Narcolepsy is a sleep disorder of neurological origin characterized by excessive daytime sleepiness, accompanied in most cases by cataplexy (muscle hypotonia attacks). The prevalence of the disease in Europe is 3-5 per 10000 inhabitants. It generally appears between the second and third decades of life. There is an important genetic component, as several members of the same family may be affected (incidence of 1-2% in first-degree relatives).
A complete clinical history, to rule out other problems (neurological disorders), sleep apnea syndrome, restless legs syndrome, medications, etc.
General analysis and genetic study (HLA DR B1 * 1501, DQB1 * 0602, DQA1 * 0102).
Nocturnal polysomnography: sleep study to see the structure and time that it takes to enter the REM phase, as well as to rule out other causes of hypersomnolence.
Multiple latency test: held in the morning, after the overnight study, and serves to detect the level of daytime hypersomnolence and the abnormal presence of episodes of REM sleep.
Levels of hypocretins in cerebrospinal fluid (lumbar puncture): form part of the diagnosis and are the main cause of the disease. In narcoleptic patients, they are diminished in the nervous system.
When it comes to treating the disorder, several factors are taken into account, such as age, associated diseases, lifestyle and impact of sleepiness and/or drugs on the quality of life of the patient.
A regular sleep schedule is key along with avoiding alcohol and medications that depress the central nervous system. Physical exercise, increasing the number of hours of nighttime sleep, and performing scheduled short naps during the day is recommended.
In any case, each patient should be evaluated individually, taking into account the impact of symptoms on their daily activities, and side effects of drug treatment.