Paladin Labs and GlaxoSmithKline sign agreement on Dexedrine Therapeutics Daily (press release) (registration), PA - Nov 29, 2008 Financial terms of the transaction for the drug used for the treatment of attention deficit hyperactivity disorder and narcolepsy were not disclosed. ...TSE:PLB
Sleeping Disorders and its Impact on Health HealthJockey.com, India - Nov 24, 2008 Diagnosis is based primarily on examination of signs and symptoms. Apart from a clinical interview of the patient, information from family members and ...
New start on the cards as Joanne fights back nebusiness.co.uk, UK - Joanne Lawson, a gifted painter and sculptor, refused to give in to illness after she was diagnosed with ME and the sleeping sickness narcolepsy, ...
Athersys, Inc. Q3 2008 Earnings Call Transcript Seeking Alpha, NY - Nov 27, 2008 We are encouraged by recent significant partnerships in the stem cell area and signs of growing interest among larger biotech and pharmaceutical companies. ...ATHX
The Current Cinema New Yorker, United States - Nov 23, 2008 He trades favors with the Teamsters, arranging a boycott of Coors beer in gay bars when the brewery won?t sign a contract with the union; in return, ...
Going to work on smart drugs Macleans.ca, Canada - Nov 6, 2008 For those with debilitating sleep disorders such as narcolepsy, which can cause individuals to pass out at all hours of the day, the drug?s energizing ...
Medical practice moving to new $1.2M office Bizjournals.com, NC - Nov 7, 2008 Dayton Lung and Sleep Medicine treats between 50 and 75 patients a day with ailments including asthma, narcolepsy, insomnia and sleep apnea. ...
Book tells the story of a contemporary Cajun character The Daily Advertiser, LA - Aug 3, 2008 Louisiana native Penelope Przekop tells the story of a young woman named Angel who must learn to live with her narcolepsy while discovering lies and secrets ...
Britney Spears' Drug, Provigil, Beats Adderall CollegeOTR, NY - Jul 15, 2008 Provigil, which is used to treat excessive sleepiness or narcolepsy, is being used to keep tech executives awake and now the college set will catch on for ...
Dr. Richard B. Peters Joins JAMA Jamestown Post Journal, NY - Jul 19, 2008 ... neuropathy, Parkinson's disease, dementia, movement disorders, narcolepsy, neuromuscular diseases, trigeminal neuralgia and pseudotumor cerebri. ...
Genomewide Association Analysis of Human Narcolepsy and a New Resistance Gene - M Kawashima, G Tamiya, A Oka, H Hohjoh, T Juji, T … - The American Journal of Human Genetics, 2006 - Elsevier ... associated polymorphisms, a minor allele displayed significantly reduced frequency
in patients with narcolepsy compared with controls (OR 0.19?0.33), which ...
Epidemiology-2 - J BROMAN - Journal of Sleep Research, 2006 - Blackwell Synergy ... various symptoms, we offered a Dutch web-based system ... All symptoms of narcolepsy
and rest-less legs ... to within-subject variance (ICC) was 0.19 which corresponds ... -
Promotion of sleep by targeting the orexin system in rats, dogs and humans - C Brisbare-Roch, J Dingemanse, R Koberstein, P … - Nature Medicine, 2007 - nature.com ... text access provided to Googlebot Access by Web Services. ... pathophysiological hallmark
of rodent, canine and human narcolepsy. ... at any dose (P = 0.19) over the 12 ...
Timing of spontaneous sleep-paralysis episodes - TA GIRARD, JA CHEYNE - Journal of Sleep Research, 2006 - Blackwell Synergy ... with later SP Latencies, r(293) = 0.19, P = 0.001. ... R. and Mullington, J.
Chronobiological aspects of narcolepsy . ... F. Isolated sleep paralysis: a web survey . ...
The Circadian Clock Mutation Alters Sleep Homeostasis in the Mouse - E Naylor, BM Bergmann, K Krauski, PC Zee, JS … - Journal of Neuroscience, 2000 - neuroscience.org ... in calibrated REM delta power (F (2,18) = 1.85; p = 0.19); hence, this ... et al., 1999 )
have been associated with sleep pathology similar to human narcolepsy. ...
Timing of spontaneous sleep-paralysis episodes F Password, ISI View - Journal of Sleep Research, 2006 - Blackwell Synergy ... with later SP Latencies, r(293) = 0.19, P = 0.001. ... R. and Mullington, J.
Chronobiological aspects of narcolepsy . ... F. Isolated sleep paralysis: a web survey . ...
Timing of spontaneous sleep-paralysis episodes AGD TODD, J ALLANCHEYNE - J. Sleep Res, 2006 - ingentaconnect.com ... reported, online over the World Wide Web, using a ... of 19% with disturbances of sleep
(2% narcolepsy, 6% apnea ... with later SP Latencies, r(293) ? 0.19, P ? 0.001 ... -
Medical Resident Driving Simulator Performance Following a Night on Call - JC Ware, MR Risser, T Manser, KH Karlson, Jr - Behavioral Sleep Medicine, 2006 - Lawrence Earlbaum ... Barger and colleagues (2005) administered a Web-based survey ... sleep disorder (eg,
sleep apnea, narcolepsy), had a ... block were 1.05 (0.13), 1.30 (0.19), 1.29 (0.15 ...
Source: Google Scholar
What is narcolepsy?
Narcolepsy is a disorder of excessive sleepiness that appears to be neurologically based. Research shows that there is a difficulty in the release of brain chemicals known to enhance wakefulness as well as an over excitement of brain areas involved in REM (dream) sleep. Therefore, persons with this disorder experience sudden, profound and unavoidable attacks of daytime sleep. They may also experience one or all of the following additional symptoms which are thought to be intrusions of REM sleep into wakefulness: cataplexy, best described as muscle weakness or paralysis in response to sudden emotion (laughter); sleep paralysis, the inability to move or call out when first awake; hallucinations when fighting off sleep or when just waking up. Additionally, persons can experience fragmented nighttime sleep. In a sense, persons with narcolepsy cannot comfortably stay in any state of consciousness, be it wake or sleep. How common is narcolepsy?
The disease, although underreported, is thought to affect 1 in 2500 Americans. Onset of the disease usually occurs in the second decade of life but onset has been seen in young children and older persons as well. It is, unfortunately, not uncommon for persons with narcolepsy to see as many as 7 physicians and wait up to 15 years for a correct diagnosis. In young children of school age, the symptoms are often mistaken for mental retardation, learning disabilities or sleep deprivation. In older people symptoms have been frequently misinterpreted as psychiatric in nature. In the past, narcoleptics have been diagnosed incorrectly as schizophrenic.
What causes narcolepsy?
We are unclear as to the cause(s) of narcolepsy. Many times the onset will follow an exciting or unsettling life event such as going off to college or the death of a loved one. For some, we can track a genetic factor. There is an increased risk of developing narcolepsy or narcoleptic-like symptoms among families with affected persons. On the other hand there are cases of identical twins where only one has narcolepsy. Although the genetic link is not completely defined, there is evidence of an association with a particular gene (called HLA allele DQB1*0602). The association is not sufficient to cause narcolepsy but it may predispose persons to the disorder if other contributing factors coexist. The presence of the genetic factor can be found with a special blood test. While a positive blood test may confirm the diagnosis in the presence of other diagnostic tests, it should not be used as the sole method of diagnosis.
How does one diagnosis narcolepsy? Diagnosis is best made at a sleep disorder center where tests of sleepiness will
be given. The evaluation should include a detailed history of symptoms and a
physical exam. Sleep will be evaluated with a nighttime sleep study, called a
polysomnogram, followed by a daytime study of sleepiness (The Multiple Sleep
Latency Test). During these tests, a patient’s sleep is monitored by brainwaves, eye movements and muscle tone. Body movements, breathing and heart rate are also studied. This allows the clinician to screen for other sleep disorders that may cause symptoms similar to narcolepsy. Furthermore, we know that narcolepsy can co-exist with other disorders and confuse the treatment effects. If other sleep disorders, like sleep apnea, are found, those disorders should be adequately treated before the diagnosis of narcolepsy is confirmed. That may mean another study is needed after good control of a coexisting disorder is obtained.
Please see our "Sleep Apnea" article for a full discussion of this disorder.
How is narcolepsy treated?
Treatment of the disorder must involve a number of different types of approaches. Medication therapies have relied on stimulant therapy to treat the sleepiness of narcolepsy. Tricyclics or other antidepressants are used to treat the cataplexy and other REM-related symptoms as they emerge. At the moment, the stimulants of choice in the U.S. are amphetamines, caffeine and Cylert. Unfortunately, these may cause side effects that make it impossible for some patients to receive adequate improvements in symptoms. Some of the side effects are nervousness, jitteriness, headache, palpitations, insomnia, muscle jerks, and anorexia. Along with medications, treatment strategies should include behavioral changes such as frequent, short naps, improved sleep hygiene, and stress reduction. Supportive counseling is important not only for the patient but also for the family. The family must be educated about the disease and the changes they may observe in their loved one. It is not uncommon for sleepy people who are newly alert to look around at their world and be unhappy with the world in general or their place in it. By the same token, family members who are not used to the newly alert patient’s involvement in family matters may be annoyed. Therefore, supportive counseling can be an important and successful adjunct to care.
While no one wishes to be different or "sick", persons with narcolepsy can live effective and happy lives. In general symptoms evolve for a year or two after onset. During that time it is important to stay in close touch with the treating clinician to optimize medication control. Once fully developed, the disease should not worsen throughout one’s life. Clearly, there are life issues that emerge for persons with narcolepsy. Educational and career choices are important. Early diagnosis and treatment helps prevent lost years of educational failure or poor career choices. In general, persons with narcolepsy should be encouraged to avoid careers where alertness is vital (i.e., law enforcement, driving or flying). Women with this diagnosis will have to evaluate the impact of pregnancy. It may be necessary for them to withdraw from their medication during pregnancy. This could impact their ability to work or otherwise care for their families. The Americans with Disability Act protects persons with narcolepsy from job discrimination if they warn the employer at the time of hire. The employer has to offer reasonable accommodations to the employee. This could be as simple as allowing a brief nap break. I have found that an explanatory letter to an employer or educator works wonders to smooth the path for my patients.
Is there anything new in narcolepsy?
A new drug, Provigil (modafinil), has been recently studied in two large studies in the US, of which our laboratory was part. The drug is a unique promoter of the wakeful state, different from known stimulants and amphetamine-like drugs. In our study of the drug, few side effects were noted. The only significant one was an initial mild-to-moderate headache. The drug remains active for 12-14 hours, allowing once-a-day dosing. Additionally, no affect on nighttime sleep was noted.
At the moment, this promising drug is awaiting final FDA approval for marketing, and hopefully will be available in the spring.
Is there other information available?
There are now a number of support groups and self-education groups available to newly diagnosed persons. The Narcolepsy Network can be reached at 401-667-2523 or at narnet@narcolepsynetwork.com. The National Sleep Foundation has interesting materials on narcolepsy and can be reached at (202)-341-3471 or www.sleepfoundation.org. There is also a hot line 1-888-41-AWAKE.
