NARCOLEPSY Neurological Disorder What is it Chronic neurological

NARCOLEPSY Neurological Disorder

What is it? • Chronic neurological disorder affecting brain’s ability to regulate sleep-wake cycles. • Two types: • Narcolepsy with Cataplexy

Go to Sleepzzzzzzzzzzz • NREM(Non-Rapid Eye Movement) Step 1 • REM(Rapid Eye Movement) Step 2 • NREM (80 -100 minutes)

Biological Alarm Clock

With Narcolepsy: • There is no step 1 (NREM= Non rapid Eye movement) • REM IMMEDIATELY

Defined by four major symptoms • Excessive: daytime sleepiness (EDS). • Cataplexy: most dramatic symptom of narcolepsy • Hypnagogic hallucinations: intense and sometimes terrifying experiences • Sleep paralysis: frightening inability to move shortly after awakening or dozing off.

Main sign: Daytime sleepiness may cause: • Mental cloudiness or "fog" • Memory problems • Problems focusing • Lack of energy • Depression • Extreme exhaustion

Other signs: • Fall asleep suddenly (any where, any time) • sleep longer than usual (up to 18 hrs a day ) • Experience drowsiness • Wake up frequently during night time hours • Sleep attacks last from few sec. to an hour

Narcolepsy with Cataplexy the most severe one • Loss of muscle tone(Cataplexy) • Head nodding • Drooping eyelids • Difficulty speaking • Difficulty moving arms or hands or a weakened grip • Buckling of the knees • Can be associated with sleep-onset or sleep-offset paralysis • Exceptionally can last from hours to days!! • https: //youtu. be/VA 6 Fei. Gg. LF 0

RESEARCH: Discover • People with narcolepsy: lack of Orexin • hypocretin 1 -2 (Orexin A and B) • Regulates the sleep-wake cycle

Sleep attacks triggered By Strong Emotions: • Laughter • Anger • Fear • Excitement

Co-morbidity varies Disorder Narcolepsy (%) Controls (%) Adjusted Odds Ratio P Value Major depressive disorder 17. 1 6. 4 2. 7 <. 001 Bipolar disorder 8. 5 1. 9 4. 6 <. 001 Post-traumatic 11. 3 stress disorder 5. 3 2. 1 <. 001 Social anxiety 21. 1 8. 7 2. 4 <. 001 Panic disorder 12. 5 3. 9 3. 2 <. 001 Agoraphobia 8. 5 1. 3 6. 5 <. 001 Simple phobia 5. 2 1. 3 4. 1 <. 001 Obsessivecompulsive disorder 3. 7 1. 0 3. 8 <. 001 Generalized anxiety disorder 5. 5 1. 7 3. 3 <. 001

Psychosocial impact • Adult, Child and Teens: • Severe psychosocial stress • Embarrassment, • Academic decline • Feelings of loss of self-worth related to the symptoms of their disease. • Adult narcoleptics also face the concerns of the workplace • Accident at home or other places

Psychosocial Impact (Cont. ) • need for stimulants often creates problems with pharmacists and family.

How is narcolepsy diagnosed? • Patient's symptoms • family history of narcolepsy • physical exam • test results

SPECIFIC TESTS with Sleep Specialist • Polysomnogram (PSG) • Multiple sleep latency test (MSLT) • Hypocretin test (Require to sleep overnight in a sleep disorder center

How is narcolepsy treated? • No CURE • Medicines to relieve daytime sleepiness: • Stimulant: . Modafinil • Pemoline • Methylphenidate • Amphetamines • Medicines to relieve other symptoms: • Several Different Antidepressant