Narcolepsy: New understanding of irresistible sleep

Lois Elaine Krahn, John L. Black, Michael H. Silber

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Recently, low levels of a newly identified neuropeptide, hypocretin 1, were described in the cerebrospinal fluid of patients with narcolepsy. This neurochemical-finding furthers our understanding of this enigmatic sleep disorder typically characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations. Narcolepsy appears to be fundamentally related to abnormally regulated rapid eye movement sleep. The diagnosis of this disorder remains challenging because of multiple other conditions that can cause daytime sleepiness and the difficulties in recognizing cataplexy based on patient report. The role of hypocretins in narcolepsy is unclear but intriguing because the cell bodies are restricted to the lateral hypothalamus, a brain region long associated with sleep regulation, with neuronal widespread projections to areas including the locus ceruleus, ventral tegmental area, amygdala, and dorsal raphe. Hypocretins potentially modulate the activity of monoamines and acetylcholine, and therefore their absence leads to the multiple symptoms of narcolepsy. This article reviews the current understanding of the diagnosis and treatment of narcolepsy and discusses the possible implications of the hypocretin discovery.

Original languageEnglish (US)
Pages (from-to)185-194
Number of pages10
JournalMayo Clinic Proceedings
Volume76
Issue number2
StatePublished - 2001

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Narcolepsy
Sleep
Cataplexy
Sleep Paralysis
Lateral Hypothalamic Area
Ventral Tegmental Area
Locus Coeruleus
Hallucinations
REM Sleep
Amygdala
Neuropeptides
Acetylcholine
Cerebrospinal Fluid
Orexins
Brain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Krahn, L. E., Black, J. L., & Silber, M. H. (2001). Narcolepsy: New understanding of irresistible sleep. Mayo Clinic Proceedings, 76(2), 185-194.

Narcolepsy : New understanding of irresistible sleep. / Krahn, Lois Elaine; Black, John L.; Silber, Michael H.

In: Mayo Clinic Proceedings, Vol. 76, No. 2, 2001, p. 185-194.

Research output: Contribution to journalArticle

Krahn, LE, Black, JL & Silber, MH 2001, 'Narcolepsy: New understanding of irresistible sleep', Mayo Clinic Proceedings, vol. 76, no. 2, pp. 185-194.
Krahn, Lois Elaine ; Black, John L. ; Silber, Michael H. / Narcolepsy : New understanding of irresistible sleep. In: Mayo Clinic Proceedings. 2001 ; Vol. 76, No. 2. pp. 185-194.
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