Narcolepsy is a lifelong neurological sleep disorder in which the brain cannot regulate sleep and wakefulness properly. Type 1 includes cataplexy, a sudden loss of muscle tone triggered by emotion, and is caused by loss of the brain chemical hypocretin (orexin). Type 2 has sleepiness without cataplexy.
It is not cured by more sleep. Medication and planned naps control symptoms well enough for most people to study, work and, where the law allows, drive.
Symptome
- Overwhelming daytime sleepiness and sleep attacks
- Cataplexy: knees buckling, jaw dropping or collapse with laughter or surprise, with awareness preserved
- Sleep paralysis on waking or falling asleep
- Vivid dream-like hallucinations at sleep onset
- Broken night sleep
- Automatic behaviour and lapses of memory
- Weight gain around the time of onset
Ursachen und Risikofaktoren
Type 1 narcolepsy results from loss of hypocretin-producing cells in the hypothalamus, very probably through an autoimmune process in people carrying the HLA-DQB1*06:02 gene. Infections such as streptococcus and H1N1 influenza have been linked to onset. It usually begins between the ages of 10 and 30, and diagnosis is commonly delayed by many years.
Wie es diagnostiziert wird
- Overnight polysomnography: Excludes sleep apnoea and other causes of sleepiness, and records how quickly REM sleep appears.
- Multiple sleep latency test (MSLT): Five daytime nap opportunities the next day; falling asleep in under 8 minutes on average with early REM in at least two naps supports the diagnosis.
- Sleep diary or actigraphy: One to two weeks before testing, to prove adequate sleep.
- CSF hypocretin: A lumbar puncture measurement used in unclear cases.
Behandlungsmöglichkeiten
- Scheduled naps and sleep routine: One or two 15 to 20 minute naps reduce sleep attacks.
- Wake-promoting drugs: Modafinil, pitolisant or solriamfetol; stimulants such as methylphenidate as second line.
- Sodium oxybate: Taken at night; improves sleepiness, cataplexy and night sleep. It is tightly regulated.
- Antidepressants for cataplexy: Venlafaxine or similar, which must not be stopped abruptly.
- Support at school and work: Adjustments and driving advice.
Wenn es dringend ist
Narcolepsy itself is not an emergency. Sudden stopping of cataplexy medication can cause continuous cataplexy, and any first collapse with loss of awareness should be assessed locally for seizure or heart causes.
Reisen nach Türkiye zur Behandlung
The diagnostic sleep study and MSLT need two nights and a day in a sleep laboratory, preceded by a sleep diary and sometimes a medication washout, so it can be done in a short visit with planning. Lifelong prescribing involves controlled drugs whose rules differ between countries, so arrange a prescriber at home first.
Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.
Häufig gestellte Fragen
Must I stop medication before testing?
Antidepressants and stimulants distort the MSLT and are usually stopped about 2 weeks before, only under medical advice.
Can I drive?
Rules vary by country. Most allow it once symptoms are controlled and your doctor agrees.
Will it get worse with age?
It is usually stable after the first few years; cataplexy often softens over time.