scholarly journals Life Effects of Narcolepsy in 180 Patients from North America, Asia and Europe Compared to Matched Controls

1981 ◽  
Vol 8 (4) ◽  
pp. 299-304 ◽  
Author(s):  
Roger Broughton ◽  
Quais Ghanem ◽  
Yasuo Hishikawa ◽  
Yoshiro Sugita ◽  
Sonia Nevsimalova ◽  
...  
Keyword(s):  
Memory Impairment ◽  
Disability Insurance ◽  
Sleep Paralysis ◽  
Daytime Drowsiness ◽  
Earning Capacity ◽  
Falling Asleep ◽  
Visual Problems ◽  
Home Accidents ◽  
Hypnagogic Hallucinations ◽  
European Populations

SUMMARY:A questionnaire survey has been made of the life effects of narcolepsy in 180 patients, 60 each from North American, Asian and European populations, with 180 similarly distributed age and sex matched controls. Life-effects were attributed by the patients to the primary symptoms of excessive daytime drowsiness, sleep attacks, cataplexy, vivid hypnagogic hallucinations and sleep paralysis, and also to other frequent symptoms such as visual problems (blurring, diplopia) and memory impairment. Occupational problems were prevalent (over 75%) and included statistically significant deleterious effects upon performance, promotion, earning capacity, fear of or actual job loss and increased disability insurance. Driving was greatly affected and patients fell asleep at the wheel more frequently (66%), had near or actual accidents from drowsiness or falling asleep at the wheel (67%), and could experience cataplexy (29%) or sleep paralysis (12%) while driving. Work or home accidents attributed to sleepiness or sleep (49%) or related to smoking (49%) were much more common in patients. There were also deleterious effects on education, recreation and personality related to the disease. Narcolepsy can produce a variety of life-effects probably more serious and pervasive than, for instance, those of epilepsy, therefore emphasizing the importance of early diagnosis and treatment.

scholarly journals Increased creative thinking in narcolepsy

Brain ◽  
2019 ◽  
Vol 142 (7) ◽  
pp. 1988-1999 ◽  
Author(s):  
Célia Lacaux ◽  
Charlotte Izabelle ◽  
Giulio Santantonio ◽  
Laure De Villèle ◽  
Johanna Frain ◽  
...  
Keyword(s):  
Eye Movement ◽  
Creative Thinking ◽  
Sleep Paralysis ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Behaviour Disorder ◽  
Lucid Dreaming ◽  
Sleep Behaviour ◽  
Falling Asleep ◽  
Hypnagogic Hallucinations

Abstract Some studies suggest a link between creativity and rapid eye movement sleep. Narcolepsy is characterized by falling asleep directly into rapid eye movement sleep, states of dissociated wakefulness and rapid eye movement sleep (cataplexy, hypnagogic hallucinations, sleep paralysis, rapid eye movement sleep behaviour disorder and lucid dreaming) and a high dream recall frequency. Lucid dreaming (the awareness of dreaming while dreaming) has been correlated with creativity. Given their life-long privileged access to rapid eye movement sleep and dreams, we hypothesized that subjects with narcolepsy may have developed high creative abilities. To test this assumption, 185 subjects with narcolepsy and 126 healthy controls were evaluated for their level of creativity with two questionnaires, the Test of Creative Profile and the Creativity Achievement Questionnaire. Creativity was also objectively tested in 30 controls and 30 subjects with narcolepsy using the Evaluation of Potential Creativity test battery, which measures divergent and convergent modes of creative thinking in the graphic and verbal domains, using concrete and abstract problems. Subjects with narcolepsy obtained higher scores than controls on the Test of Creative Profile (mean ± standard deviation: 58.9 ± 9.6 versus 55.1 ± 10, P = 0.001), in the three creative profiles (Innovative, Imaginative and Researcher) and on the Creative Achievement Questionnaire (10.4 ± 25.7 versus 6.4 ± 7.6, P = 0.047). They also performed better than controls on the objective test of creative performance (4.3 ± 1.5 versus 3.7 ± 1.4; P = 0.009). Most symptoms of narcolepsy (including sleepiness, hypnagogic hallucinations, sleep paralysis, lucid dreaming, and rapid eye movement sleep behaviour disorder, but not cataplexy) were associated with higher scores on the Test of Creative Profile. These results highlight a higher creative potential in subjects with narcolepsy and further support a role of rapid eye movement sleep in creativity.

Narcolepsy: Differential Diagnosis or Etiology in Some Cases of Bipolar Disorder and Schizophrenia?

CNS Spectrums ◽  
2003 ◽  
Vol 8 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Alan B. Douglass
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Psychiatric Patients ◽  
Human Leukocyte ◽  
Sleep Paralysis ◽  
Leukocyte Antigen ◽  
Psychotic Features ◽  
Hypnagogic Hallucinations ◽  
Rule Out

AbstractDoes narcolepsy, a neurological disease, need to be considered when diagnosing major mental illness? Clinicians have reported cases of narcolepsy with prominent hypnagogic hallucinations that were mistakenly diagnosed as schizophrenia. In some bipolar disorder patients with narcolepsy, the HH resulted in their receiving a more severe diagnosis (ie, bipolar disorder with psychotic features or schizoaffective disorder). The role of narcolepsy in psychiatric patients has remained obscure and problematic, and it may be more prevalent than commonly believed. Classical narcolepsy patients display the clinical “tetrad”—cataplexy, hypnagogic hallucinations, daytime sleep attacks, and sleep paralysis. Over 85% also display the human leukocyte antigen marker DQB10602 (subset of DQ6). Since 1998, discoveries in neuroanatomy and neurophysiology have greatly advanced the understanding of narcolepsy, which involves a nearly total loss of the recently discovered orexin/hypocretin (hypocretin) neurons of the hypothalamus, likely by an autoimmune mechanism. Hypocretin neurons normally supply excitatory signals to brainstem nuclei producing norepinephrine, serotonin, histamine, and dopamine, with resultant suppression of sleep. They also project to basal forebrain areas and cortex. A literature review regarding the differential diagnosis of narcolepsy, affective disorder, and schizophrenia is presented. Furthermore, it is now possible to rule out classical narcolepsy in difficult psychiatric cases. Surprisingly, psychotic patients with narcolepsy will likely require stimulants to fully recover. Many conventional antipsychotic drugs would worsen their symptoms and make them appear to become a “chronic psychotic,” while in fact they can now be properly diagnosed and treated.

Hypnagogic Hallucinations and Sleep Paralysis

Narcolepsy ◽  
2008 ◽  
pp. 87-97 ◽  
Author(s):  
Armando D’Agostino ◽  
Ivan Limosani
Keyword(s):  
Sleep Paralysis ◽  
Hypnagogic Hallucinations

Neurology and Sleep Research

1971 ◽  
Vol 16 (4) ◽  
pp. 283-293 ◽  
Author(s):  
Roger Broughton
Keyword(s):  
Sleep Deprivation ◽  
Rem Sleep ◽  
Epileptic Seizures ◽  
Sleep Paralysis ◽  
Sleep Research ◽  
Cerebrovascular Accidents ◽  
Therapeutic Relevance ◽  
New Knowledge ◽  
Neurological Conditions ◽  
Hypnagogic Hallucinations

This brief review documents some of the important contributions of recent sleep research to the understanding of a number of neurological conditions. Narcoleptic attacks have been shown to be either episodes of NREM or REM sleep; and cataplexy, sleep paralysis and vivid hypnagogic hallucinations consist of dissociated or inappropriate REM sleep. Important relationships of the hypersomnias and various comas to sleep mechanisms are being increasingly elucidated. Various types of epileptic seizures have been found to be affected differentially by the two types of sleep and by arousal from them; and sleep deprivation may activate or perpetuate epilepsy. Finally, some miscellaneous conditions, such as dyskinesias, cerebrovascular accidents, migraine, and memory and repair functions have been considered. As well as being of pathophysiological interest, much of this new knowledge has a direct diagnostic and therapeutic relevance.

scholarly journals What do we know about sleep paralysis?

2018 ◽  
Vol 19 (3) ◽  
pp. 174-184
Author(s):  
Paulina Wróbel-Knybel ◽  
Michał Flis ◽  
Rafał Dubiel ◽  
Hanna Karakuła-Juchnowicz
Keyword(s):  
Mental Disorders ◽  
Rem Sleep ◽  
Cultural Context ◽  
Somatic Symptoms ◽  
The Body ◽  
Somatic Complaints ◽  
Bibliographic Databases ◽  
Sleep Paralysis ◽  
Somatic Disorders ◽  
Hypnagogic Hallucinations

Summary Introduction: Sleep paralysis (SP) is a condition that widely occurs among people all over the world. It has been known for thousands of years and is rooted in the culture of many countries. It arouses strong emotions, though still little is known about it. The clinical picture of the disorder can be very diverse. It is often accompanied by hypnopompic and hypnagogic hallucinations, somatic complaints and the feeling of intense anxiety. A feeling of paralysis in the body with inhibited consciousness is always observed with the experience. SP pathophysiology is not fully understood, however, most theories explaining this phenomenon are based on the assumption that it results from dysfunctional overlap of REM sleep and wakefulness. It is experienced by healthy people, but it is more often associated with somatic and mental disorders, which is why it is becoming an object of interest for researchers. Aim: The aim of this work is to present the most important information about the disorder known as sleep paralysis - its history, cultural context, pathophysiology, prevalence, symptomatology, coexistence with other somatic and mental disorders as well as diagnostics and available forms of prevention and treatment. Materials and methodology: The available literature was reviewed using the Google Scholar bibliographic databases searching the following keywords: sleep paralysis, REM sleep parasomnias, sleep disorder, night terrors and time descriptors: 1980-2018. Results 1. Sleep paralysis has already been described in antiquity, and interpretations related to its occurrence are largely dependent on culture and beliefs. 2. Symptomatology of the disorder is very diverse: both mental and somatic symptoms are present. 3. The pathophysiology of the disorder has not been fully explained. The basis of most theories regarding sleep paralysis is the assumption that it results from the dysfunctional overlap of REM sleep and wakefulness. 4. The prevalence of SP at least once in a lifetime is 7.6% in the general population, although it is estimated that it is much more frequent in people with various mental and somatic disorders. 5. Treatment of SP is associated with a change in lifestyle and the use of pharmacotherapy and psychotherapy.

scholarly journals 43 Tinnitus as an Aura for Sleep Paralysis

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 199-199
Author(s):  
Luvleen Shergill ◽  
Jasir Nayati ◽  
Reshma Nair ◽  
Alan R. Hirsch
Keyword(s):  
Hearing Loss ◽  
Physical Examination ◽  
Screening Test ◽  
Sleep Paralysis ◽  
Motor Paralysis ◽  
Falling Asleep ◽  
History Of ◽  
Posterior Neck ◽  
Transient Paralysis ◽  
Motor Movements

AbstractObjectiveTo understand that tinnitus may be an aura for sleep paralysis.BackgroundSleep paralysis is a transient-paralysis which occurs during awakening or falling asleep (Wilson, 1928). Those affected experience symptoms including visual, auditory, and haptic hallucinations, voluntary motor paralysis with intact ocular and respiratory motor movements, and diffuse or localized paresthesias. Sleep paralysis associated with tinnitus as an aura, has not heretofore been described.MethodsA 34 year-old, right-handed female presented with a 13 year history of sleep paralysis. One month prior, she began to notice tinnitus prior to the onset of sleep paralysis. The tinnitus was bilateral, high-pitched, with a volume intensity of 5/10, lasting seven seconds prior to sleep initiation. She denied hearing loss, vertigo, dizziness, cataplexy, deja vu and jamais vu. After termination of tinnitus, she experienced paresthesia, “like at a dentist’s office” radiating from her posterior neck, to her tongue and down to her toes. She described seeing a white-shadowy male figure moving around her room, lasting seven seconds. Accompanied by a masculine “ahh” sound, lasting for three seconds. The sleep paralysis occurred after these events, lasting up to eight hours, or until her husband wakes her.ResultsAbnormalities in Physical Examination: General Examination: right arm hemangioma 4 by 5cm. Reflexes: absent bilateral brachioradialis, 1+ bilateral quadriceps femoris and bilateral Achilles tendon. Neuropsychiatric Examination: Calibrated Finger Rub Auditory Screening Test: faint 70 AU (normal).DiscussionTinnitus has been described as an aura for migraines (Schankin, 2014), temporal lobe epilepsy (TLE) (Florindo, 2006), and narcolepsy-cataplexy (Marco, 1978). These epochs may represent amigranous migraines, which initially present with tinnitus that occurs both during the day and night, forcing the patient to be partially awoken at night with induction of the sleep paralysis sequence. It would be worthwhile to query those with narcolepsy or sleep paralysis if tinnitus precedes the event.

scholarly journals HLA and sleep parameter associations in post-H1N1 narcolepsy type 1 patients and first-degree relatives

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Hilde T Juvodden ◽  
Marte K Viken ◽  
Sebjørg E H Nordstrand ◽  
Rannveig Viste ◽  
Lars T Westlye ◽  
...  
Keyword(s):  
Human Leukocyte ◽  
Sleep Paralysis ◽  
Protective Effects ◽  
Hla Alleles ◽  
Leukocyte Antigen ◽  
First Degree Relatives ◽  
Sleep Parameters ◽  
Similar Disease ◽  
Hypnagogic Hallucinations

Abstract Study Objectives To explore HLA (human leukocyte antigen) in post-H1N1 narcolepsy type 1 patients (NT1), first-degree relatives and healthy controls, and assess HLA associations with clinical and sleep parameters in patients and first-degree relatives. Methods Ninety post-H1N1 NT1 patients and 202 of their first-degree relatives were HLA-genotyped (next generation sequencing) and phenotyped (semistructured interviews, Stanford Sleep Questionnaire, polysomnography, and multiple sleep latency test). HLA allele distributions were compared between DQB1*06:02-heterozygous individuals (77 patients, 59 parents, 1230 controls). A subsample (74 patients, 114 relatives) was investigated for associations between HLA-loci and continuous sleep variables using logistic regression. Identified candidate HLA-loci were explored for HLA allele associations with hypnagogic hallucinations and sleep paralysis in 90 patients, and patient allele findings were checked for similar associations in 202 relatives. Results DQB1*06:02 heterozygous post-H1N1 NT1 patients (84.4% H1N1-vaccinated) showed several significant HLA associations similar to those reported previously in samples of mainly sporadic NT1, i.e. DQB1*03:01, DRB1*04:01, DRB1*04:02, DRB1*04:07, DRB1*11:04, A*25:01, B*35:03, and B*51:01, and novel associations, i.e. B*14:02, C*01:02, and C*07:01. Parents HLA alleles did not deviate significantly from controls. The HLA-C locus was associated with sleep parameters in patients and relatives. In patients C*02:02 seems to be associated with protective effects against sleep paralysis and hypnagogic hallucinations. Conclusions Our findings of similar risk/protective HLA-alleles in post-H1N1 as in previous studies of mainly sporadic narcolepsy support similar disease mechanisms. We also report novel allelic associations. Associations between HLA-C and sleep parameters were seen independent of NT1 diagnosis, supporting involvement of HLA-C in sleep subphenotypes.

scholarly journals Nightmare Disorder and Isolated Sleep Paralysis

2020 ◽  
Author(s):  
Ambra Stefani ◽  
Birgit Högl
Keyword(s):  
Stress Disorder ◽  
Fear Of Falling ◽  
Sleep Paralysis ◽  
Brain Areas ◽  
Imagery Rehearsal Therapy ◽  
Falling Asleep ◽  
Rem Atonia ◽  
Nightmare Disorder ◽  
Isolated Sleep Paralysis ◽  
Dissociated State

AbstractNightmare disorder and recurrent isolated sleep paralysis are rapid eye movement (REM) parasomnias that cause significant distress to those who suffer from them. Nightmare disorder can cause insomnia due to fear of falling asleep through dread of nightmare occurrence. Hyperarousal and impaired fear extinction are involved in nightmare generation, as well as brain areas involved in emotion regulation. Nightmare disorder is particularly frequent in psychiatric disorders and posttraumatic stress disorder. Nonmedication treatment, in particular imagery rehearsal therapy, is especially effective. Isolated sleep paralysis is experienced at least once by up to 40% of the general population, whereas recurrence is less frequent. Isolated sleep paralysis can be accompanied by very intense and vivid hallucinations. Sleep paralysis represents a dissociated state, with persistence of REM atonia into wakefulness. Variations in circadian rhythm genes might be involved in their pathogenesis. Predisposing factors include sleep deprivation, irregular sleep–wake schedules, and jetlag. The most effective therapy consists of avoiding those factors.

Treatment of narcolepsy: A rare disease of unknown etiology

2021 ◽  
Vol 19 ◽  
Author(s):  
Joaquín M. Campos ◽  
Claudia Molina
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Neurological Disease ◽  
Short Review ◽  
European Population ◽  
Sodium Oxybate ◽  
Unknown Etiology ◽  
Sleep Paralysis ◽  
Main Symptom ◽  
Diagnostic Difficulties ◽  
Hypnagogic Hallucinations

Background: Narcolepsy, also known as Gélineau syndrome, is a chronic and neurological disease that affects 0.05% of the European population, though that percentage could be higher due to the diagnostic difficulties. The main symptom is excessive daytime sleepiness, although it may be accompanied by cataplexy, sleep paralysis and hypnagogic hallucinations. Objective: Nowadays, there is no cure for narcolepsy and the treatment is symptomatic: psychostimulants for the sleepiness by means of amphetamines, methylphenidate or modafinil, and antidepressants and sodium oxybate for treating cataplexy. Method: This is a short review regarding pharmacotherapy for narcolepsy. Result: Hypocretins were discovered in 1998. They are neuropeptides whose deficit is responsible for this symptomatology, has opened up a new field of investigation. Conclusion: Agonists of hypocretins could be a promising therapy against this disease.

Hallucinations and sleep

2014 ◽  
Vol 29 (S3) ◽  
pp. 584-584 ◽  
Author(s):  
M.-F. Vecchierini
Keyword(s):  
Cognitive Impairment ◽  
Healthy Subjects ◽  
Epidemiological Studies ◽  
Sleep Paralysis ◽  
Visual Hallucinations ◽  
Secondary Symptom ◽  
Behavioural Symptoms ◽  
Long Duration ◽  
High Prevalence ◽  
Hypnagogic Hallucinations

Few epidemiological studies have explored hallucinations’ prevalence and types in the general population. Ohayon et al. [1] have emphasized the high prevalence of hypnagogic and/or hypnopompic hallucinations present respectively in 37 and 12.5% of the 4972 subjects. The rate of hypnagogic hallucinations was related to age. Women were more likely to report such hallucinations. The most frequent type of hallucinations was unexpected, that is kinesthesic (feeling of falling in an abyss) but all types of hallucinations could be present. These hallucinations had no relationship to a specific pathology in more than 50% of the cases but were exclusively present at nighttime. In old age, visual hallucinations are the most frequent. In a cohort of old non-demented subjects, 17.4% of them had hallucinations and behavioural symptoms (anxious agitation or/and irritability).Several neurological pathologies included sleep disorders and hallucinations. Narcolepsy and Parkinson disease (P.D.) will be only considered here. In narcolepsy, with or without cataplexy, hallucinations are now called “secondary” symptom, as they are incidental, reported in 35 to 66% of the patients.Hypnagogic and hypnopompic hallucinations are most often visual but all types have been described, formed, without whole scenes but terrifying the patient who is often implicated in it and sometimes associated with sleep paralysis, especially during daytime when sleep occurs in REM. Are they pieces of dream? These hallucinations can be differentiated on a phenomenological basis from hallucinations in healthy subjects and from hallucinations in schizophrenia [2]. They have also some differences with hallucinations observed in P.D. [3].In P.D. hallucinations affected 25% of the patients in long duration disease. They are mainly visual, or with sensation of a presence (person or animal), coexisting with delusions and anxiety. They are rarely only a side- effect of dopaminergic treatment but are often linked to daytime sleepiness with REM sleep attacks, described in this disease and to cognitive impairment.

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