Dauvilliers Y, Montplaisir J, Cochen V, Desautels A, Einen M, Lin L, Kawashima.
#NARCOLEPSY WITH CATAPLEXY CBT FREE#
Citation on PubMed or Free article on PubMed Central Elevated Tribbles homolog 2-specific antibody levels Lecendreux M, Lammers GJ, Donjacour CE, Du Pasquier RA, Pfister C, Petit B, Hor
It is unclear how these genetic changes influence the risk of developing the condition. Most people with narcolepsy have the HLA-DQB1*06:02 variation, and many also have specific versions of other, closely related HLA genes. A variation of the HLA-DQB1 gene called HLA-DQB1*06:02 has been strongly associated with narcolepsy, particularly in people who also have cataplexy and a loss of hypocretins. The HLA-DQB1 gene has many different normal variations, allowing each person's immune system to react to a wide range of foreign proteins. The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders (such as viruses and bacteria). The HLA-DQB1 gene is part of a family of genes called the human leukocyte antigen (HLA) complex. The most well-studied of these genes is HLA-DQB1, which provides instructions for making part of a protein that plays an important role in the immune system. Researchers have identified changes in several genes that influence the risk of developing narcolepsy. It is unclear what triggers the death of hypocretin-producing neurons in people with narcolepsy, although evidence increasingly points to an abnormality of the immune system. In particular, hypocretins regulate the daily sleep-wake cycle.
These cells normally produce chemicals called hypocretins (also known as orexins), which have many important functions in the body. In most cases of narcolepsy with cataplexy, and in some cases without cataplexy, sleep abnormalities result from a loss of particular brain cells (neurons) in a part of the brain called the hypothalamus. Narcolepsy probably results from a combination of genetic and environmental factors, some of which have been identified, but many of which remain unknown. Most of the signs and symptoms persist throughout life, although episodes of cataplexy may become less frequent with age and treatment. Some people with narcolepsy have all of the major features of the disorder, while others have only one or two. The combination of hallucinations, vivid dreams, and sleep paralysis is often frightening and unpleasant for affected individuals. Many people with narcolepsy also experience sleep paralysis, which is an inability to move or speak for a short period while falling asleep or awakening. Affected individuals often have realistic and distressing dreams, and they may act out their dreams by moving excessively or talking in their sleep. They often experience vivid hallucinations while falling asleep (hypnogogic hallucinations) or while waking up (hypnopompic hallucinations). Most affected individuals have trouble sleeping for more than a few hours at night.
However, some do not, which has led researchers to distinguish two major forms of the condition: narcolepsy with cataplexy and narcolepsy without cataplexy. Most people diagnosed with narcolepsy also have cataplexy. Episodes of cataplexy usually last just a few seconds, and they may occur from several times a day to a few times a year. These episodes of muscle weakness can cause an affected person to slump over or fall, which occasionally leads to injury. They last from a few seconds to a few minutes and often lead to a longer nap, after which affected individuals wake up feeling refreshed.Īnother common feature of narcolepsy is cataplexy, which is a sudden loss of muscle tone in response to strong emotion (such as laughing, surprise, or anger). "Sleep attacks" can occur at unusual times, such as during a meal or in the middle of a conversation. Affected individuals feel tired during the day, and several times a day they may experience an overwhelming urge to sleep. Narcolepsy is characterized by excessive daytime sleepiness. Although this condition can appear at any age, it most often begins in adolescence. Narcolepsy is a chronic sleep disorder that disrupts the normal sleep-wake cycle.
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