Narcolepsy is frequently associated with the genetic marker HLA DQB1*0602. Patients with cataplexy often have low levels of a neurotransmitter called Hypocretin. In most cases of narcolepsy without cataplexy (and in rare cases with cataplexy), the cause of the symptoms is unclear and the diagnostic is purely based on the result of an abnormal sleep test called the multiple sleep latency test (MSLT) (see below). The Cause of Narcolepsy with and without Cataplexy Obesity – Many patients with narcolepsy also gain weight as the result of inactivity and sleepiness.Nighttime eating and excessive dreaming with motor activity (acting out dreams, see also REM sleep Behavior Disorder) also frequently occur. Patients often do fall asleep rapidly but are unable to stay asleep for more than a few hours at a time. Difficulties maintaining sleep – Nighttime sleep is disturbed.Automatic behavior – a person continues to function or talk while being half asleep, and awakens with no memory of doing these activities.Hypnagogic hallucinations – vivid, sometimes disturbing dreamlike experiences that occur while dozing, falling asleep and/or upon awakening.Sleep paralysis – the temporary inability to talk or move when waking it may last a few seconds to minutes.Cataplexy is a cardinal symptom as it almost always indicates that the cause of the narcolepsy is a lack of hypocretin in the brain. While cataplexy can manifest as something as minor as a slight slackening of the facial muscles, in extreme cases, a person may experience total collapse or even muscle paralysis. Cataplexy – a sudden weakening of the muscles, often triggered by a strong emotion. Normally, people do not reach the REM stage until after 60 – 90 minutes.īeside excessive daytime sleepiness, patients may display the following symptoms: Another difference with other hypersomnia is that with narcolepsy, when the person falls asleep, they generally experience the REM stage of sleep within 10 minutes. The disorder is sometimes confused with insomnia due to its characteristic disturbed night-time sleep and with epilepsy because of unexplained sudden falls caused by cataplexy. Most patients also experience cataplexy, suddenly feeling paralyzed or weak in the head, legs or other body parts especially after excitement or laughing. A brief nap is generally refreshing, but the sleepiness re-occur rapidly a few hours later. A person with narcolepsy will experience extreme fatigue and may fall asleep at odd and inappropriate times, such as during work or school. Narcolepsy is a chronic, neurological sleep disorder characterized by excessive daytime sleepiness. Hypersomnias (other than narcolepsy) are subdivided into Idiopathic Hypersomnia (persistent sleepiness lasting more than 3 months without abnormal tendencies to enter REM sleep) and Recurrent Hypersomnia (recurrent episodes of sleepiness that are entirely reversible in between). Hypersomnia is a term that refers either to an excessive quantity of daily sleep or a difficulty to stay awake during the day, or both. In narcolepsy, other symptoms beside excessive daytime sleepiness are present, and there is a tendency to fall asleep directly or extremely rapidly into Rapid Eye Movement (REM) Sleep (dreaming sleep). In about 10 percent of cases, narcolepsy runs in families.These refer to a group of disorders for which excessive daytime sleepiness is the core symptom, but due to insufficient sleep (sleep deprivation), disturbed nocturnal sleep, insomnia, circadian rhythm disorders, sleep-related breathing (sleep apnea) disorders or medical issues. Less often, the cause of narcolepsy is an injury that damages the brain. Their immune system mistakenly turns against their body and attacks the brain cells that produce hypocretin. Some people experience hallucinations and sleep paralysis when they’re falling asleep or waking up.Ĭertain people with autoimmune disorders are more likely to get narcolepsy with cataplexy. The lack of hypocretin makes it hard for someone to stay awake during the day, blurring the line between wakefulness and sleep. That loss of muscle tone causes you to lose control over your body when you’re awake. It’s the same loss of muscle tone that naturally happens during rapid eye movement (REM) sleep. The loss of muscle tone, cataplexy, happens because sleep and wakefulness overlap in narcolepsy. When it’s in short supply, your brain has trouble regulating your sleep-wake cycles. This chemical, which is produced in a brain region called the hypothalamus, controls sleep and wakefulness. Low levels of the chemical hypocretin cause narcolepsy with cataplexy. Narcolepsy affects signals in your brain that are supposed to keep you awake.
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