Recently, there is increasing evidence that sleep dysfunction is intimately related to the development of attention deficit hyperactivity disorder (ADHD). Historically, there has even been the suggestion for various overlap syndromes, such as Syndrome Z and Primary Disorder of Vigilance, which were defined by a combination of narcolepsy and ADHD symptoms. Many clinicians perceive ADHD to be the antithesis of narcolepsy however, there is a significant clinical similarity. Attention Deficit Hyperactivity DisorderĪttention deficit hyperactivity disorder (ADHD) is characterized by symptoms of inattention, impulsivity and hyperactivity. Additionally, regular assessment for co-occurring psychiatric disorders in narcolepsy patients may also improve quality of life and functionality.Ģ. Consideration of narcolepsy as a part of the differential diagnosis for psychiatric disease may reduce time to diagnosis. Improved familiarity with psychiatric illnesses that may share similar features to narcolepsy or may be comorbid ( Figure 1) may improve therapeutic outcomes. It has been suggested that psychiatric symptoms are either a result of the chronic disabling nature of the disease or it may represent a “shared pathophysiology” or a combination of both. The underpinnings of the development of psychiatric symptoms, however, remain unclear. Narcolepsy has long been described to have a high co-morbidity for psychiatric disease, which is frequently quoted as the cause for delay in diagnosis. It is estimated to affect about 1 in 2000 individuals and frequently can take as long as 8–10 year to be accurately diagnosed. Alternatively, it may be diagnosed by evaluating cerebrospinal fluid (CSF) hypocretin (HRT), which is found to be low in narcolepsy type 1. SOREMPs are the presence of REM sleep within 15 minutes of sleep onset, as opposed to the typical cycle taking about 90–120 min. Instability in the transition between wakefulness and rapid eye movement (REM) sleep causes these symptoms.ĭiagnosis is generally made based on the presence of EDS and findings of an average sleep latency of ≤8 and the presence of two or more sleep onset REM periods (SOREMPs) on sleep testing. Narcolepsy is a disabling neurodegenerative condition that is characterized by the pentad features of excessive daytime sleepiness (EDS), sleep fragmentation, sleep related hallucinations, sleep paralysis, and cataplexy brief episodes of loss of tone frequently provoked by strong emotions. Further research is necessary to better understand the underlying pathophysiology between psychiatric disease and narcolepsy. Comprehensive care for patients with narcolepsy should include surveillance for psychiatric illness and appropriate treatment when necessary. The overlap in pharmaceutical intervention may further enhance the difficulty to distinguish between diagnoses. Inversely, the development of psychiatric symptoms can lead to the deterioration in function and quality of life. Deterioration in function may lead to the secondary development of psychiatric symptoms. Narcolepsy is a disabling neurodegenerative condition that carries a high risk for development of social and occupational dysfunction. However, narcolepsy is frequently misdiagnosed initially as a psychiatric condition, contributing to the protracted time to accurate diagnosis and treatment. It is not uncommon for the two to occur co-morbidly. Narcolepsy and psychiatric disorders have a significant but unrecognized relationship, which is an area of evolving interest, but unfortunately, the association is poorly understood.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |