Narcolepsy: environment, genes and treatment
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Narcolepsy is a central sleep disorder typically involving symptoms of daytime somnolence, unintentional lapses into sleep, sleep paralysis and frequent nocturnal awakenings. The disorder involves a dissociated sleep-wake cycle with rapid eye movement (REM) sleep intruding into wakefulness. Narcolepsy with cataplexy (type 1 narcolepsy) is caused by loss of hypocretin-secreting neurons, decreasing CSF levels of this neuropeptide. Mean prevalence is believed to be 30/100,000, with the highest rates observed in Japan and the lowest in Saudia Arabia. Age at onset is typically 10–30 years, peaking at 15 years and rarely presenting <10 years and >40 years of age.
Although this is a rare disorder, it has significant social implications and at present has only a limited repertoire of effective therapeutic strategies. Longitudinal studies have demonstrated that those with narcolepsy tend to have a lower quality of life, a lower level of education and employment, depression and...