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Narcolepsy

Narcolepsia · Narkolepsie

What it is

Loss of orexin neurons destroys the wake-sleep boundary; the 2009 Pandemrix flu vaccine triggered it in about 1 in 18 000 vaccinated children.

Symptoms & signs

  • Overwhelming daytime sleepiness
  • cataplexy (collapse with emotion)
  • sleep paralysis
  • hypnagogic hallucinations

🚩 Get help if…

  • see a doctor soon Falling asleep while driving or at dangerous work
  • see a doctor soon Sudden falls or weakness when laughing or angry
  • see a doctor soon New sleepiness after a head injury
  • see a doctor soon Low mood or thoughts of suicide

Where it strikes

Medical treatment

  • Modafinil, solriamfetol, pitolisant
  • sodium oxybate
  • scheduled naps
  • antidepressants for cataplexy

Natural & lifestyle

  • Fixed sleep schedule
  • planned 20-minute naps
  • caffeine timing
  • light exposure in the morning

Emerging & experimental

  • Orexin receptor agonists (TAK-861)
  • immunotherapy near onset

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Ketogenic diet — a small study reduced sleepiness early / small studies
  • Timed caffeine regimes — patients' strategies; untested anecdotal / traditional

ICD codes