Narcolepsia - La clinique du sommeil

Narcolepsia

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Narcolepsy is a rare sleep disorder, but fairly well known because of its symptoms rather dramatic. This syndrome, which tends to persist throughout life, affecting approximately three in 10 000 persons.  

The symptoms of narcolepsy can be terrifying at the beginning and continue to be a source of frustration even after the person is accustomed to, but they never cause serious illness. People with narcolepsy are usually healthy and normal in all other respects.   Their natural life expectancy is exactly the same as people without diabetes. No physical abnormality or lesion tissue has never been associated with this disorder, either as a cause or consequence.

SYMPTOMS AND COMPLICATIONS

Narcoleptics have four common symptoms, but very few have all. 

  • Excessive daytime sleepiness
  • Cataplexy or sudden loss of muscle tone
  • Sleep paralysis
  • Hallucinations

Causes

The cause of narcolepsy is unknown, but the transmission seems to be linked to heredity. Not only has there been a family tendency, but also all those who have been diagnosed with narcolepsy have a few types of tissues. 

Most symptoms of narcolepsy seem to occur when the brain is suddenly in a state between REM sleep or REM or dream stage (rapid eye movement) during the day. In addition, some symptoms occur when the brain enters a state similar to REM sleep or REM (SP) without loss of consciousness. 

REM sleep itself is a poorly understood phenomenon. Most dreams occur during REM sleep, but their significance remains controversial and poorly understood. Sleep always leads to a decrease in muscle tone, blood pressure and pulse, but these changes are particularly pronounced during REM sleep. Normally, one night, a person will a light sleep (stage 1) to deep sleep (stage 4) and returns to stage 3 and 2 and between dreams during REM sleep four or five times in overnight. 

During REM sleep, the person is usually quite still and moving only his eyes, eyelids remaining closed. A recording of electrical waves in the brain - an electroencephalogram (EEG) - performed during this period reveals a low voltage fast activity throughout the brain. The researchers observed this type of plot in almost everyone, but they do not yet know the meaning. In addition, they have no explanation as to how REM sleep or REM sleep-like state can occur suddenly in people awake.

Diagnostic

The diagnosis of narcolepsy is based on the examination of complete polysomnography night followed by iterative testing of the sleep latency (MSLT) day.

Treatment

Narcolepsy can not be cured, but symptoms can be stopped with medication. 

Drugs belonging to the class of nervous system stimulants, which include amphetamines such as dextroamphetamine (Dexedrine) and methylphenidate (Ritalin), are commonly used. The best treatment for the symptoms of cataplexy, sleep paralysis and hypnagogic phenomena are antidepressants belonging to the class of tricyclic or monoamine oxidase inhibitors (MAOIs). 

It is unlikely that drug treatment able to eliminate completely any desire to sleep during the day. The best way to tame this situation is to take short naps planned, usually three to four naps of about twenty minutes each. If the treatment fails to completely eliminate the symptoms, the person with narcolepsy may prefer to avoid occupations that require them to drive long distances or operate dangerous machinery for extended periods.

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