Narcolepsy and psychosomatic illnesses
S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer in Sleep and Psychosomatic Medicine, 2017
Narcolepsy is a chronic, debilitating neurological disorder, the hallmarks of which are hypersomnia and cataplexy. Narcolepsy is a neurological condition, but its etiology and pathogenesis remain obscure, although there have been recent advances in the understanding of the disease. The pharmacological management of narcolepsy entails the use of stimulants for excessive daytime somnolence, tricyclic antidepressants for secondary symptoms, and benzodiazepines to consolidate disturbed nocturnal sleep. Narcolepsy may be misdiagnosed as depression or hypothyroidism, while the symptoms of hypnagogic hallucinations may be mistaken for schizophrenia. A study in Germany documents the economic burden of narcolepsy on 75 patients diagnosed with the disease. Information on the symptoms of narcolepsy and their economic impacts was obtained through a standardized telephone interview. A comparison study with epilepsy showed that narcolepsy patients were more affected at work and had poorer driving records, higher accident rates from smoking, and greater problems in planning recreation.
Types of Sleep Disturbances in Women
Zippi Dolev, Mordechai Zalesch, Judy Kupferman in Sleep and Women's Health, 2019
This chapter describes the common types of sleep disorders from which women suffer: Insomnia, Restless legs syndrome, Obstructive sleep apnea, Excessive daytime sleepiness and Parasomnia. Women will express depression in the classic manner of low moods, depressive thoughts, early rising, or oversleeping, whereas for men, depression can be expressed in workaholism, attacks of rage and anger, need for excessive activity and risk taking, or alcohol and drug abuse, as well as insufficient sleep. Narcolepsy is a chronic neurological disorder that is unrelated to mental illness or psychological or hormonal problems and is usually caused by the brain's inability to regulate the sleep and wake cycles because of a lack of cells that produce the neuropeptide orexin. In extreme premenstrual dysphoric disorder, excessive sleeping can be observed as part of the general condition. Sleep-related eating disorders are an almost unstudied phenomenon for which information is very sparse.
Case 29
Edward Schwarz, Tomos Richards in Cases of a Hollywood Doctor, 2019
A patient is seen in your GP clinic requesting a repeat prescription of nasal decongestants. You note six of his friends are waiting patiently in the waiting room with a variety of garden tools. One is asleep and one appears very cross at having to wait for so long. You perform a perfect consultation, using a tried and tested consultation model and as you are about to show him out of your clinic, he stops you and tells you he is about to start a family with his new wife. You notice that he is of short stature with a large head and prominent forehead. You remember that his wife is of normal stature and is normally well except having recently suffered from a nasty case of narcolepsy.
Quickly diagnosed and treated prepubertal Type 1 narcolepsy case
Published in Psychiatry and Clinical Psychopharmacology, 2018
Fikret Poyraz Çökmüş, Orkun Aydın, Didem Sücüllüoğlu Dikici, Şermin Yalın Sapmaz
Excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucination are the classic tetrad of narcolepsy. It has been shown that narcolepsy, a chronic and disabling disease, starts in childhood and adolescence rather than adulthood. The International Classification of Sleep Disorder (ICSD-3) classifies narcolepsy into Type 1 (narcolepsy with cataplexy) and Type 2 (narcolepsy without cataplexy). There is low awareness and knowledge of narcolepsy among the general public, primary care physicians, and sleep specialists. It has been shown that the lack of recognition of disease symptoms delayed the diagnosis of narcolepsy from 8.7 to 22.1 years. In this case report, we will discuss the case of Type 1 narcolepsy, which started in the prepubertal period and was diagnosed and treated in a short period of time.
Improving predictive accuracy of a survey measure of risk for narcolepsy
Published in Health Psychology and Behavioral Medicine: an Open Access Journal, 2014
Jane F. Gaultney, David D. Gray, Kristin Daley
Narcolepsy is a brain disorder that may go unrecognized and untreated for many years. The ability to use easily obtained survey information about symptoms of narcolepsy would facilitate identification of individuals potentially at risk for narcolepsy who could be referred for further testing. The purpose of the present study was to explore whether a survey instrument could successfully distinguish narcolepsy from other sleep disorders using data that could easily be obtained from a community or general patient sample. The hypothesized model added the Epworth Sleepiness Scale to a narcolepsy symptoms checklist to explore whether it improved accuracy of classification. Data related to symptoms were extracted from medical records of patients with a known diagnosis of narcolepsy, obstructive sleep apnea, or insomnia. The sample was then randomly split in half, allowing exploratory and confirmatory binary logistic regression. Adding the Epworth Sleepiness Scale score to the original list of symptoms more accurately classified those with or without narcolepsy. Although these findings require additional testing before they can be confirmed and generalized, they suggest that a self-report screening instrument for narcolepsy with acceptable accuracy is possible.
Narcolepsy and A(H1N1)pdm09 vaccination
Published in Human Vaccines & Immunotherapeutics, 2014
Robbert van der Most, Marcelle Van Mechelen, Eric Destexhe, Martine Wettendorff, Emmanuel Hanon
Epidemiological data from several European countries suggested an increased risk of the chronic sleep disorder narcolepsy following vaccination with Pandemrix™, an AS03-adjuvanted, pandemic A(H1N1)pdm09 influenza vaccine. Further research to investigate potential associations between Pandemrix™ vaccination, A(H1N1)pdm09 influenza infection and narcolepsy is required. Narcolepsy is most commonly caused by a reduction or absence of hypocretin produced by hypocretin-secreting neurons in the hypothalamus, and is tightly associated with HLA-II DQB1*06:02. Consequently, research focusing on CD4+ T-cell responses, building on the hypothesis that for disease development, T cells specific for antigen(s) from hypocretin neurons must be activated or reactivated, is considered essential. Therefore, the following key areas of research can be identified, (1) characterization of hypothetical narcolepsy-specific auto-immune CD4+ T cells, (2) mapping epitopes of such T cells, and (3) evaluating potential mechanisms that would enable such cells to gain access to the hypothalamus. Addressing these questions could further our understanding of the potential links between narcolepsy and A(H1N1)pdm09 vaccination and/or infection. Of particular interest is that any evidence of a mimicry-based mechanism could also explain the association between narcolepsy and A(H1N1)pdm09 influenza infection.
Related Knowledge Centers
- Cataplexy
- Neurological Disorder
- Sleep Apnea Syndrome
- Sleep Paralysis
- Kleine
- Levin Syndrome
- Disorders of Excessive Somnolence