Types And Degrees Of Narcolepsy

Narcolepsy, also known as Gelineau syndrome, is a rare condition of varying types and degrees. It causes people to fall asleep unexpectedly and affects about 0.1% of the world’s population.

The term narcolepsy was coined by Jean-Baptiste-Édouard Gélineau in the late 1800s. This researcher was the first to describe it in 1880. He gave it that name based on two Greek words, narke and lepsis, which together mean ‘numb attack’.

What is narcolepsy?

Narcolepsy is a chronic neurological disorder that causes sleep arrhythmias. The main symptom is strong drowsiness during the day and sudden drowsiness attacks that cannot be stopped.

Thus, those with any form or degree of narcolepsy have great difficulty staying awake for several hours, regardless of the circumstances they are in. For this reason, it has a significant impact on quality of life.

In some cases, this condition occurs with a sudden loss of muscle tone, which is medically defined as cataplexy. This can happen as a result of an intense emotion and eventually the appearance will determine the type and degree of narcolepsy.

There is no cure for this disease and as such there is no specific treatment. However, there are a number of medications that help control these sudden sleep attacks. In addition, lifestyle changes can be helpful (Spanish link), as well as social and psychological support.

Characteristics of the disease

Narcolepsy is a rare condition that causes severe sleep attacks that the patient cannot control. However, there are even more features. These are the main features of narcolepsy:

• Excessive daytime sleepiness. A decrease in alertness and concentration. This is usually the first symptom to manifest and then the sudden desire to sleep.
• Cataplexy. As we mentioned above, it does not appear in all cases, nor with the same intensity.

• Sleep paralysis. This is the temporary inability to move or speak. It especially occurs when someone falls asleep or wakes up. They are usually short periods.
• Changes in REM sleep. REM sleep is the deepest. During this sleep, there is usually rapid eye movement. Someone with narcolepsy can enter this stage at any time.
• Hallucinations. They are called hypnagogic hallucinations if they occur before a person falls asleep or hypnopompic hallucinations if they occur when he or she wakes up. They can be very lively and terrifying.

People with narcolepsy may also experience other sleep disorders, such as obstructive sleep apnea, sleep fragmentation, and restless legs syndrome (RLS). Although it is paradoxical, they can also suffer from insomnia (Spanish link).

Types and degrees of narcolepsy

According to the criteria of the DSM-5, the fifth version of the Diagnostic and Statistical Manual of Mental Disorders, there are five types and degrees of narcolepsy, which are the following:

• Without cataplexy and with hypocretin deficiency. In this type of narcolepsy there is a deficiency of the hormone orexin or hypocretin. This is a protein that affects neuronal function. The main function of this protein is to regulate the sleep-wake cycle. This type does not cause cataplexy episodes.
• With cataplexy and without hypocretin deficiency. In this case, there is no deficiency of hypocretin, but there is cataplexy. This is a sudden muscle weakness on both sides of the body. It is the least understood symptom of this condition, affecting 5% of all cases.

• Autosomal dominant cerebellar ataxia (ADCA), deafness and narcolepsy. This degree of narcolepsy is caused by a DNA mutation. Ataxia is a lack of motor coordination that affects voluntary movements and even impairs functions such as swallowing, speech, and vision. It comes on late and as it progresses it often leads to dementia.
• Autosomal dominant cerebellar ataxia, deafness, narcolepsy, obesity, and type 2 diabetes. This is due to a mutation in the oligodendrocytes, a class of cells that affect myelin formation. The latter is a substance that increases the speed of nerve transmission, and its deficiency affects mobility.
• Secondary to another medical condition. One of the types of narcolepsy appears as a result of another disease. Sarcoidosis, for example, or Whipple’s disease. Both destroy cells that produce hypocretin (Spanish link).

All grades of narcolepsy require medical attention

While there is no cure for narcolepsy, there are currently treatments available (Spanish link). They relieve most of the symptoms and then allow the patient to lead an almost normal life.

People who suffer from this condition can also make lifestyle changes such as taking scheduled naps to relieve sudden sleepiness. Likewise, they should be strict with their sleeping habits. Someone with narcolepsy also needs psychological and social support.