Narcolepsy

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Tetrad of narcolepsy


Clinic

  • Narcolepsy is a long-term neurological disorder that involves a decreased ability to regulate sleep–wake cycles.
  • Only about 20 -25 % of people with narcolepsy experience all four symptoms.
  • Excessive daytime sleepiness and brief involuntary sleep episodes.
  • They have episodes of sudden loss of muscle strength, known as cataplexy. (70%)
  • Narcolepsy paired with cataplexy is evidenced to be an autoimmune disorder.
  • Cataplexy can be brought on by strong emotions.
  • Vivid hallucinations or sleep paralysis while falling asleep or waking up (Less commonly)
  • Sleep quantity in narcolepsy is not changed but its quality decreased.
  • Narcolepsy is a clinical syndrome of hypothalamic disorder
  • Low levels of the neuropeptide orexin, which may be due to an autoimmune disorder triggered by INFL (H1N1) infection.
  • Trauma, tumors or other brain diseases affecting the parts of the brain that regulate wakefulness or REM sleep.
  • They are also more likely to develop RBD.

Hypnagogic hallucinations

  • They are vivid, often frightening, dreamlike experiences that occur while dozing or falling asleep.
  • Hypnopompic hallucinations refer to the same sensations while awakening from sleep.
  • Visual or auditory hallucinations
  • They may visibly fall asleep at unpredictable moments
  • They fall quickly into what appears to be very deep sleep, then wake up suddenly and can be disoriented when they do (dizziness is a common occurrence).
  • They have very vivid dreams, which they often remember in great detail.
  • Along with vivid dreaming, people with narcolepsy are known to have audio or visual hallucinations prior to falling asleep.

Other symptoms


Irregular sleep–wake cycles

  • Excessive daytime sleepiness due to irregular sleep–wake cycles.
  • Decreasing amount of restorative deep.
  • They have sufficient REM sleep, but do not feel refreshed / Sleep deprivation
  • Excessive sleepiness esp commonly during monotonous situations
  • Daytime several naps
  • Vivid dreams even during very brief naps.
  • Night-time sleep is fragmented with frequent awakenings.


Abnormal REM sleep

  • It is a prominent symptom of narcolepsy
  • They typically have higher REM sleep density
  • They enter into REM in the beginnings of sleep, even during day-sleep.
  • REM sleep without atonia
  • Some aspects of REM sleep that normally occur only during sleep occur at other times.
    • Muscular atonia can occur during wakefulness in a cataplexy episode
    • Sleep paralysis and vivid dreams can occur while falling asleep or waking up.

Related disease

Cataplexy

Miasms

FFI