Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
| Autor: | Shalini Paruthi, Julie Flygare, Katherine M. Sharkey, Emily C. Barker |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cataplexy Pitolisant business.industry Excessive daytime sleepiness Neurological disorder medicine.disease Orexin 03 medical and health sciences Behavioral Neuroscience chemistry.chemical_compound 0302 clinical medicine 030228 respiratory system chemistry Medicine Wakefulness medicine.symptom business Psychiatry Sleep paralysis 030217 neurology & neurosurgery Applied Psychology Narcolepsy |
| Zdroj: | Nature and Science of Sleep. 12:453-466 |
| ISSN: | 1179-1608 |
| DOI: | 10.2147/nss.s162762 |
| Popis: | Narcolepsy is a neurological disorder of the sleep-wake cycle characterized by excessive daytime sleepiness (EDS), cataplexy, nighttime sleep disturbances, and REM-sleep-related phenomena (sleep paralysis, hallucinations) that intrude into wakefulness. Dysfunction of the hypocretin/orexin system has been implicated as the underlying cause of narcolepsy with cataplexy. In most people with narcolepsy, symptom onset occurs between the ages of 10 and 35 years, but because the disorder is underrecognized and testing is complex, delays in diagnosis and treatment are common. Narcolepsy is treated with a combination of lifestyle modifications and medications that promote wakefulness and suppress cataplexy. Treatments are often effective in improving daytime functioning for individuals with narcolepsy, but side effects and/or lack of efficacy can result in suboptimal management of symptoms and, in many cases, significant residual impairment. Additionally, the psychosocial ramifications of narcolepsy are often neglected. Recently two new pharmacologic treatment options, solriamfetol and pitolisant, have been approved for adults, and the indication for sodium oxybate in narcolepsy has been expanded to include children. In recent years, there has been an uptick in patient-centered research, and promising new diagnostic and therapeutic options are in development. This paper summarizes current and prospective pharmacological therapies for treating both EDS and cataplexy, discusses concerns specific to children and reproductive-age women with narcolepsy, and reviews the negative impact of health-related stigma and efforts to address narcolepsy stigma. |
| Databáze: | OpenAIRE |
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