Explanations of Other Sleep Disorders

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Explanations of Narcolepsy

  • Psychological Explanations
  • Very early approach said that narcolepsy disguised sexual fantasies
  • REM
  • Classic symptons of narcolepsy is cataplexy. Similary to what happens in REM sleep.
  • During daytime, narcolepsy often experience intrusions of REM type sleep.
  • At night, narcoleptics have abnormal REM sleep.
  • Malfunction in the system that regulates REM sleep.
  • HLA
  • In 1980s, narcolepsy was linked to a mutation of the immune system.
  • Increased frequency of on type of HLA was found in narcoleptic patients.
  • HLA molecules found on the surface of WBC and coordinate immune response.
  • More than 90% of people suffering from narcolepsy with cataplexy found to have the HLA variety.
  • Hypocretin
  • Research has uncovered a link between hypocretin and narcolepsy.
  • Hypocretin regulates sleep and wakefulness through interactions with systems that regulate emotion and homeostatis in the hypothalamus.
  • There are about 10,000 to 20,000 hypocretin producing cells in the hypothalamus.
  • In many narcoleptics a large number of these cells are missing, resulting in low levels of hypocretin.

Evaluation

  • REM
  • REM explanation supported by vogel who observed REM sleep at the onset of sleep in a narcoleptic patient.
  • More commonly occurs later in the first cycle of sleep stages.
  • Further supported by recordings of neuron activity in the brainstem of narcoleptic dogs.
  • Cataplexy co-occured with brain cell activity which only occurs in REM sleep.
  • HLA
  • Specific HLA variant is not found in all narcoleptics; reasonably common in general population
  • Hypocretin
  • Evidence of Lower Levels
  • First evidence for hypocretins came from narcoleptic dogs who were found to have a mutation in a gene on chromosone 12.

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