Talk:Narcolepsy

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Causes
This section can be edited to flow better: some of the studies discussed are duplicates, ect. I am in the process of doing this. Additionally, I would like to propose that we include a link-out somewhere in this section to the "Autoimmune disease" page of Wikipedia. RichLee72 (talk) 18:06, 12 November 2013 (UTC)

The best source for a correct and updated text about what causes narcolepsy (as far as we know) is Stanford's Center for narcolepsy, lead by Dr. Mignot.Matthartig (talk) 08:13, 15 April 2014 (UTC)

It is known now, through the work of Emanual Mignot that Narcolepsy Type 1 is caused by lacking Hypocretin (OREXIN).

It is also known that this is mostly triggered by the flu only in people who posses a specific DNA mutation. Or by a flu vaccine. The antibody's mistake OREXIN neurotransmitters for the Flu virus (or vaccine) cells, due to its similar composition.

Narcolepsy Type 2 is essentially unexplained daytime sleepiness and symptoms similar to type 1 narcolepsy. Type 2 doesn't have Cataplexy as a main symptom as Cataplexy is a distinguishing feature of lacking OREXIN.

It is likely there is a spectrum of Narcolepsy based on OREXIN count, so much of Type 2 cases could be caused by SOME Orexin missing. Need to the seek proper sources for this info and edit main page. Most of this comes from Emanual Mignot and his discovery's. FishbrainLTD (talk) 23:38, 4 December 2022 (UTC)

Introduction
"and possibly falls asleep at inappropriate times, such as while at work, school, or when talking to your partner" That does not sound right, especially the last part. 189.175.19.50 (talk) 04:54, 31 August 2010 (UTC)
 * You are correct. It sounds awful, especially because it refers to the second person. I reverted the edit which created that last phrase. Thank you for alerting me to that. --Tea with toast (talk) 00:25, 1 September 2010 (UTC)

Very recent new study: A registry based comparative cohort study in four Swedish counties of the risk for narcolepsy after vaccination with Pandemrix - A first and preliminary report, by the Medical Products Agency.

''The incidence of narcolepsy in vaccinated children born from 1990 and later was 4.06 cases per 100,000 person years, compared with an incidence of 0.97 cases per 100,000 person years in unvaccinated, yielding a relative risk of 4.19 (95% CI: 1.76-12.1). No corresponding increase in risk was seen in adults. The median latency from vaccination to diagnosis of narcolepsy was 8 months'' http://www.lakemedelsverket.se/upload/nyheter/2011/PandemrixRegReport110328.pdf 212.85.89.247 (talk) 19:36, 29 March 2011 (UTC)

This whole section is obsolete, worst part being: "Narcolepsy is a neurological sleep disorder." No, it is not a sleep disorder. Narcolepsy with cataplexy is an autoimmune disease, resulting in the loss of a neuropeptid called orexin or hypocretin. The symptoms are not only sleep-related, since orexin/hypocretin is also involved in metabolism, memory, processing emotions, etc. This article should focus on the orexin/hypocretin system, since narcolepsy is the lack of production or signaling of this neurotransmitter.Matthartig (talk) 08:26, 15 April 2014 (UTC)

Orexin (talk) 19:21, 5 July 2020 (UTC) That is is ridiculously it is a sleep disorder because it effects your waking and sleeping states due to the lack of restorative sleep hypothesis or some mechanisms of the oxreinergic system failing to regulate the whole process properly. There is a reason why at Lecister University Hospital in England, UK. Narcolepsy department is located in the sleep disorders. The pathogenesis of narcolepsy is a "hit and run autoimmunity" attack ie. one time killing of at least 50%+ of Oxrein Neurons (usually 90%). It is not a persistent autoimmune disease of the brain as that would result in brain inflammation all the time in that area, which is not the case. Don't confuse the pathogenesis with the pathophysiology that comes from that afterwards.

Portrayal of narcolepsy in pop culture
Because of excessive edits to the Narcolepsy article adding any and all pop culture references of narcolepsy (and because of frequent topics on this talk page discussing which ones to keep or remove). I propose that the we establish guidelines for what should and should not be included.

I believe that the purpose of the section is to show the perception of narcolepsy by society and how its portrayal in media may help or hinder the understanding of the disorder. The section should not be a bare list of items, but rather a discussion that uses pop culture items as examples. Any item included in the text should discuss the sociological implicaions and be supported by reliable references. It is worth noting the excessive amount of comedy that makes fun of the disorder in a negative way, but examples should be limited, and there should be inclusion of those items that offer real understanding of the disorder (the fictional book "The Little Sleep" listed in the article may be a good example of this).

In summary, the "pop culture" section should be a discussion of what pop culture items suggest about the social understanding of narcolepsy and not a list of every tv show and song that makes reference to narcolepsy. Any stand-alone items that give mention to narcolepsy should be removed. However, some items may warrant inclution if a reasonable argument can be made for it. --Tea with toast (talk) 19:28, 12 September 2009 (UTC)


 * That is a very sensible suggestion. -- Derek Ross | Talk'' 06:04, 13 September 2009 (UTC)


 * I definately think the character portrayal from Gus Van Sant's "My Own Private Idaho" should be referenced.  Mainly due to the way the characters cataplexic hallucinations are depicted.  His having narcoleptic attacks links the film together, and without making fun of the condition.  It shows how he works through life with it and really communicates the confusion of the disorder to the viewer i think.  Lastly, it was released in 1991- when narcolepsy was extremely under exposed and alien to mass society and, although not a mainstream film, the character was portrayed by a very popular actor of the time- River Phoenix.

Indeed! Gus Van Sant's "My Own Private Idaho should definitely be referenced! It portrays Narcolepsy in a relevant and accurate way instead of just making fun of the disorder. I actually was diagnosed shortly after that film came out (after having it for 5 years!!) No one had heard of it back then. The fact that Narcolepsy is still widely misunderstood is highlighted even more by it's exaggerated stereotypes depicted in pop culture, and so I concur, the "pop culture" section should be about how it reflects the lack of social understanding of Narcolepsy. I would also like to suggest this book link. Narcolepsy: A Funny Disorder That's No Laughing Matter - by Marguerite Jones Utley I don't really fancy trying to do an edit myself just yet though as I am a total newbie here and will probably just screw it up and get flagged for vandalising or something so i would really appreciate any help from more experienced users! I have a few more comments and suggestions for this article also but I guess I will come back again soon with the rest ;) Thanks (Hooma (talk) 04:53, 16 November 2009 (UTC))

λῆψις transliteration
My Greek is a little rough, but I'm pretty sure λῆψις is transliterated lēpsis, not leptos. 67.190.234.202 (talk) 04:36, 8 June 2010 (UTC)
 * Ah. You're right. Fixed now. -- Derek Ross | Talk'' 17:04, 8 June 2010 (UTC)

Famous people with narcolepsy
I reverted an edit by an IP for Doug Hadlock as a famous person with narcolepsy. It was not cited, nor was the person famous.

I've noticed a lot of IP's making changes to the "Famous People with Narcolepsy" section, few of the entries are sourced and at least one of the citations is not up to standard. Would someone go through these and find firmer evidence supporting these claims? Or at least take them down if they are unverifiable? Fickce4 (talk) 20:05, 26 September 2010 (UTC)
 * It's mentioned in Kimmel's article with two sources, so I've kept his entry. The others were not verified by reliable sources, so I've removed them. --Ronz (talk) 21:00, 26 September 2010 (UTC)


 * Thanks! I hadn't seen the mention in Kimmel's article. Fickce4 (talk) 22:08, 26 September 2010 (UTC)

Vandalism
You guys are doing an amazing job reverting vandalism. I was wondering if there is any way for the article to be protected from IP edits, etc. Fickce4 (talk) 11:27, 5 October 2010 (UTC)
 * It is possible to do semi-protection which will close the page to IP edits. However we don't generally do that unless things are bad since we are "the encyclopedia that anyone can edit" and we like to live up to that ideal as much as we can. Even if it does mean that we have to keep on reverting a lot of stupid stuff. Not all IP edits are vandalism and we try not to penalise the "good" IPs just because there are a lot of "bad" IPs about. -- Derek Ross | Talk'' 15:59, 5 October 2010 (UTC)

Not surprised you're seeing vandalism, since someone is pushing a novaxer connection to H1N1 vaccines, using a single specious cite of 1 non-peer reviewed Swedish article. If you want to work alongside editors who push stupid novax agendas on the basis of a single unsubstantiated Swedish medical review with no actual associated double-blinded, peer-reviewed publications of actual studies (not reviews), you should probably expect some vandalism from people who believe in science as more than just a tool for attacking itself. — Preceding unsigned comment added by 108.28.183.176 (talk) 09:55, 18 May 2021 (UTC)

Citation Needed
"When a narcoleptic falls asleep they generally experience the REM stage of sleep within 10 minutes; whereas most people do not experience REM sleep until after 90 minutes" Added a "Citation Needed" tag as there is no proof on whether people with narcolepsy actually experience REM within 10 minutes of falling asleep in this article. Coolgyman (talk) 17:21, 9 September 2011 (UTC)
 * It's one of the standard tests. Normally carried out by hooking the subject up to an EEG machine and graphing their brainwaves while they have a nap. However I'm fairly sure that someone who is sleep-deprived would go into REM sleep pretty fast even if they weren't narcoleptic. So the test is indicative but not conclusive. -- Derek Ross &#124; Talk'' 18:53, 21 February 2013 (UTC)

"A rare subset of narcoleptics also experience heightened senses of taste and smell supertaster, phenomenon." This needs a citation (I couldn't find one to add). Clicking the "[20]" leads one in circles. As a narcoleptic supertaster, I'd love to see a source for this! Asnively (talk) 00:21, 11 December 2013 (UTC)

Merge?
I merged List of People With Narcolepsy and Narcolepsy for I thought it was the correct thing to do. I quoted the original List of People With Narcolepsy article and added an external link. — Preceding unsigned comment added by GKWPI12 (talk • contribs) 04:53, 29 December 2011 (UTC)

It was a bit silly that there were two lists of people with narcolepsy in two separate articles. I've decided to leave the List of people with narcolepsy article as it is (no-one deleted it), and remove the lists from this article. The same idea can be seen in the Epilepsy article. --Danjewell (talk) 18:31, 31 December 2011 (UTC)

Image
An image (File:Even_at_work_someone_with_narcolepsy_falls_asleep_in_the_middle_of_a_shift_2013-11-13_16-35.jpg) was added at the top of the article with caption "Even at work someone with narcolepsy falls asleep in the middle of a shift". The issue was raised at WT:MED. I removed the image because it shows an identifiable person but there is no source to verify the condition of the person or the accuracy of the caption. There is no verification that the person is asleep or that they have narcolepsy. I have removed the image after it was re-added and invite discussion here. Johnuniq (talk) 05:13, 14 November 2013 (UTC)
 * Agreed, of course, per the discussion at WP:MED. Flyer22 (talk) 07:56, 14 November 2013 (UTC)

New identification as autoimmune disease
Hello; According to this article, narcolepsy has been re-identified as an auto-immune disease.

Can a medical bod look over this and confirm/update the article accordingly? Cheers — Preceding unsigned comment added by VanillaSeagull (talk • contribs) 21:06, 3 January 2014 (UTC)

INDEED. This article is obsolete, it has been for a long time and it needs a real makeover asap. No serious patient association recommends it, as it is a serious blow to the awareness programs.Matthartig (talk) 08:08, 15 April 2014 (UTC)

Is it possible we need to reconsider this? The paper (there seems to be just the one) responsible for the confirmation was retracted about six months ago, I can't find any new research to support the conclusion. Darryl from Mars (talk) 21:22, 22 January 2015 (UTC)

I think again, we must not confuse pathogenesis with the pathophysiology that comes afterwards. Narcolepsy usually stabilize symptomatically at a certain level, it can get worse or better but generally it remains the same after the one-time autoimmune attack. There should really be two sections one on pathogenesis and one on pathophysiology. To avoid this confusion. It's pathophysiology is a neurological sleep disorder due to lack of oxrein production via the Neurons being destroyed in a one-time autoimmune attack (pathogenesis). Sleep disorders because a the oxreinergic system is a central system in regulation of waking and sleeping states. Orexin (talk) 20:27, 5 July 2020 (UTC)

Pathophysiology
10.1016/S1474-4422(14)70218-2 Lancet Neurology JFW &#124; T@lk  12:37, 17 February 2015 (UTC)

A history of diet?
From the article: " Low levels of hypocretin have been correlated with a past history of infection, diet, contact with toxins such as pesticides, and brain injuries due to brain tumors or strokes.[16]" A past history of diet? Don't most living people have a history of eating food?IAmNitpicking (talk) 20:49, 2 November 2015 (UTC)

NEJM review
10.1056/NEJMra1500587 - this week. JFW &#124; T@lk  09:20, 31 December 2015 (UTC)

Outdated
The following was left in the article in this dif:

Very dated info found below. Dsm diagnosis has been updated and isn't reflected here. Hypocretin is actually included in the algorithm for diagnosis currently.

-- Jytdog (talk) 23:00, 25 June 2016 (UTC)

Causes of Narcolepsy, including, 'not getting enough sleep'.
'Not getting enough sleep'? 'Not getting enough sleep' should have a Wiki page all of its own. :D Just for chat, like. At 2am, I am in a narcoleptic fit. 'Staying up late' ingrained as a treat from childhood is a voyage into the unknown. Especially if you're taking alcohol, or some less harmful drug, such as ... pretty much any you'd care to name. The sense of adventure is quite primal. The later it gets, the more likely are random unexpected events. These are mostly in the mental sphere, but occasionally escape into real life. I guess this is more like Chat than Talk, but do we have any ideas? Thanks for your response. :) 81.97.126.187 (talk) 01:20, 10 September 2016 (UTC)

Genetics
This is about genetics and therefore belongs in that section

"The primary genetic factor that has been strongly implicated in the development of narcolepsy is involves an area of chromosome 6 known as the human leukocyte antigen (HLA) complex.[12][13] Specific variations in HLA genes are strongly correlated with the presence of narcolepsy;[12] however, these variations are not required for the condition to occur and sometimes occur in individuals without narcolepsy.[12][14] These genetic variations in the HLA complex are thought to increase the risk of an auto-immune response to orexin-releasing neurons in the lateral hypothalamus."

Doc James (talk · contribs · email) 00:49, 19 January 2017 (UTC)

SpinozaUSA (talk) 17:59, 22 January 2020 (UTC) "Rodents are genetically engineered to lack orexin." What does this mean? A rodent strain has been bred to lack the Orexin gene? Or that rodents naturally don't make Orexin?


 * From the original article: "Mice that were genetically engineered to lack orexin were observed to have abrupt transient episodes of behavioral arrest during the dark (active) phase." --Kupur (talk) 23:09, 1 May 2020 (UTC)

From my reading most of the papers have some kind of method which just makes them lack Oxrein production via mimicking killing the neurons off in the first few weeks. Rather than lacking the Oxrein gene. As the pathogenesis usually lies in an attack on the neurons producing the polypeptide. Orexin (talk) 20:10, 5 July 2020 (UTC)

Frequency
"Estimates of frequency vary from 0.2 to 600 per 100,000 people being affected. "

Ref supports... Doc James (talk · contribs · email) 05:09, 15 February 2020 (UTC)
 * The ref might support it, but that's still not a useful figure. To give an idea, that would be equivalent to saying that "Each year in the United States, between 200 and 600,000 Americans die from Cause X." 200 would be unfortunate, while 600,000 is approaching an emergency. That's not in any way a useful figure; it spans multiple orders of magnitude. At that point, we're better off, and more accurate, to say the frequency is simply unknown. If it were, for example, "between 1 and 5 Americans per 100,000", that would be a narrow enough range to at least give an idea of frequency, but there is a vast difference between 0.2 in 100k and 600 in 100k. Seraphimblade Talk to me 16:39, 15 February 2020 (UTC)
 * It represents the current state of understand of the topic in question, which is obviously poor. We see this level of low precision in a lot of areas.
 * So yes this might affect 2 per million or it might affect 6 per 1000. Doc James  (talk · contribs · email) 17:36, 18 February 2020 (UTC)
 * Our goal is simple to reflect the best avaliable source.
 * The source is good https://books.google.ca/books?id=j4F-CwAAQBAJ&pg=PA39#v=onepage&q&f=false
 * Source says "As with many rare diseases, prevalence varies depending on the study methods and population, ranging from 0.2 per 100,000 people in Israel to 590 per 100,000 people in Japan"
 * Doc James (talk · contribs · email) 17:41, 18 February 2020 (UTC)
 * , I think that's useful context, but it's missing when just presenting it as a factoid in the lead and/or infobox. What would you think about presenting it in the body, with that context present so that it makes sense? Seraphimblade Talk to me 23:37, 18 February 2020 (UTC)
 * User:Seraphimblade We could adjust the lead to say "Estimates of frequency range from 0.2 to 600 per 100,000 people in various countries." Doc James  (talk · contribs · email) 01:07, 19 February 2020 (UTC)
 * I'm good with that, so long as there's then elaboration in the body as to why those figures might diverge so far. (Is it really far less common in Japan than Israel, and if so why, or do Japanese researchers and health authorities count something as a confirmed case very differently than Israeli researchers and authorities do?) Or does no one yet know why it's so different? As long as some explanation is offered, I can see it as useful information, but it certainly would require some explanation. Seraphimblade Talk to me 01:13, 19 February 2020 (UTC)
 * Okay added User:Seraphimblade Doc James  (talk · contribs · email) 01:25, 19 February 2020 (UTC)

REQUEST TO REMOVE .2 BASED ON THE FOLLOWING — Preceding unsigned comment added by 72.207.53.131 (talk) 02:54, 14 December 2020 (UTC) The .2 is not at all a useful statistic, it is misleading and not even necessarily true. Israel is a very small country and a single study identified their rate as ".2". This is no way represents a world view in any sense and is completely misleading to almost anyone wanting to learn about narcolepsy.

Apart from it being misleading to readers. It is almost certainly not even true 0.2 in Israel. This is what we call an outlier, and it is an outlier so extreme and beyond any other reasonable explanation (places with similar populations exhibit rates magnitudes higher) that it should be discarded, especially since the purpose of an article is to inform (not debate) and because it came from a single study.

As the other commenter noted, this is a "factoid", but it's not even that because the fact is a single study said it in light of countless studies suggesting otherwise.

Should be removed, it's just silly that it's included.

Factual Inaccuracy Tag (March 2020)
Added the factual inaccuracy tag to the classification section for the incorrect information that there are four types of narcolepsy. There are two types: type 1 (with cataplexy) and type 2 (without cataplexy). There is also idiopathic hypersomnia, which has its own page. Much of this section seems to be conflating and confusing these conditions and their classifications, and the second paragraph seems to have been copied/pasted. The source cited for the four types statement is old (2007) and a quick search didn't show other sources making this claim, outdated or not.

Cleanup and clarification needed, with the addition of current sources. — Preceding unsigned comment added by 2600:1700:B6C9:0:F1D8:A3:80D:9B83 (talk) 17:28, 23 March 2020 (UTC)


 * Will cleanup. ICSD-3 and DSM-5 identify 2 types of narcolepsy. ICD-11 has type 1 and type 2, as well as unspecified. 	--Kupur (talk) 23:17, 1 May 2020 (UTC)

I am pretty sure the "About 70% of those affected also experience episodes of sudden loss of muscle strength, known as cataplexy.[1]" isn't quite right, and I can't find it in ref 1. A better source suggests 20% type 1: https://pubmed.ncbi.nlm.nih.gov/31004158/ — Preceding unsigned comment added by 190.97.114.134 (talk) 23:42, 28 July 2020 (UTC)

Changes required to the /Treatment/Behavioral section
The entire /Treatment/Behavioral section is quite poorly written. 2600:1700:6AE5:2510:0:0:0:46 (talk) 22:14, 6 October 2022 (UTC)

How about adding that sodium oxybate reduces REM sleep and increases deep sleep? — Preceding unsigned comment added by 2001:569:7D73:9B00:39F8:39F9:B45B:ADD7 (talk) 01:20, 21 December 2022 (UTC)

a hypersomnia pathological hypothesis
In view of idiopathic hypersomnia, atypical depression, type 2 narcolepsy whose pathology is unknown in scientific research so far, a hypersomnia pathological hypothesis is that the small blood vessels next to the arousal control nucleus (Fudan University and other teams have replicated such arousal control nucleus through animal experiments) lead to excessive carbon dioxide, which becomes a natural 7*24 hours anesthetic, thereby causing complex symptoms such as lethargy.[1 ] Shishui baike (talk) 14:49, 2 January 2024 (UTC)


 * As explained on your user talk page, on Wikipedia sources for medical claims must meet the standards given in WP:MEDRS. Primary sourcing to animal experiments do not meet those standards. MrOllie (talk) 14:52, 2 January 2024 (UTC)