What is narcolepsy
Is a sleep disorder which results in the following clinical features:
excessive daytime sleepiness
cataplexy
hypnagogic/hynopompic hallucinations
sleep paralysis
Please note that not all patients have this tetrad
What causes narcolepsy
abnormalities of the brain neurotransmitter hypocretin
which regulates sleep
What is cataplexy
is a sudden loss of muscle tone leading to head droop or even fallin with intact awareness- attacks are often set off my a sudden surprise or emotion
What are hypnagogic/hynopompic hallucinations
dream like hallucinations which occur while falling asleep or waking from sleep
What is used to confirm a diagnosis of narcoplepsy
multiple sleep latency testing demonstrating rapid transition from wakefulness to sleep and short time to onset of rem sleep
What causes sleep paralysis
intrusion of rem atonia into wakefulness
How is narcolepsy treated
good sleep hygiene
Medications to treat EDS
Tricyclics or SSRIs for cataplexy
What drugs are used to treat EDS
modafinil
methylphenidate
What tricyclics are used for narcolepsy
clomipramine
what are the two phases of sleep
non REM and REM sleep
what is associated with REM sleep
dreaming and physiological arousal
What accompanies slow wave sleep (non rem)
increased cellular mitotic rate- repairs cells
what conditions is slow wave sleep increased in
adolescence
pregnancy
thyrotoxicosis
what are the three different types of insomnia and when do they usually occur
Initial (trouble getting to sleep) = mania, anxiety, depression, substance misuse
Middle( waking in middle of night)=sleep apnoe, prostatism
Late (early morning wakening)= depression, malnutrition ie anorexia
