Type 2 narcolepsy is associated with normal levels of orexin and features less-severe symptoms without cataplexy. Type 1 narcolepsy features low levels of orexin, excessive daytime sleepiness, and cataplexy. The neuropeptide regulates sleep/wake states and appetite. The pathophysiological causes of narcolepsy lie in the hormone orexin (also known as hypocretin). 2 The MSLT is used to measure how quickly patients fall asleep in quiet daytime situations. 3 The confusion surrounding narcolepsy-cataplexy continued into the 1900s, as further research revealed the association between REM sleep and narcolepsy, leading to the creation of the multiple sleep latency test (MSLT) as a diagnostic tool for narcolepsy. In the early 1900s, Löwenfeld was the first to use the term cataplexy in describing muscle paralysis caused by strong emotions. 2 However, Gélineau proposed a fairly open-ended definition that did not differentiate the cataplexic symptoms from those associated with somnolence. 2 Narcolepsy was later recognized as a clinical disorder and named by the French physician Gélineau, after the landmark diagnosis of a wine merchant suffering from daytime drowsiness and sleep attacks. 1Įarly descriptions of narcolepsy appeared in German case reports during the late 1800s, describing a unique condition that featured both episodes of sleepiness and muscle weakness triggered by excitement. Other symptoms include cataplexy, which is the muscle weakness of rapid-eye movement (REM) sleep triggered by strong emotions while awake, vivid hallucinations, and sleep paralysis. It is characterized by excessive daytime sleepiness and uncontrollable episodes of sleep that greatly disrupt a daily routine. Narcolepsy is a chronic neurological disorder that affects how the brain controls sleep patterns. Demons in the sleep center: narcolepsy mimicking other sleep disorders. Johns Hopkins University, Baltimore, Marylandĭepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
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