![]() ![]() He also said that his brother has apnea and that both of his parents snore. On review of symptoms, he reported having gastroesophageal reflux disease, snoring, and memory and concentration difficulty. He was currently at his highest weight for his lifetime. In addition to his domestic duties, he reported having a busy work life, needing to get up very early every day to train clients. He lives with his wife and 3 children, one of whom is a newborn, and he reported that he often takes care of the children and house due to his spouse’s work schedule. He works as a physical trainer and had a strong, healthy build with no medical issues. This report describes an interesting case in which a patient presented with symptoms mimicking those of other sleep disorders but in whom narcolepsy was ultimately diagnosed and confirmed with the results of an MSLT study.Ī 35-year-old man presented to the clinic with chief concerns of excessive daytime sleepiness and profound tiredness. Symptoms typically begin to appear during childhood and adolescence, but people can live with narcolepsy for years before receiving a definitive diagnosis. Currently, the disorder affects nearly 1 in 2000 people in the United States and 3 million people worldwide, but it is estimated that narcolepsy is properly diagnosed in only 25% of the individuals who have it. 1ĭue to the variability in its symptoms and similarity to other sleep disorders, narcolepsy can be misdiagnosed. 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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