Many cases of narcolepsy are thought to be caused by a lack of a brain chemical called
Narcolepsy may have several causes. Nearly all people with narcolepsy who have cataplexy have extremely low levels of the naturally occurring chemical hypocretin, which promotes wakefulness and regulates REM sleep. Hypocretin levels are usually normal in people who have narcolepsy without cataplexy.
While hypocretin deficiency underlies narcolepsy, abnormalities in dopaminergic neurotransmission also contribute to the sleepiness and cataplexy that typify the disorder.
The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of hypocretin (hi-poe-KREE-tin), also called orexin. Hypocretin is a chemical in the brain that helps control being awake and when you enter REM sleep. Hypocretin levels are low in people who experience cataplexy.
Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause. major psychological stress. an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix)
Genetic factors clearly play a role. Most people with narcolepsy have inherited a gene that codes for the human leukocyte antigen (HLA) DQB1*06:02, which is important for immune function. This gene is found in 12–25% of the general population, and it increases the risk of developing narcolepsy 7- to 25-fold.
Causes and risk factors
Your family history or environment can raise your risk of narcolepsy. Narcolepsy may also occur after an upper airway infection or, rarely, because of a head injury, sarcoidosis, a stroke, or another medical condition.
There's no specific cure for narcolepsy, but you can manage the symptoms and minimise their impact on your daily life. Making some simple changes to your sleeping habits can sometimes help. If your symptoms are more severe, you'll usually need to take medicine.
Narcolepsy in childhood-adolescence is characterized by a high occurrence of psychiatric comorbidities. The most frequent psychiatric disorders reported in these patients are attention deficit/hyperactivity disorder, depression, anxiety disorder, and schizophrenia.
Some symptoms of narcolepsy depend on emotional stimuli; for instance, cataplectic attacks can be triggered by emotional inputs such as laughing, joking, a pleasant surprise, and also anger.
Doctors may confuse it with a mental health condition. Some narcolepsy symptoms are similar to those of depression. If your narcolepsy makes you hallucinate, that could lead doctors to suspect mental illness.
Melatonin. Melatonin is the hormone best known to affect sleep, being low during the daytime but rising once darkness sets in, leading to sleep. Melatonin is secreted by the pineal gland, to which the SCN projects via multiple synapses to drive the Circadian rhythm of production of this hormone.
Abnormalities in the somatotropic axis, such as GH deficiency of hypothalamic or pituitary origin, result in an alteration of normal sleep patterns which may explain the fatigue reported in these individuals.
While some hormones such as progesterone, estrogen, and testosterone can contribute to insomnia— especially in premenstrual women, pregnant women, and women in menopause— those problems are temporary and resolve once hormone levels return to normal.
Nutrients that can help manage narcolepsy include calcium and magnesium, choline, chromium picolinate, coenzyme Q10, omega-3 fatty acids, B vitamins, vitamin C complex (including bioflavonoids) and vitamins D and E.
While running can be mentally engaging enough for some people with narcolepsy, others may perform more complicated activities, such as playing pick up games of basketball, dancing or rock climbing. Other potentially engaging exercises include: Martial arts. Hiking.
Narcolepsy is a common sleep disorder with a prevalence of about 0.02%. However, it may remain largely unrecognized in the Indian population owing to the perceived low prevalence. To the best of our knowledge there is only one case of narcolepsy reported from India so far.
Although there are rare families where narcolepsy is passed on through several generations, most cases of narcolepsy occur at random rather than being inherited. The likelihood of developing narcolepsy is influenced by proteins known as histocompatibility leukocyte antigens (HLA).
Frequency. Narcolepsy affects about 1 in 2,000 people in the United States and Western Europe. However, the disorder is likely underdiagnosed, particularly in people with mild symptoms. Worldwide, narcolepsy appears to be most common in Japan, where it affects an estimated 1 in 600 people.
Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Your health care provider may recommend modafinil (Provigil) or armodafinil (Nuvigil).
One U.S. study placed the incidence of new cases of narcolepsy at . 74 per 100,000 person-years in the general population in the United States. The disorder has also been estimated to affect 1 in 2,000 people in the general population.
Narcolepsy is caused by the selective destruction of the orexin-producing neurons. What kills the orexin-producing neurons remains a major mystery, but several lines of evidence suggest that NT1 is an autoimmune disease mediated by T cells.