Sleep Disorders: Narcolepsy

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  • Narcolepsy
    • Two main symptoms - feeling sleepy all the time and loss of muscular control during the day.
    • REM
      • 1960's view was that Narcolepsy was linked to a malfunction in the system that regulates REM sleep. This explained some of the classic symptoms such as lack of muscle tone which accompanies REM sleep.
      • Vogel observed REM sleep and proposed the REM hypothesis.
        • The REM hypothesis was supported when recordings of the neuron activity in the brain stem of narcoleptic dogs showed that cataplexy is linked to the activation of cells that are usually only active during REM sleep.
          • However, in general, research has not been convincing.
    • HLA
      • 1980's research indicated that narcolepsy was linked to a malfunction of the immune system.
      • Honda et al found increased frequency of HLA antigen in narcolepsy patients.
      • HLA molecules found on surface of white blood cells and co-ordinate the immune response.
      • This link continues to be researched.
        • The specific HLA variant that is most commonly found in narcoleptics is not found in all narcoleptics and is commonly found the general popualtion.
          • This means that HLA cannot be the only explanation for the cause of narcolepsy.
    • Hypocretin
      • Play an important role in maintaining wakefulness
      • Lin et al - narcoleptic dogs had a mutation in a gene on chromosome 12 therefore disrupting the processing of hypocretin
      • Hypocretins are the most promising lead.
        • It was found human narcoleptics had lower levels of hypocretin.
          • This show that the evidence from dogs has been confirmed in humans and that hypocretins is a very strong link.


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