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What is narcolepsy? -

Narcolepsy is a rare and very unique sleep disorder, with no other condition to compare it to. The symptoms of narcolepsy are unique to itself, and it was a greatly misunderstood disorder for a very long time.

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What is narcolepsy? -

While most people think of narcolepsy as nothing more than a penchant for suddenly falling asleep at random and occasionally inappropriate times, there is much more to this neurological condition than just that.

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What causes narcolepsy? -

On a neurological level, narcolepsy is caused by a deficiency in the neurotransmitter orexin, also called hypocretin. This neurotransmitter serves many functions in our daily lives, the most important of which is keeping us awake and alert, and making sure all of the other parts of our brains remember to keep working and stay alert. When the brain doesn't produce enough orexin, it can very easily and suddenly fall into rest mode.

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History of narcolepsy -

Narcolepsy has likely been affecting people for thousands of years, but it wasn't until 1880 that French physician Jean-Baptiste-Édouard Gélineau described the condition in a medical journal. Of course, this preliminary description was far from perfect, and Gélineau's personally favored treatment was to feed the patient arsenic. Thankfully, great strides have been made in the understanding and treatment of narcolepsy since the 19th century.

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Types of narcolepsy -

There are two types of narcolepsy, type one and type two. Type one is the most common and involves extremely low levels of orexin and the spontaneous bouts of sleep that have become so characteristic of narcolepsy. Type two is a milder form of the disorder, and patients diagnosed with type two narcolepsy usually have higher if not average levels of orexin.

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When does narcolepsy usually manifest? -

Narcolepsy is almost always a lifelong chronic condition, and can manifest itself at any time, usually between the ages of 15 and 50. In some cases, symptoms begin to appear slowly over time, and in other cases symptoms can manifest quickly and intensely over a mere matter of weeks. While the symptoms may ebb and flow over the course of the afflicted's lifetime, narcolepsy is not known to grow progressively and consistently worse over time.

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How many people live with narcolepsy? -

Narcolepsy is decidedly difficult to properly diagnose, and thus all estimates must be taken with a grain of salt. Most experts say anywhere from 135,000 to 200,000 people in the United States have a diagnosis of narcolepsy, but since the disorder is thought to be severely underdiagnosed, especially in children, the true number may be considerably higher.

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Why is narcolepsy so hard to diagnose? -

Narcolepsy has proven a difficult diagnosis because, while all of its symptoms grouped together make for a relatively unique condition, many of the preliminary symptoms on their own point to a myriad of different conditions. Fatigue and lethargy, for example, are tell-tale signs of not only narcolepsy, but also Lyme disease, fibromyalgia, depression, and a number of other mood disorders.

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Effects of narcolepsy -

The effects of narcolepsy are much more complex and widespread than one might originally think. Sleep disorders may seem to be simply that, an issue with sleeping habits, but there are many other battles going on beneath the surface.

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Excessive daytime sleepiness -

The most obvious and well-known symptom of narcolepsy is known as excessive daytime sleepiness, or EDS. EDS is the main component of both types one and two of narcolepsy. This persistent drowsiness throughout the day is in no way affected by how much sleep the afflicted person had the night before.

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Sleep attacks -

Sometimes, EDS manifests as what is known as "sleep attacks," where the uncontrollable urge to sleep comes on suddenly at different intervals throughout the day.

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Cataplexy -

Cataplexy is one of the distinguishing features between type one, which is characterized by the presence of cataplexy, and type two, which is categorized by its absence. Cataplexy is the total loss of muscular control in one's body, without losing necessarily losing consciousness, and is usually triggered by strong emotions such as joy, excitement, anger, or frustration. Cataplexy is often the first symptom of narcolepsy to manifest itself, and may set in years before EDS makes an appearance.

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Trouble sleeping -

Unfortunately, EDS can become a vicious cycle, and many narcoleptics suffer from insomnia or frequently disrupted sleep during the night. Individuals suffering from narcolepsy are also more prone to being shaken awake from intense dreams.

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Sleep paralysis -

These fragmented sleep patterns that commonly accompany narcolepsy also allow for more frequent episodes of sleep paralysis. While episodes thankfully don't last more than a few minutes at most, the experience of having a lucid mind stuck in a motionless body can be disturbing and distressing for many people.

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Hallucinations -

Two types of hallucinations are common in people who suffer from narcolepsy or sleep paralysis. The first, hypnagogic hallucinations, occur when one is on the verge of falling asleep, and the second, hypnopompic hallucinations, rear their head upon waking up. Both types of hallucinations are usually visual in nature, and almost always frightening.

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Automatic behavior -

During sleep attacks, which can sometimes be as brief as just a few seconds, some narcoleptics will participate in what is called "automatic behavior." If, for example, someone is writing a letter and they are hit with a sleep attack, they may continue writing despite being unconscious. While their hand may continue moving, the writing itself will likely quickly become incoherent.

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The dangers of narcolepsy -

As one might imagine, living with narcolepsy can prove exceedingly inconvenient, and sometimes dangerous. Not knowing when you might fall asleep makes everyday activities such as driving and cooking more dangerous than they normally would be.

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The narcoleptic gene -

Recent studies into what might cause the orexin deficiency that causes narcolepsy have taken note of a certain gene mutation, known as HLA-DQB1*06:02, that may be attacking orexin neurotransmitters, confusing them for foreign, hostile bodies. If this theory can be proven, scientists may have found a root genetic cause for narcolepsy.

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Treatments for narcolepsy -

Thankfully, there are a number of treatments available to diminish the symptoms of narcolepsy. The first pharmaceutical line of defense is a drug called modafinil, meant to stimulate the nervous system to ensure it always knows when to be in working, waking order. Modafinil may also sometimes be supplemented by stimulants and antidepressants, specifically SSRIs.

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Treatments for narcolepsy -

Holistic treatments have also proven to be extremely effective, and can be as simple as taking control away from your EDS, and taking short frequent naps throughout the day.

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Famous people with narcolepsy -

While narcolepsy is a relatively rare condition, there have been many famous people throughout history who have thrived despite the condition.

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Winston Churchill -

While never properly diagnosed with narcolepsy, biographers, historians, and medical professionals agree that it is very likely former British Prime Minister Winston Churchill suffered from the disorder.

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Jimmy Kimmel -

Late-night talk show host and comedian Jimmy Kimmel has always been open about his battle with narcolepsy, and regularly incorporates the condition into his stand-up routines. Thankfully, Kimmel claims he lives with only a mild form of narcolepsy that he is able to keep under control.

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Harriet Tubman -

Harriet Tubman, the face of the Underground Railroad and one of the most influential figures in American history, is thought to have developed narcolepsy after suffering a headwound during her early life as an enslaved person. Tubman was prone to attacks of cataplexy, sleep paralysis, and vivid hallucinations.

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Kurt Cobain -

Kurt Cobain, although never properly diagnosed with narcolepsy, mentioned in a number of interviews that he believed he suffered from the condition.

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Thomas Edison -

While the evidence here is thin, some biographers and historians have suggested that Thomas Edison was subject to narcoleptic sleep attacks throughout his life. Others claim he was simply constantly sleep-deprived, as he was a famously ardent workaholic.

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Louis Braille -

Louis Braille, the French educator and inventor known for developing the revolutionary braille writing system used by the visually impaired, might have had narcolepsy, although he had passed away some decades before the condition was first described.

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Nastassja Kinski -

German actress Nastassja Kinski, best known for her role in Wim Wenders' seminal 1984 masterpiece 'Paris, Texas,' has frequently spoken publicly about her struggles with narcolepsy. As a teenager and young adult, Kinski claims she was often mislabeled as a "party girl" due to her persistent sleep attacks.

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Narcolepsy in animals -

Humans aren't the only species that can develop narcolepsy. The condition has also been observed in a number of domesticated animals, from dogs and cats to sheep and horses.

Sources: (National Institute of Neurological Disorders and Stroke) (National Organization of Rare Diseases) (Narcolepsy Network)

See also: Celebs living with sleep disorders

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