1. Neurological Disorder NARCOLEPSY

2. What is it? Chronic neurological disorder affecting brain’s ability to regulate sleep-wake cycles. Two types: Narcolepsy Narcolepsy with Cataplexy

3. Go to Sleepzzzzzzzzzzzzzzzzzzzzzz NREM(Non-Rapid Eye Movement) Step 1 REM(Rapid Eye Movement) Step 2 NREM (80-100minutes)

4. Biological Alarm Clock

5. With Narcolepsy: There is no step 1 (NREM= Non rapid Eye movement) REM IMMEDIATELY

6. Defined by four major symptoms Excessive : daytime sleepiness (EDS). Cataplexy : most dramatic symptom of narcolepsy Hypnagogic hallucinations: intense and sometimes terrifying experiences Sleep paralysis : frightening inability to move shortly after awakening or dozing off.

7. Main sign: Daytime sleepiness may cause: Mental cloudiness or "fog" Memory problems Problems focusing Lack of energy Depression Extreme exhaustion

8. Other signs : Fall asleep suddenly (any where, any time) sleep longer than usual (up to 18 hrs a day ) Experience drowsiness Wake up frequently during night time hours Sleep attacks last from few sec. to an hour

9. Narcolepsy with Cataplexy the most severe one Loss of muscle tone(Cataplexy) Head nodding Drooping eyelids Difficulty speaking Difficulty moving arms or hands or a weakened grip Buckling of the knees Can be associated with sleep-onset or sleep-offset paralysis Exceptionally can last from hours to days!! https://youtu.be/VA6FeiGgLF0

10. RESEARCH: Discover People with narcolepsy: lack of Orexin hypocretin 1-2 (Orexin A and B) Regulates the sleep-wake cycle

11. Sleep attacks triggered By Strong Emotions: Laughter Anger Fear Excitement

12. Co-morbidity varies Disorder Narcolepsy (%) Controls (%) Adjusted Odds Ratio P Value Major depressive disorder 17.16.42.7<.001 Bipolar disorder 8.51.94.6<.001 Post-traumatic stress disorder 11.35.32.1<.001 Social anxiety21.18.72.4<.001 Panic disorder12.53.93.2<.001 Agoraphobia8.51.36.5<.001 Simple phobia5.21.34.1<.001 Obsessive- compulsive disorder 3.71.03.8<.001 Generalized anxiety disorder 5.51.73.3<.001

13. Psychosocial impact Adult, Child and Teens: Severe psychosocial stress Embarrassment, Academic decline Feelings of loss of self-worth related to the symptoms of their disease. Adult narcoleptics also face the concerns of the workplace Accident at home or other places

14. Psychosocial Impact (Cont.) need for stimulants often creates problems with pharmacists and family.

15. How is narcolepsy diagnosed? Patient's symptoms family history of narcolepsy physical exam test results

16. SPECIFIC TESTS with Sleep Specialist Polysomnogram (PSG) Multiple sleep latency test (MSLT) Hypocretin test (Require to sleep overnight in a sleep disorder center

17. How is narcolepsy treated? No CURE Medicines to relieve daytime sleepiness: Stimulant:. Modafinil Pemoline Methylphenidate Amphetamines Medicines to relieve other symptoms: Several Different Antidepressant