Narcolepsy (uncontrollable sleep)

Head | Neurology | Narcolepsy (uncontrollable sleep) (Disease)


Narcolepsy is a pathological disorder that is characterized by a sudden need for sleep during the day, falling asleep without having any special fatigue.

The first symptom to appear is excessive daytime sleepiness, which may remain unrecognized for a long time and it develops gradually over time. Additional symptoms include disturbed nocturnal sleep and automatic behavior (patients carry out certain actions without conscious awareness). All of the symptoms of narcolepsy may be present in various combinations and degrees of severity. Other primary symptoms of narcolepsy include: loss of muscle tone (cataplexy), distorted perceptions (hypnagogic hallucinations), and inability to move or talk (sleep paralysis).

Causes and Risk factors

Narcolepsy usually begins in teenagers or young adults and affects both sexes equally.

Advances have been made in the last few years in determining the cause of narcolepsy. The newest discovery has been the finding of abnormalities in the structure and function of a particular group of nerve cells, called hypocretin neurons, in the brains of patients with narcolepsy. These cells are located in a part of the brain called the hypothalamus and they normally secrete neurotransmitter substances (chemicals released by nerve cells to transmit messages to other cells) called hypocretins.

Abnormalities in the hypocretin system may be responsible for the daytime sleepiness and abnormal REM sleep found in narcolepsy.

It is theorized that an autoimmune reaction causes the loss of nerve cells in the brain in patients with narcolepsy. The environment (for example, infection or trauma) might trigger an autoimmune reaction where normal brain cells are attacked by the bodys own immune system. As a result, the neurons are damaged and ultimately destroyed, and they and their neurotransmitter chemicals disappear. Whether narcolepsy is an autoimmune disease remains to be proven.

Diagnosis and Treatment

There is no known cure. The goal of treatment is to reduce symptoms. Changing behavioral activities such as reducing stress, avoiding heavy meals, and taking daytime naps may reduce episodes. Medications may be necessary and include: dextroamphetamine, methylphenidate, and modafinil. ...