Narcolepsy

Narcolepsy

Abstract

Narcolepsy is a disorder of the regulation of consciousness and sleep characterized by excessive diurnal somnolence, sudden onset of attacks of cataplexy during full consciousness, hallucinations and sleep paralysis. The frequency is estimated to be 0.05% of the general population. The age of narcolepsy onset varies widely, with symptoms appearing as of the first years of life until about 50 years of age. The diurnal somnolence associated with attacks of cataplexy is sufficient to identify the disease. For atypical or incomplete types, complementary examinations are required. EEG recordings during sleep completed the following day with repeated tests of falling asleep. Impairment in the orexin system caused by genetic and autoimmune mechanisms may trigger narcolepsy. HLA typing detects the DR15 DQB1*0602 gene in the quasi-totality of narcoleptic subjects. Treatment for excessive diurnal somnolence and sleep attacks relies on naps distributed throughout the day and modafinil or methylphenidate. The treatment of cataplexy attacks calls upon tricyclic antidepressants or non anti-cholinergic agents. Narcolepsy can be severely debilitating and is often attenuated by these therapeutic agents that control the symptoms without curing the disease.

Narcolepsy

Introduction

An estimated 70 million people in the United States suffer from sleep problems, and more than half of those with sleep problems have a sleep disorder that is chronic. The four most prevalent sleep disorders are insomnia, obstructive sleep apnea, narcolepsy, and periodic Limb Movements in Sleep, with sleep apnea accounting for nearly 80% of all sleep diagnoses in sleep centers in the United States. About 30 million Europeans mature persons have common or chronic insomnia. Approximately 18 million have obstructive sleep apnea, but only 10% to 20% have been diagnosed. An estimated 250,000 people have narcolepsy, and more than 5% of adults are affected by periodic limb movements in sleep syndrome. Sleep disorders have major societal impacts. Each year, sleep disorders, sleep deprivation, and excessive daytime sleepiness (EDS) add approximately $16 billion annually to the cost of health care in the United States and result in $50 to $100 billion annually in lost productivity (in 1995 dollars). According to the National Highway Traffic and Safety Administration, 100,000 accidents and 1,500 traffic fatalities per year are related to drowsy driving. Nearly two thirds of older English have sleep difficulties, and the prevalence of sleep problems will increase as the older adult population increases. The 1990s has seen a significant increase in our awareness of the importance of diagnosing and treating sleep disorders. The prevalence rates, risk factors, and treatment options will be reviewed for each of the four major sleep disorders.

Narcoplepsy

Narcolepsy is a chronic neurological disorder initiated by the brain's inability to regulate sleep-wake circuits normally. It is estimated that approximately 250,000 adult Europeans are affected by narcolepsy. Narcolepsy is the most common neurological cause of EDS. Direct medical costs for narcolepsy can cost the patient more than $15,000 per year. The impact of narcolepsy is often more severe than that of other chronic diseases, such as epilepsy. Genetics may play a large role, with first-degree relatives having a 40-fold ...