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Narcolepsy

MedGen UID:
45001
Concept ID:
C0027404
Disease or Syndrome
Synonyms: Gelineau Syndrome; Gelineau's Syndrome; Gelineau's Syndromes; Gelineaus Syndrome; Narcoleptic Syndrome; Narcoleptic Syndromes; Paroxysmal Sleep; Sleep, Paroxysmal; Syndrome, Gelineau; Syndrome, Gelineau's; Syndrome, Narcoleptic; Syndromes, Gelineau's; Syndromes, Narcoleptic
SNOMED CT: Narcolepsy (60380001); Paroxysmal sleep (60380001); Gelineau's syndrome (60380001); Narcoleptic syndrome (60380001)
 
HPO: HP:0030050
Monarch Initiative: MONDO:0021107
Orphanet: ORPHA619284

Definition

An abnormal phenomenon characterized by a classic tetrad of excessive daytime sleepiness with irresistible sleep attacks, cataplexy (sudden bilateral loss of muscle tone), hypnagogic hallucinations, and sleep paralysis. [from HPO]

Conditions with this feature

Narcolepsy 1
MedGen UID:
371809
Concept ID:
C1834372
Disease or Syndrome
Adie (1926) first delineated narcolepsy as a separate and specific entity. It is a sleep disorder characterized by attacks of disabling daytime drowsiness and low alertness. The normal physiologic components of rapid eye movement (REM) sleep, dreaming and loss of muscle tone, are separated and also occur while the subject is awake, resulting in half-sleep dreams and episodes of skeletal muscle paralysis and atonia (cataplexy and sleep paralysis). Unlike normal sleep, that of narcolepsy often begins with REM activity and the time taken to fall asleep is shorter than normal. In contrast to animal models, human narcolepsy is not a simple genetic disorder. Most human cases of narcolepsy are sporadic and carry a specific HLA haplotype (Peyron et al., 2000). Familial cases are the exception rather than the rule, and monozygotic twins show only partial concordance (25 to 31%) (Mignot, 1998). Genetic Heterogeneity of Narcolepsy Additional narcolepsy loci have been mapped to chromosomes 4 (NRCLP2; 605841), 21q (NRCLP3; 609039), 22q13 (NRCLP4; 612417), 14q11 (NRCLP5; 612851), and 19p13.2 (NRCLP6; 614223). NRCLP7 (614250) is caused by mutation in the MOG gene (159465) on chromosome 6p22. Resistance to narcolepsy is associated with minor alleles of a SNP and a marker in the NLC1A gene (610259) on chromosome 21q22.
Narcolepsy 3
MedGen UID:
332320
Concept ID:
C1836907
Disease or Syndrome
Narcolepsy is a chronic sleep disorder that disrupts the normal sleep-wake cycle. Although this condition can appear at any age, it most often begins in adolescence.\n\nNarcolepsy is characterized by excessive daytime sleepiness. Affected individuals feel tired during the day, and several times a day they may experience an overwhelming urge to sleep. "Sleep attacks" can occur at unusual times, such as during a meal or in the middle of a conversation. They last from a few seconds to a few minutes and often lead to a longer nap, after which affected individuals wake up feeling refreshed.\n\nAnother common feature of narcolepsy is cataplexy, which is a sudden loss of muscle tone in response to strong emotion (such as laughing, surprise, or anger). These episodes of muscle weakness can cause an affected person to slump over or fall, which occasionally leads to injury. Episodes of cataplexy usually last just a few seconds, and they may occur from several times a day to a few times a year. Most people diagnosed with narcolepsy also have cataplexy. However, some do not, which has led researchers to distinguish two major forms of the condition: narcolepsy with cataplexy and narcolepsy without cataplexy.\n\nSome people with narcolepsy have all of the major features of the disorder, while others have only one or two. Most of the signs and symptoms persist throughout life, although episodes of cataplexy may become less frequent with age and treatment.\n\nNarcolepsy also affects nighttime sleep. Most affected individuals have trouble sleeping for more than a few hours at night. They often experience vivid hallucinations while falling asleep (hypnogogic hallucinations) or while waking up (hypnopompic hallucinations). Affected individuals often have realistic and distressing dreams, and they may act out their dreams by moving excessively or talking in their sleep. Many people with narcolepsy also experience sleep paralysis, which is an inability to move or speak for a short period while falling asleep or awakening. The combination of hallucinations, vivid dreams, and sleep paralysis is often frightening and unpleasant for affected individuals.
Narcolepsy 7
MedGen UID:
481896
Concept ID:
C3280266
Disease or Syndrome
Narcolepsy also affects nighttime sleep. Most affected individuals have trouble sleeping for more than a few hours at night. They often experience vivid hallucinations while falling asleep (hypnogogic hallucinations) or while waking up (hypnopompic hallucinations). Affected individuals often have realistic and distressing dreams, and they may act out their dreams by moving excessively or talking in their sleep. Many people with narcolepsy also experience sleep paralysis, which is an inability to move or speak for a short period while falling asleep or awakening. The combination of hallucinations, vivid dreams, and sleep paralysis is often frightening and unpleasant for affected individuals.\n\nSome people with narcolepsy have all of the major features of the disorder, while others have only one or two. Most of the signs and symptoms persist throughout life, although episodes of cataplexy may become less frequent with age and treatment.\n\nAnother common feature of narcolepsy is cataplexy, which is a sudden loss of muscle tone in response to strong emotion (such as laughing, surprise, or anger). These episodes of muscle weakness can cause an affected person to slump over or fall, which occasionally leads to injury. Episodes of cataplexy usually last just a few seconds, and they may occur from several times a day to a few times a year. Most people diagnosed with narcolepsy also have cataplexy. However, some do not, which has led researchers to distinguish two major forms of the condition: narcolepsy with cataplexy and narcolepsy without cataplexy.\n\nNarcolepsy is characterized by excessive daytime sleepiness. Affected individuals feel tired during the day, and several times a day they may experience an overwhelming urge to sleep. "Sleep attacks" can occur at unusual times, such as during a meal or in the middle of a conversation. They last from a few seconds to a few minutes and often lead to a longer nap, after which affected individuals wake up feeling refreshed.\n\nNarcolepsy is a chronic sleep disorder that disrupts the normal sleep-wake cycle. Although this condition can appear at any age, it most often begins in adolescence.
Autosomal dominant cerebellar ataxia, deafness and narcolepsy
MedGen UID:
813625
Concept ID:
C3807295
Disease or Syndrome
ADCADN is an autosomal dominant neurologic disorder characterized by adult onset of progressive cerebellar ataxia, narcolepsy/cataplexy, sensorineural deafness, and dementia. More variable features include optic atrophy, sensory neuropathy, psychosis, and depression (summary by Winkelmann et al., 2012).

Professional guidelines

PubMed

Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
J Sleep Res 2021 Dec;30(6):e13387. Epub 2021 Jun 25 doi: 10.1111/jsr.13387. PMID: 34173288
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
Nat Rev Neurol 2019 Sep;15(9):519-539. Epub 2019 Jul 19 doi: 10.1038/s41582-019-0226-9. PMID: 31324898
Golden EC, Lipford MC
Cleve Clin J Med 2018 Dec;85(12):959-969. doi: 10.3949/ccjm.85a.17086. PMID: 30526757

Recent clinical studies

Etiology

Pérez-Carbonell L, Mignot E, Leschziner G, Dauvilliers Y
Lancet 2022 Sep 24;400(10357):1033-1046. Epub 2022 Sep 14 doi: 10.1016/S0140-6736(22)01018-2. PMID: 36115367
Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
Eur J Neurol 2021 Sep;28(9):2815-2830. Epub 2021 Jun 25 doi: 10.1111/ene.14888. PMID: 34173695
Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
J Sleep Res 2021 Dec;30(6):e13387. Epub 2021 Jun 25 doi: 10.1111/jsr.13387. PMID: 34173288
Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C
Acta Psychiatr Scand 2021 Jul;144(1):28-41. Epub 2021 May 5 doi: 10.1111/acps.13300. PMID: 33779983Free PMC Article
Kornum BR, Knudsen S, Ollila HM, Pizza F, Jennum PJ, Dauvilliers Y, Overeem S
Nat Rev Dis Primers 2017 Feb 9;3:16100. doi: 10.1038/nrdp.2016.100. PMID: 28179647

Diagnosis

Blattner M, Maski K
Sleep Med Clin 2023 Jun;18(2):183-199. Epub 2023 Mar 8 doi: 10.1016/j.jsmc.2023.01.003. PMID: 37120161
Barateau L, Pizza F, Plazzi G, Dauvilliers Y
J Sleep Res 2022 Aug;31(4):e13631. Epub 2022 May 27 doi: 10.1111/jsr.13631. PMID: 35624073
Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C
Acta Psychiatr Scand 2021 Jul;144(1):28-41. Epub 2021 May 5 doi: 10.1111/acps.13300. PMID: 33779983Free PMC Article
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
Nat Rev Neurol 2019 Sep;15(9):519-539. Epub 2019 Jul 19 doi: 10.1038/s41582-019-0226-9. PMID: 31324898
Golden EC, Lipford MC
Cleve Clin J Med 2018 Dec;85(12):959-969. doi: 10.3949/ccjm.85a.17086. PMID: 30526757

Therapy

Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
J Sleep Res 2021 Dec;30(6):e13387. Epub 2021 Jun 25 doi: 10.1111/jsr.13387. PMID: 34173288
Trotti LM, Arnulf I
Neurotherapeutics 2021 Jan;18(1):20-31. doi: 10.1007/s13311-020-00919-1. PMID: 32901432Free PMC Article
Thorpy MJ
CNS Drugs 2020 Jan;34(1):9-27. doi: 10.1007/s40263-019-00689-1. PMID: 31953791Free PMC Article
Nepovimova E, Janockova J, Misik J, Kubik S, Stuchlik A, Vales K, Korabecny J, Mezeiova E, Dolezal R, Soukup O, Kobrlova T, Pham NL, Nguyen TD, Konecny J, Kuca K
Med Res Rev 2019 May;39(3):961-975. Epub 2018 Nov 14 doi: 10.1002/med.21550. PMID: 30426515
Scammell TE
N Engl J Med 2015 Dec 31;373(27):2654-62. doi: 10.1056/NEJMra1500587. PMID: 26716917

Prognosis

Barateau L, Pizza F, Chenini S, Peter-Derex L, Dauvilliers Y
Rev Neurol (Paris) 2023 Oct;179(7):727-740. Epub 2023 Aug 25 doi: 10.1016/j.neurol.2023.08.001. PMID: 37634997
Abad VC
Expert Rev Neurother 2023 Jul-Dec;23(9):819-834. Epub 2023 Aug 29 doi: 10.1080/14737175.2023.2249234. PMID: 37585269
Howell M, Avidan AY, Foldvary-Schaefer N, Malkani RG, During EH, Roland JP, McCarter SJ, Zak RS, Carandang G, Kazmi U, Ramar K
J Clin Sleep Med 2023 Apr 1;19(4):759-768. doi: 10.5664/jcsm.10424. PMID: 36515157Free PMC Article
Büttner-Teleagă A, Kim YT, Osel T, Richter K
Int J Environ Res Public Health 2021 Nov 7;18(21) doi: 10.3390/ijerph182111696. PMID: 34770209Free PMC Article
Maski K, Trotti LM, Kotagal S, Robert Auger R, Rowley JA, Hashmi SD, Watson NF
J Clin Sleep Med 2021 Sep 1;17(9):1881-1893. doi: 10.5664/jcsm.9328. PMID: 34743789Free PMC Article

Clinical prediction guides

Dauvilliers Y, Mignot E, Del Río Villegas R, Du Y, Hanson E, Inoue Y, Kadali H, Koundourakis E, Meyer S, Rogers R, Scammell TE, Sheikh SI, Swick T, Szakács Z, von Rosenstiel P, Wu J, Zeitz H, Murthy NV, Plazzi G, von Hehn C
N Engl J Med 2023 Jul 27;389(4):309-321. doi: 10.1056/NEJMoa2301940. PMID: 37494485
Lanza G, Fisicaro F, Cantone M, Pennisi M, Cosentino FII, Lanuzza B, Tripodi M, Bella R, Paulus W, Ferri R
Sleep Med Rev 2023 Feb;67:101735. Epub 2022 Dec 8 doi: 10.1016/j.smrv.2022.101735. PMID: 36563570
Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C
Acta Psychiatr Scand 2021 Jul;144(1):28-41. Epub 2021 May 5 doi: 10.1111/acps.13300. PMID: 33779983Free PMC Article
Reading PJ
J Neurol 2019 Jul;266(7):1809-1815. Epub 2019 Apr 19 doi: 10.1007/s00415-019-09310-3. PMID: 31004212
Johns MW
Sleep 1991 Dec;14(6):540-5. doi: 10.1093/sleep/14.6.540. PMID: 1798888

Recent systematic reviews

Büttner-Teleagă A, Kim YT, Osel T, Richter K
Int J Environ Res Public Health 2021 Nov 7;18(21) doi: 10.3390/ijerph182111696. PMID: 34770209Free PMC Article
Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
Eur J Neurol 2021 Sep;28(9):2815-2830. Epub 2021 Jun 25 doi: 10.1111/ene.14888. PMID: 34173695
Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, Dolenc-Groselj L, Jennum P, Khatami R, Manconi M, Mayer G, Partinen M, Pollmächer T, Reading P, Santamaria J, Sonka K, Dauvilliers Y, Lammers GJ
J Sleep Res 2021 Dec;30(6):e13387. Epub 2021 Jun 25 doi: 10.1111/jsr.13387. PMID: 34173288
Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C
Acta Psychiatr Scand 2021 Jul;144(1):28-41. Epub 2021 May 5 doi: 10.1111/acps.13300. PMID: 33779983Free PMC Article
Tiseo C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T, Hubalek IA, Marchenko Y, Overeem LH, Piroso S, Tkachev A, Martelletti P, Sacco S; European Headache Federation School of Advanced Studies (EHF-SAS)
J Headache Pain 2020 Oct 27;21(1):126. doi: 10.1186/s10194-020-01192-5. PMID: 33109076Free PMC Article

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