Narcolepsy: The Human Cat Nap!
- bxgenetics
- Jun 11
- 4 min read
Updated: Jun 12
BY MARY LOUKAITIS
Imagine taking an exam. You encounter a challenging prompt. Then you suddenly… sleep. You may have narcolepsy.
What is narcolepsy?
Narcolepsy is a sleep disorder that significantly impacts the lifestyle and functioning of 200,000 individuals in the United States and 3 million worldwide. People experience narcolepsy as excessive, unpredictable sleepiness and sometimes a rapid loss of muscle function known as cataplexy. Think about unintentionally taking many cat naps throughout the day.
Genetic and environmental factors likely contribute to narcolepsy. Regardless, individuals must reduce symptoms to enhance daily functioning. Management strategies involve stimulant drugs, dietary restrictions, and a regular sleep schedule. Researchers are investigating neurotransmitter delivery, cell implants, and brain receptor-binding molecules as emerging therapies for narcolepsy.
What causes narcolepsy?
Alterations in the production of neurotransmitters, brain chemicals that facilitate communication between brain cells, produce narcolepsy symptoms. Brain cells control our daily functions and activities. In narcolepsy, the hypocretin neurotransmitter is affected. Hypocretin regulates our sleep-wake cycle and energy consumption by modulating brain cell activity. Think about the number of zeros you would get without hypocretin… yikes!
There are two forms of narcolepsy: Type 1 and Type 2. Type 1 narcolepsy involves sleepiness with cataplexy. Type 2 narcolepsy involves sleepiness without cataplexy and may be more than four times as common as Type 1 narcolepsy, though there is no literature consensus on this relative frequency.
Type 1 narcolepsy is the most understood and researched form of narcolepsy. In Type 1 narcolepsy, a gene encoding a human leukocyte antigen (HLA) protein may be mutated or permanently altered. Human leukocyte antigen proteins differentiate between our proteins and proteins from potentially harmful foreign sources. These HLAs bind to foreign proteins, presenting them to immune T cells from the surface of antigen-presenting cells or white blood cells known as leukocytes. These immune T cells recognize foreign particles, triggering an immune system-mediated attack on potentially infected cells.
Some research suggests that mutated HLA genes encode proteins that cause immune cells to attack hypocretin-producing cells. An immune response from bacterial or viral infection may trigger Type 1 narcolepsy in individuals with HLA mutations. After infection, mutant HLAs from the surface of antigen-presenting cells may present the wrong proteins to T cells. Instead of only presenting foreign proteins, mutant HLAs present hypocretin cell proteins. Immune T cells then facilitate the killing of hypocretin cells, causing daytime sleepiness and cataplexy. Remember that time you submitted your homework to the wrong assignment and your grade dropped?
The causes of Type 2 narcolepsy are unclear, but it is suspected to develop from a milder loss of hypocretin-producing cells. In one case, researchers reported Type 2 narcolepsy from damage to the hippocampus. The hippocampus is a brain region responsible for storing memories and regulating drowsiness.
How do individuals cope with narcolepsy?
Just as lifestyle adjustments help you cope with your high school workload, lifestyle adjustments help individuals cope with narcolepsy. Sleeping consistently at night and taking scheduled naps throughout the day reduces unpredictable daytime sleepiness. Affected individuals should avoid alcohol, caffeine, and large meals before bedtime to maintain a regular sleep cycle. Alcohol and caffeine before bed can alter sleeping patterns, increasing daytime sleepiness. Similarly, eating before bed can reduce or disturb nighttime sleep, increasing daytime sleepiness.
Affected individuals should also eat low-calorie foods high in healthy fats to reduce excessive sleepiness. This diet may enhance the function of cellular mitochondria, responsible for generating energy from food. Remember the following for job interviews: The “mitochondria” is the powerhouse of the cell!
Affected individuals may take stimulants like modafinil, armodafinil, and solriamfetol to reduce daytime sleepiness and cataplexy. These medications increase brain activity to increase alertness. Despite these medication and lifestyle adjustments, patients may still experience a reduced quality of life from daytime sleepiness.
What are emerging therapies for narcolepsy?
Because of incomplete symptom control in affected individuals, researchers are testing new narcolepsy treatments like hypocretin delivery, cell implants, and receptor agonists.
The delivery of hypocretin into the brain may alleviate cataplexy and sleepiness caused by the reduction of hypocretin-producing cells. Administering hypocretin receptor agonists or stimulators may enhance the activity of hypocretin-detecting brain cells, thus reducing cataplexy and sleepiness. The implantation of new hypocretin-producing cells into the hypothalamus, a brain region regulating sleep, may also reduce narcolepsy symptoms by amplifying hypocretin signalling.
Unlike senioritis, narcolepsy is a lifelong sleep disorder that is treatable with medication and lifestyle adjustments. Researchers are currently developing additional treatments for narcolepsy to enhance symptom control and improve the quality of life for affected individuals.
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