55. Narcolepsy can also develop early in life, probably more frequently than is generally recognized. For example, 3-year-old children have been diagnosed with the disorder. 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. Many older patients find that some daytime symptoms decrease in severity after age 60.
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What Causes Narcolepsy?
The cause of narcolepsy remains unknown but during the past decade, scientists have made considerable progress in understanding its pathogenesis and in identifying genes strongly associated with the disorder. Researchers have also discovered abnormalities in various parts of the brain involved in regulating REM sleep that appear to contribute to symptom development. Experts now believe it is likely that - similar to many other complex, chronic neurological diseases - narcolepsy involves multiple factors interacting to cause neurological dysfunction and REM sleep disturbances.
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How is Narcolepsy Diagnosed?
Two tests in particular are considered essential in confirming a diagnosis of narcolepsy: the polysomnogram (PSG) and the multiple sleep latency test (MSLT).
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What Treatments are Available?
Narcolepsy cannot yet be cured. But EDS and cataplexy, the most disabling symptoms of the disorder, can be controlled in most patients with drug treatment.
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What Behavioral Strategies Help People Cope With Symptoms?
None of the currently available medications enables people with narcolepsy to consistently maintain a fully normal state of alertness. Thus, drug therapy should be supplemented by various behavioral strategies according to the needs of the individual patient.
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What Research is Being Done?
Research is ongoing in many countries. Within the American Federal government for example, the National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health (NIH), has primary responsibility for sponsoring research on neurological disorders. As part of its mission, the NINDS supports research on narcolepsy and other sleep disorders with a neurological basis through grants to major medical institutions across the country.
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