![]() However, clusters in families sometimes occur-up to 10% of individuals diagnosed with narcolepsy type 1 (with cataplexy) report having a close relative with similar symptoms. Most cases of narcolepsy are sporadic, meaning the disorder occurs in individuals with no known family history. Researchers believe that in individuals with narcolepsy, the body’s immune system selectively attacks the hypocretin-containing brain cells because of a combination of genetic and environmental factors. Autoimmune disorders occur when the body’s immune system turns against itself and mistakenly attacks healthy cells or tissue. ![]() Although the reason for this cell loss is unknown, it appears to be linked to abnormalities in the immune system. When cataplexy is present, the cause is most often the loss of brain cells that produce hypocretin. Hypocretin levels are usually normal in people who have narcolepsy type 2 (without cataplexy). Although the cause of narcolepsy is not completely understood, current research suggests that narcolepsy may be the result of a combination of factors working together to cause a lack of hypocretin. Nearly all people with narcolepsy type 1 (with cataplexy) have extremely low levels of the naturally occurring chemical hypocretin, which promotes wakefulness and regulates REM sleep. Since people with narcolepsy are often misdiagnosed with other conditions, such as psychiatric disorders or emotional problems, it can take years for someone to get the proper diagnosis. There are two types: narcolepsy type 1 (formerly narcolepsy with cataplexy) and narcolepsy type 2 (formerly narcolepsy without cataplexy). However, since this condition often goes undiagnosed, the number may be higher. It is estimated that anywhere from 135,000 to 200,000 people in the United States have narcolepsy. Symptoms often start in childhood, adolescence, or young adulthood (ages seven to 25), but can occur at any time in life. Narcolepsy affects both males and females equally. REM sleep latency of fewer than 15 minutes or two or more sleep-onset REM periods (SOREMPs) and a mean sleep latency of fewer than eight minutes.episodes of cataplexy occurring at least several times a month.In addition, one of the following must be present: In order to make a diagnosis of narcolepsy, an individual must have symptoms occurring at least three times a week over the past three months. Obviously, regular narcoleptic episodes could interfere with the ability to perform one’s job or complete schoolwork, and in some situations, narcolepsy can result in significant harm and injury (e.g., driving a car or operating machinery or other potentially dangerous equipment). Once awakened from a narcoleptic attack, people report that they feel refreshed (Chokroverty, 2010). The typical episode can last from a minute or two to half an hour. Surprisingly, narcoleptic episodes are often triggered by states of heightened arousal or stress. For example, around one-third of individuals diagnosed with narcolepsy experience vivid, dream-like hallucinations during narcoleptic attacks (Chokroverty, 2010). Narcoleptic episodes take on other features of REM sleep. These sleep episodes are often associated with cataplexy, which is a lack of muscle tone or muscle weakness, and in some cases involves complete paralysis of the voluntary muscles similar to the kind of paralysis experienced by healthy individuals during REM sleep (Burgess & Scammell, 2012 Hishikawa & Shimizu, 1995 Luppi et al., 2011). Figure 1. Those with narcolepsy may have a difficult time staying awake at work.Ī person with narcolepsy cannot resist falling asleep at inopportune times.
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