![]() ĭisrupted nighttime sleep (DNS) is also a common symptom in patients with narcolepsy and is characterized by difficulties in sleep continuity, such as frequent arousals, an inability to stay asleep, and poor sleep quality, although patients usually fall asleep quickly. Patients with narcolepsy often wake up feeling refreshed after naps (unlike patients with obstructive sleep apnea, idiopathic hypersomnia, and sleep deprivation) but may experience sleep inertia after waking, feel sleepy again soon after waking, and have trouble staying awake throughout the day, particularly during sedentary periods, leading to persistent daytime sleepiness. EDS is characterized by a constant background of baseline sleepiness, tiredness or fatigue together with lapses into sleep throughout the day that can be voluntary (naps) or involuntary (sleep attacks). NT2 is less well understood, does not present with cataplexy, and exhibits normal levels of orexin (if measured). ![]() NT1 is characterized by cataplexy and, when measured, orexin (also known as hypocretin) deficiency. There are two types of narcolepsy, narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). Narcolepsy is a chronic and often disabling neurologic sleep disorder that affects patients’ quality of life and is primarily defined by EDS and altered REM sleep. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.ĭefinition and Clinical Symptomatology of Narcolepsy Thus, the aim of this review is to describe the current understanding of narcolepsy and discuss the consideration of comorbidities in clinical strategies for the diagnosis and management of patients with this disorder. In order to address the consequences and clinical burden associated with the lack of recognition of narcolepsy, there is a need for a better understanding of the symptoms, clinical spectrum, comorbidities, pathophysiology, and treatment options. Even after diagnosis and treatment, the impact of narcolepsy is high, with patients experiencing lower quality of life, reduced productivity, and higher utilization of healthcare resources than individuals without narcolepsy. Narcolepsy symptoms can significantly affect patients’ lives, impairing their ability to function at school and work, as well as negatively impacting their household responsibilities, relationships with friends and family, mood, and self-esteem. ![]() ![]() In addition, the high presence of comorbidities in patients with narcolepsy may delay recognition and, consequently, treatment of this disorder. One of the main reasons for the delay between the onset of narcolepsy symptoms and the time of diagnosis is the overlap of symptoms with other more common disorders, such as insomnia, obstructive sleep apnea, attention-deficit hyperactivity disorder (ADHD), depression, anxiety and mood disorders, and other psychiatric conditions. Although narcolepsy is associated with major impairments in function and quality of life, it is often under-recognized, which leads to a delay in diagnosis of 9–22 years, ultimately increasing the disease burden. Symptoms characteristic of disrupted REM sleep can include cataplexy, sleep paralysis, sleep-related hallucinations, and frequent vivid dreams. Narcolepsy is a chronic neurologic disorder characterized by excessive daytime sleepiness (EDS), disruption of rapid eye movement (REM), sleep regulation, and disturbed nocturnal sleep it is a 24 h of the day disorder.
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