Types And Degrees Of Narcolepsy

Narcolepsy is a disorder in which sleep cycles are disrupted. There are five modes of presentation of this disease. Some only affect the way you sleep, and others can even lead to dementia.

Narcolepsy, also known as Gélineau syndrome, is a rare disorder that manifests in different degrees and in different ways. It leads to untimely falling asleep. The problem is estimated to affect around 0.1% of the world’s population.

The term narcolepsy was coined by Jean-Baptiste-Édouard Gélineau at the end of the 19th century. This researcher was the first to describe it, in 1880. He gave it this name based on two Greek roots: narkē and lepsy , which together mean “sleep attack”.

What is narcolepsy?

Narcolepsy is defined as a chronic neurological disorder that causes alterations in the structure of sleep. Its main characteristics are the presence of a strong daytime sleepiness and sudden attacks of sleepiness that cannot be stopped.

Those who suffer from any of the types or degrees of narcolepsy have great difficulty staying awake for several hours, regardless of the circumstances in which they find themselves. It therefore has a decisive influence on the quality of their life.

In some cases, this disorder is accompanied by a sudden loss of muscle tone which is defined, in medical terms, as cataplexy. This can happen as a result of experiencing intense emotion, and ultimately whether or not it occurs is what defines certain types and degrees of narcolepsy.

The disease has no cure or specific treatment as such. However, there are medications that help control these sudden sleep attacks. In addition, lifestyle changes can be very beneficial, as can social and psychological support.

Characteristics of the disease

The main features of narcolepsy are as follows:

• Excessive daytime sleepiness: alertness and concentration decrease. This is usually the first symptom to appear. Then sleep attacks occur
• Cataplexy: as stated, this is not present in all cases. In addition, it does not always manifest with the same intensity
• Sleep paralysis: this is the temporary inability to move or speak. It occurs especially when falling asleep or waking up. Usually these are short episodes
• Changes in the REM sleep cycle: REM sleep is the deepest sleep and usually involves rapid eye movements. A person with narcolepsy can enter this phase at any time.
• Hallucinations: we speak of hypnagogic hallucinations if they occur before falling asleep, or hypnopompic hallucinations if they occur upon awakening. They can be very alive and terrifying

People with narcolepsy may also suffer from other sleep disorders, such as obstructive sleep apnea, fragmented sleep, and restless leg syndrome. Paradoxically, they can also suffer from insomnia.

Types and degrees of narcolepsy

According to the criteria of DSM-5 (fifth version of the Diagnostic and Statistical Manual of Mental Disorders), there are five types and degrees of narcolepsy, which are as follows

• Without cataplexy and with hypocretin deficiency : in this type of narcolepsy, there is a deficiency of the hormone orexin or hypocretin. It is a protein that affects the functioning of neurons. Its main function is to control the sleep-wake cycle. There are no episodes of cataplexy in this mode of presentation
• With cataplexy and without hypocretin deficiency : in this case, there is no hypocretin deficiency, but there is cataplexy. It is sudden muscle weakness on both sides of the body. It is the least understood symptom of this disorder and it accompanies 5% of all cases
• Autosomal dominant cerebellar ataxia, deafness, and narcolepsy : This degree of narcolepsy is caused by a DNA mutation. Ataxia is a lack of motor coordination that affects voluntary movement and can even impair functions such as swallowing, speech, and sight. It is late onset and often leads to dementia as it progresses
• Autosomal dominant narcolepsy, obesity, and type 2 diabetes : This is caused by a mutation in oligodendrocytes, a class of cells that affect myelin formation. The latter is a substance that increases the speed of transmission of nerves and its deficiency affects mobility
• Secondary to another medical condition : Narcoleptic disorder has among its types what is derived as a consequence of another disease. Examples are sarcoidosis or Whipple’s disease. Both destroy the cells that produce hypocretin

All degrees of narcolepsy require assistance

Although there is no cure for narcolepsy, treatments are currently available. These relieve most of the symptoms and allow the affected person to lead an almost normal life.

People with this condition may also make lifestyle changes, such as taking scheduled naps to relieve the sudden drowsiness that comes with it. They must also be rigorous with regard to sleep hygiene. A person with narcolepsy needs psychological and social support.