Narcolepsy is excessive daytime sleepiness, possibly accompanied by features such as:
- Cataplexy (=brief attacks of sudden loss of skeletal muscle tone and power, often in response to emotion)
- Irresistible sleep attacks
- Hyponagogic hallucinations
- Sleep paralysis
It is believed that narcolepsy with cataplexy is due to loss of hypocretin-containing neurons in the hypothalamus.
Onset usually in teens/20s
Male predominance
Increased risk if a family member has the disorder
Associations with
- HLA DQB1
- Streptococcal infection
- Heavy metal exposure
- H1N1 vaccination or infection
Management
- Narcolepsy
- DVLA must be informed – usually able to continue driving cars (if controlled) but not bus/lorry
- Good sleep hygiene
- Medication
- Amphetamine-like stimulants such as dexamphetamine
- Modafinil
- Sodium oxybate
- Cataplexy
- Antidepressant drugs such as clomipramine or SSRIs
References
