Between 10 percent and 24 percent of those with type 2 narcolepsy have low hypocretin levels, compared to 90 percent of those with type 1. Unlike type 1 narcolepsy, hypocretin levels in people with type 2 tend to be normal. The precise reason why people develop type 2 narcolepsy remains unknown. However, in some cases, people with type 2 develop cataplexy and thus transition to type 1. What sets them apart is the lack of cataplexy. People with type 2 can experience excessive daytime sleepiness, sleep attacks, sleep paralysis, disrupted nighttime sleep, and hallucinations. The symptoms of type 2 narcolepsy are similar to those of type 1. One estimate suggests that type 2 narcolepsy accounts for 36 percent of people with narcolepsy. Type 2 narcolepsy is rare and there is limited information on its prevalence. Type 2 narcolepsy is also referred to as narcolepsy without cataplexy. Learn more about the diagnosis of narcolepsy. Cataplexy and a positive multiple sleep latency test (MSLT) - a sleep study which measures how quickly a person falls asleep and if they enter REM sleep.They must also have one of two additional sets of criteria: To receive an official diagnosis of type 1 narcolepsy, a person must exhibit excessive daytime sleepiness for at least three months that cannot be explained by another health condition or medication/substance use. A provider will also consider the possibility of other health or psychiatric conditions or substance use that could impact sleep patterns. A health care provider may consider the possibility of other sleep disorders like idiopathic hypersomnia (excessive sleepiness), insufficient sleep syndrome (chronic sleep deprivation), or obstructive sleep apnea (disordered breathing during sleep). The diagnostic process involves differential diagnosis - ruling out other health conditions that may cause similar symptoms. Diagnosing Type 1 Narcolepsyĭiagnosing narcolepsy of any type can be challenging, and many people experience several years’ delay between the onset of symptoms and a diagnosis. Learn more about the causes of narcolepsy. Genetic factors are also involved in type 1 narcolepsy. Low levels of hypocretin may be related to an autoimmune process, where the body’s immune system mistakenly attacks the nerve cells in the brain that produce hypocretin. Approximately 90 percent of people with type 1 narcolepsy have low or undetectable hypocretin levels. Hypocretin helps the body regulate sleep. Low levels of a brain chemical called hypocretin (sometimes called orexin) contribute to the development of type 1 narcolepsy. ![]() Learn more about cataplexy in Symptoms of Narcolepsy. People with type 1 narcolepsy may rarely have cataplexy episodes or have multiple episodes each day. A person may experience a momentary drooping of their eyelids or a complete inability to move or speak. Cataplexy, the sudden loss of muscle tone, is usually triggered by strong emotions like anger, stress, or excitement. The presence of cataplexy is the primary differentiator between type 1 and type 2 narcolepsy. Cataplexy - Sudden period of muscle weakness.Hallucinations - Usually occur when waking (hypnopompic hallucinations) but sometimes when falling asleep (hypnagogic hallucinations).Sleep paralysis - Inability to move the limbs or speak, usually upon waking.Symptoms of Type 1 NarcolepsyĬommon symptoms of type 1 narcolepsy include: ![]() Narcolepsy with cataplexy is believed to impact between 25 and 100 of every 100,000 people. Type 1 narcolepsy is also called narcolepsy with cataplexy. Rarely, people can develop secondary narcolepsy as the result of an injury. The terminology used to describe types of narcolepsy changed in 2014 with the publication of the third edition of The International Classification of Sleep Disorders. There are two main types of narcolepsy - type 1, or narcolepsy with cataplexy, and type 2, or narcolepsy without cataplexy. Narcolepsy impacts men and women equally. Some researchers have identified peak times for development of narcolepsy around ages 15 and 36. Symptoms of narcolepsy can appear at any age, but usually manifest before age 50. Narcolepsy is a rare condition - an estimated 135,000 to 200,000 Americans have narcolepsy. For example, the muscle limpness that normally only occurs during REM sleep can occur suddenly when a person is awake. However, in people with narcolepsy the states of being asleep and being awake blur together. For people without narcolepsy, REM sleep, NREM sleep, and wakefulness are separate states.
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