Narcolepsy: what does it mean? Light? Cataplexy?

Narcolepsy is a rare sleep disorder. It is manifested in particular by clinical signs such as hypersomnia or drowsiness and causes sleep attacks. Distinguish between narcolepsy with cataplexy and narcolepsy type 2. Definition, cause, symptoms, test and treatment narcolepsy.

What does narcolepsy mean?

The word “narcolepsy” comes from the Greek “narkê” which means “falling asleep” and “lêpsis” for “to take” or “grip”

Definition: what is narcolepsy?

“Narcolepsy (or Gélineau’s disease) is a sleep disorder characterized by hypersomnia, which affects approximately 1 in 2,000 people“, informs Dr. Sylvie Royant-Parolapsychiatrist specializing in sleep disorders, network president Morpheus. Hypersomnia is a rare neurological disorder that results in uncontrollable and sudden falling asleep in the middle of a day’s activity. There are two forms of narcolepsy:

► Narcolepsy with cataplexy which is accompanied by a sudden loss of muscle tone without alteration of consciousness and occurring at any time of the day, triggered by emotions. it’s about the narcolepsy type 1.

► Narcolepsy without cataplexy. This is narcolepsy type 2.

What is narcolepsy with cataplexy?

Narcolepsy type 1 is the full form of narcolepsy. “This form includes bouts of daytime sleep, accompanied by emotion-triggered drops in muscle tone (laughs, surprised…). The person surprised, or laughing, then falls to the ground. This is a bout of cataplexy. There may also be hallucinations : as soon as the narcoleptic person is tired, dozes or falls asleep, she sees images, scenes or characters or feels a presence next to her. The association of sleep attacks and cataplexy sudden sign of the existence of narcolepsy“, explains Dr. Sylvie Royant-Parola.

What is narcolepsy type 2?

“Narcolepsy type 2 is a more subtle form of narcolepsy without cataplexy. In these cases, the diagnosis can only be made on an evaluation of the sleep of the night and the sleep of the day. We see that people have falling asleep in REM sleep which is not normally the case during the day“, she specifies.

Narcolepsy is a genetically transmitted disease

What are the causes of narcolepsy?

“Narcolepsy is a genetically transmitted disease. There are “narcoleptic families”. People with the HLA DR2-DQw1 gene have a high risk of developing narcolepsyinforms Dr. Sylvie Royant-Parola. There is certainly an autoimmune dimension in this disease. An immunological process occurs in the first years of life. Some cells will attack the cells of nuclei at the cerebral level (hypocretin neurons) and make them disappear“. In most cases, people with narcoleptics present a decrease in hypocretin (neuropeptide made in the brain and involved in sleep regulation) in cerebrospinal fluid.

What are the signs of narcolepsy?

► The urgent need to sleep. The main symptom, which is particularly revealing, is sudden and sudden falling asleep, uncontrollable, which can occur in any circumstance. These unexpected naps are usually short,a duration of less than 30 minutes, after which the patient wakes up on his own. They usually occur several times a day. Other symptoms like sleep apnea, sleep paralysis, cataplexy or hallucinations, are generally associated, but they are not systematic and are rarely all expressed in the same patient. This is what makes the diagnosis difficult.

► Cataplexy : the patient suddenly loses his muscle tone on certain parts of the body such as the face, legs, arms and can thuscollapse any moment, in the middle of an activity. However, he does not lose consciousness. These cataplexy attacks are often triggered by strong emotions, positive or negative.

► Sudden and temporary paralysis which can also occur, when falling asleep or waking up. The patient tries in vain to move. The discomfort goes away on its own after a few minutes.

► Hallucinations very realistic that occur when falling asleep and sometimes during the day.

What test to know if you have narcolepsy?

“Tests to diagnose narcolepsy are done in a very specialized sleep laboratory (SFRMS Center). There are about ten in France“, explains our interlocutor. There are several protocols. It starts with polysomnography (recording of a night’s sleep) with iterative sleep onset tests the next day (TILE). Sometimes it continues with a long-term sleep recording (we let people sleep as long as they want). Added to this are assays in the cerebrospinal fluid (lumbar punctures) to see if there is a collapse of hypocretin, which is often the case.

Who to consult in case of narcolepsy?

It takes 8 years on average to make a diagnosis of narcolepsy.

“We must consult when we present abnormal sleepiness that is regular every day or so as well as cataplexy attacks. The first person to consult is the attending physician which can refer the person to a center labeled SFRMS, which avoids diagnostic errors. Narcolepsy is not well enough known and it takes 8 years on average to make a diagnosis of narcolepsy“, underlines the specialist.

What are the treatments for narcolepsy?

Treatments for narcolepsy are symptomatic. “Medications are used to treat the symptoms of drowsiness and cataplexy“says the specialist. Amphetamines and other stimulants may be prescribed as well as, sometimes, antidepressants. For people who know their disease very well, are very willing and have a certain flexibility in their working hours, nap time management may allow them to restore normal alertness and try non-drug approaches

Can narcolepsy be cured?

For now, there is no treatment to cure narcolepsy. Some people are no longer drowsy under treatment, others remain so, which can have professional consequences (for example, a contraindication to the professions of bus driver and truck driver) or make driving a car prohibited. A healthy lifestyle with regular naps can help lead an active life that is as normal as possible.

Thanks to Dr. Sylvie Royant-Parola, psychiatrist specializing in sleep disorders, president of the Morphée network.