Abstract
As a rare and disabling neurological sleep disorder that is often diagnosed during adolescence, narcolepsy type 1 (NT1) has been described as a relatively homogeneous clinical syndrome of hypothalamic deficiency in hypocretin-1 (orexin) producing neurons. 1 Longstreth W.T. Koepsell T.D. Ton T.G. Hendrickson A.F. Belle G. The epidemiology of narcolepsy. Sleep. 2007; 30: 13-26 Crossref PubMed Scopus (328) Google Scholar , 2 Mignot E. Lammers G.J. Ripley B. et al. The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Arch Neurol. 2002; 59: 1553-1562 Crossref PubMed Scopus (961) Google Scholar As up to 98% of patients are human leukocyte antigen DQB1*06:02 positive, an autoimmune-mediated hypothesis has been supported. 3 Bourgin P. Zeitzer J.M. Mignot E. CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol. 2008; 7: 649-662 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar The core features include excessive daytime sleepiness (EDS), cataplexy, fragmented nocturnal sleep with vivid dreams, and hallucinations and sleep paralysis during sleep-wake transitions. Commonly, adolescents experience concurrent depression, stigmatization from peers, and their body mass index is higher than 98th percentile. 4 Ohayon M.M. Narcolepsy is complicated by high medical and psychiatric comorbidities: a comparison with the general population. Sleep Med. 2013; 14: 488-492 Abstract Full Text Full Text PDF PubMed Scopus (160) Google Scholar
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