2-Minute Neuroscience: Narcolepsy

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Narcolepsy is a chronic condition that causes excessive daytime sleepiness and leads to an increased tendency to fall asleep during daytime activities. In this video, I discuss the symptoms of narcolepsy and explain what may happen in the brain to cause those symptoms to occur.

TRANSCRIPT:

Narcolepsy is a chronic condition that causes excessive daytime sleepiness and leads to an increased tendency to fall asleep during daytime activities. The majority of people who suffer from narcolepsy also experience cataplexy, which involves brief, sudden episodes of muscle weakness or paralysis---often brought on by strong positive emotions. The muscle weakness in cataplexy may be severe enough to cause someone to fall to the ground and be unable to speak or move for a short period of time despite remaining conscious. Patients with narcolepsy also often experience other sleep-related problems, such as disrupted sleep, sleep paralysis, and hallucinations when falling asleep or waking up. Today, narcolepsy is often classified as narcolepsy type 1 or narcolepsy type 2. Type 1 typically involves narcolepsy with cataplexy, and low levels of a neuropeptide called orexin, also known as hypocretin. Type 2 does not involve cataplexy, and levels of orexin are normal. Narcolepsy type 2 generally has less severe symptoms, but little is known about its cause.

Narcolepsy type 1 is linked to a loss of orexin-producing neurons in the hypothalamus, leading to low orexin levels. Orexin neurons have an excitatory effect on several regions of the brain that are involved in promoting wakefulness and suppressing REM sleep. Thus, the loss of these neurons leads to deficiencies in maintaining wakefulness and is linked to the dysregulation of REM sleep. This REM sleep dysregulation is thought to cause episodes of muscle paralysis and other aspects of REM sleep to occur during wakefulness, which is the basis for cataplexy.

The cause of the loss of orexin neurons in narcolepsy is not completely understood, but several lines of evidence implicate an autoimmune mechanism. According to this view, a combination of genetic and environmental factors leads to an inflammatory process in the brain that causes the immune-mediated destruction of orexin neurons, bringing about the symptoms of narcolepsy.

REFERENCES:

Bassetti CLA, Adamantidis A, Burdakov D, Han F, Gay S, Kallweit U, Khatami R, Koning F, Kornum BR, Lammers GJ, Liblau RS, Luppi PH, Mayer G, Pollmächer T, Sakurai T, Sallusto F, Scammell TE, Tafti M, Dauvilliers Y. Narcolepsy - clinical spectrum, aetiopathophysiology, diagnosis and treatment. Nat Rev Neurol. 2019 Sep;15(9):519-539. doi: 10.1038/s41582-019-0226-9. Epub 2019 Jul 19. PMID: 31324898.

Kornum BR, Knudsen S, Ollila HM, Pizza F, Jennum PJ, Dauvilliers Y, Overeem S. Narcolepsy. Nat Rev Dis Primers. 2017 Feb 9;3:16100. doi: 10.1038/nrdp.2016.100. PMID: 28179647.

Mahoney CE, Cogswell A, Koralnik IJ, Scammell TE. The neurobiological basis of narcolepsy. Nat Rev Neurosci. 2019 Feb;20(2):83-93. doi: 10.1038/s41583-018-0097-x. PMID: 30546103; PMCID: PMC6492289.

Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014 Nov;146(5):1387-1394. doi: 10.1378/chest.14-0970. PMID: 25367475.
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I can't believe Narcolepsy isn't studied as in depth as it should be! It's extremely fascinating! As I know this video will be popular, I think this video shouldn't say 'Majority cases have cataplexy' because it's actually Majority cases do NOT have cataplexy, but some do experience it. I think it hurts the true understanding of what being narcoleptic is. Just my 2 cents :)

heatherharrington
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The thing I hate about my narcolepsy the most is 💤 💤....

christopherw
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I was diagnosed with N without C in Jan 2017. I took Xyrem for a bit but the sodium content made my migraines so much worse. Then I tried xywav and had less migraine issues and good sleep. My doc retired 3 months ago and the va is so slow in getting me in. Without the sleep medicine my life is fucking miserable and I’m about to go through my private health insurance even tho the cost will be difficult. People take sleep for granted, and I wish there was more awareness. Feel I have NOBODY to talk to.

BeeBopGaming
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😮 I'm always amazed by the amount of information you are able to pack into 120 seconds I have been interested in learning about narcolepsy for a long time but I never made the effort to look for papers on it 😅 This video, as always with your content, is a clear and concise introduction and I'll be reading those papers you referenced at some point soon. Do any of them stand out to you as more comprehensive or insightful than the others? Thanks for doing what you do.

senseofmindshow
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I hallucinate just before falling asleep but didn't know is was an ailment. It's amazing and I love it.
I don't want repaired.

craigsips
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I’m not medically diagnosed but ever since 11 years old I’ve always fallen asleep at different times during tge course of my days. It got worse in college and now that I work, it’s becoming a problem for me. Prior to my teen years, I sleepwalked a lot and sleep talked. The sleep paralysis only became prominent whilst in college as well as hallucinations.

xxmoonstarxx
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I needed a quick but informative video for a co-worker as I had a strong narc. and cataplectic attack at work yesterday. :P Indeed, this video came right in time. Thanks!

KevConnor
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I hate being narcoleptic as a narII. It's the parts that have insomniac symptoms. it had been a problem since i was young so likely it begins early on but can develop more severe as you age. Like for other narcoleptic peers and it had gotten worse over time as a kid or was less invasive but still detrimental as our sleep patterns have always been fucked.

Kamexe
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I did a sleep study and they told me I had mild narcolepsy. Paired with severe ADHD (non hyperactive) and my whole life my dad always would tell me how much of a lazy piece of shit I am.

BlueCollar
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I have bad hallucinations before sleep sometimes and they are scary. They are always accompanied by muscle paralysis, but I remain fully conscious. A doctor recently recommended TMS for it, so I’m hoping that helps.

Archy__
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I've had narcolepsy since I was 9. I've always wondered if lack of orexin affects growth hormone, dopamine and other neurotransmitters, and other stuff connected with hypothalamus?

narcolepsynarcoleptic
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If I’m constantly getting sleep paralysis and getting heavy sleep randomly is this bad? I get sleep paralysis every day if not. Every other day, sometimes I wake up not being able to breathe.

piecenuggets
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Fun fact: in my case Narcolepsy was caused and delayed result of Lyme’s disease infection that reached brain. Symptoms started 3 years after being treated for Lyme’s, but took another 8 years to diagnose.

Any other Narcoleptics here?

J_McPhearsom
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just found this channel. Watching for fun! super cool

generaljoe
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Hi I have narcolepsy without cataplexy, could you please explain more about it? Or is there really so less knowledge about it?

emmaclusserath
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"The perfect storm of bad luck"💯

nathanieltyler
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My SO has narcolepsy, thank you for the video

Aconspiracyofravens
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Has there been a 2 minute video on Ideopathic Hypersomnia?

Zones
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Are they quick to take your licence with nercolepsy

Quayleman
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Over the past year my naps are getting longer every day, now up to 3 hours and if I do not nap I feel like I am going to pass out when standing. I slept 8 hours last night then today had to sleep from 5 pm to 8 pm and it was a strong sleep with much dreaming. I am taking lisinopril for high blood pressure and tramadol for pain both for at least 5 years but one thing that has really changed the past 14 months was the fact I lost 110 pounds with the OMAD one meal/day diet, is it possible OMAD is causing Narcolepsy? I take all the supplements and vitamins every day for many years. It is not a matter of should I sleep if I need a nap it is a matter can I stay awake and not pass out when standing. !4 months ago I was superman I drank one pint of rum for 30 years to sleep at night then had a strong sleep and only napped 30 minuets a day due to an episode with AFIB I stopped drinking went to OMAD and got rid of my AFIB. Any ideas what is causing my problem?
I was 320 pounds 14 months ago now I am only 210 pounds.

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