Narcolepsy

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Narcolepsy
Narcolepsy
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Narcolepsy

Narcolepsy disrupts the sleep-wake cycle. It is characterized, among other things, by daytime sleepiness despite adequate sleep at night and "sleep attacks". The sudden drowsiness usually cannot be resisted. In addition, in classic type I narcolepsy, cataplexies (laughing blow) are among the signs. This leads to a sudden loss of muscle tension. Narcolepsy is chronic…

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Symptoms

The symptoms of narcolepsy are varied. Certain symptoms are characteristic of this disorder. They can be present in different degrees. Among other things, it shows:

  • Daytime sleepiness and daytime sleep episodes. Drowsiness occurs during the day despite adequate night sleep and in a wide variety of situations, with different frequencies and degrees of intensity. Affected people notice the approaching sleep attack, but cannot avert it and fall asleep.
  • Cataplexies. These muscle tension losses occur suddenly and on both sides. They affect, for example, the legs or the knee muscles and can lead to falls. Sometimes only the posture muscles are affected. They are triggered by strong emotions such as joy or anger. Cataplexy can last different lengths of time. Those affected are conscious during this time. Narcolepsy can also occur without cataplexy (type II narcolepsy).
  • Sleep paralysis. When you wake up, your muscles may be temporarily paralyzed (with the exception of the eye muscles).
  • Hypnagogic hallucinations. This leads to intense - sometimes negative - hallucinations while falling asleep.
  • Automatic behavior. Activities are partly carried out automatically during the nodding off, e.g. writing, knitting.
  • Disturbed sleep at night. There are interruptions in sleep at night and awake times.

In addition, narcolepsy can cause other sleep disorders, such as periodic leg movements or a disturbing event during sleep (parasomnias). Narcolepsy leads to concentration disorders, depression and increased irritability as well as physical symptoms such as headaches. Everyday life, job and quality of life are often clearly restricted and, among other things, characterized by misinterpretations of the symptoms by the environment.

Among other things, the body attacks the central nervous system (autoimmune processes, as in classic autoimmune diseases). Based on a hereditary predisposition (HLA DQB602 - genetic characteristic of white blood cells), after an infection (flu or angina), so-called "hypocretin cells" of the sleep-wake regulation in the hypothalamus (region in the diencephalon) self-destruct. This cell loss destabilizes the sleep-wake regulation and the above symptoms occur. In rare cases, so-called secondary narcolepsy occurs due to damage to areas of the brain (e.g. due to circulatory disorders, tumor).

diagnosis

Among other things, the following are carried out:

  • detailed anamnesis (including symptoms, sleep diary),
  • physical and neurological examinations,
  • sleep medical examinations (polysomnography, multiple sleep latency test),
  • Laboratory tests (measurement of the hypocretin concentration in the spinal fluid),
  • Imaging examinations of the head / brain (e.g. if another underlying disease is suspected, e.g. MRI, CT).

therapy

The therapy is adapted to the individual situation of those affected and is carried out, among other things, by:

  • Information / education about narcolepsy,
  • Day structuring, individually adapted sleep phases during the day,
  • Behavioral measures (e.g. avoidance of alcohol, measures to improve sleep or the quality of sleep),
  • Medicines that promote alert messengers and reduce cataplexy,
  • psychosocial support, support in everyday life with narcolepsy,
  • possibly treatment of other sleep disorders and illnesses.

Whom can I ask?

Contact persons include:

  • Family doctor
  • Doctors who specialize in sleep medicine

Usually doctors from different disciplines and / or other experts are involved, e.g. neurologists, psychotherapists. Diagnosis and therapy also take place in specialized centers, e.g. in the sleep laboratory of a hospital department. You can find sleep laboratories on the website of the ÖGSM (Austrian Society for Sleep Medicine and Sleep Research).

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