Narcolepsy: Life is short, stay awake for it!
A Brochure

An Outreach Project by Karee JuVette | Return To Outreach Projects 2010


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A Brief History and Definition

  • Narcolepsy is a (currently) incurable chronic sleep disorder most prominently characterized by overwhelming daytime drowsiness and sudden "attacks of sleep"
  • Regardless of circumstances, victims find it difficult to stay awake for long periods of time
  • Most unique to narcolepsy, victims suffer from fits of muscle weakness, known as cataplexy
  • Westphal formally stated the first & most compelling descriptions of narcolepsy in 1877
  • Westphal described an abnormal connection between muscle weakness & extreme sleepiness; his reports also suggested a genetic component of disorder
  • In 1880, Gélineau first gave the name narcolepsy, subsequently recognizing it as a specific clinical entity
  • In 1902 Loewenfeld differentiated the muscle weakness episodes as cataplexy
  • Medical research from 1917-1927 led to Von Economo proposing correctly that the posterior hypothalamus was lesioned in human narcolepsy
  • Further work by Yoss & Daly (Mayo Clinic) and Bedrich Roth (Prague, Austria) led to classic description of narcolepsy tetrad
  • Research continues today

    • Symptoms

    Note: most of the following symptoms are note indicative of narcolepsy exclusively
    Excessive Daytime Sleepiness:

  • most universal symptom of narcolepsy
  • uncontrollable need to sleep during day
  • fall asleep without warning, anywhere and any time
  • low alertness throughout day
  • cannot concentrate and function fully

    • +Cataplexy:
  • varying degrees of severity: last few seconds to minutes; slurred speech to complete weakness of most muscles
  • uncontrollable and triggered by intense emotions
  • about 70% of narcolepsy victims experience cataplexy: varying levels of severity: 1 or 2 episodes/year to several each day

    • Sleep Paralysis:
  • experience temporary inability to move/speak while falling asleep or upon waking
  • usually brief episodes, but victim can often recall what happened and is, in fact, aware of the body's paralysis
  • these paralyses mimic those that occur during REM sleep

    • Narcolepsy victims can also experience hypnagogic hallucinations

    Trends and Treatment

    Occurs in all racial and ethnic groups, but rates vary by country:

  • Example countries:
    • US: 1/2,000 affected Israel: 1/500,000 affected Japan (world high): 1/600 affected
    Complications:
  • misunderstand victim as lazy, rude, lethargic, etc., affecting victim's overall performance
  • interference with intimate relationships, especially because cataplexy triggered by intense emotions
  • physical harm
    • -increased risk of car crashes (should not drive alone)
    -affects ability to carry out daily routines
    Stimulants:
  • drugs prescribed that stimulate the central nervous system, allowing one to stay awake during the day
    • -some drugs have many side effects, new medicine Modafinil (Provigil) better
  • Antidepressants:
  • alleviate: cataplexy, hypnagogic hallucinations, sleep paralysis

    • Sodium Oxybate (Xyrem):
  • controls cataplexy, daytime sleepiness; strictly regulated by FDA because serious side effects

    • Causes

    Note: the exact cause of narcolepsy is still unknown; genetics may play a role in the disorder; larger influence may be a trigger, like an infection, leading to damage to certain brain cells
    Normal sleep pattern vs. Narcolepsy:

  • most sleep begins with process known as NREM sleep, during which brain waves slow down considerably
  • narcolepsy victims immediately fall into REM sleep, during which the brain is much more active, effectively bypassing the NREM cycle
  • victims also fall into REM sleep randomly throughout day
  • other aspects of REM sleep (lack muscle tone, sleep paralysis, vivid dreams) occur at other times during sleep or day

    • Brain chemicals:
  • hormone hypocretin (also known as orexin) regulates REM sleep & staying awake throughout day
  • cells that make hypocretin severely damaged in narcolepsy victims; low levels hypocretin in all, lowest in those with cataplexy
  • this lack of hypocretin has led to a diagnostic test: measuring levels of hypocretin in spinal fluid

    • Thank-you for reading this brochure! If you have any questions regarding narcolepsy, please email me at: kareej[at]stanford.edu.
    Further information regarding narcolepsy can be found at: www.mayoclinic.com/health/narcolepsy.
    If you are experiencing any symptoms of a sleep-related disorder, please contact your physician immediately!
    Remember, drowsiness is red alert!

    Where to go from here:

    Return To All Outreach Projects 2010



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