Narcolepsy: An Autoimmune Disorder?

You might love your sleep -- and your naps -- but probably not enough to want narcolepsy, one of the more difficult sleep disorders to manage. What few people realize, though, is that narcolepsy isn't just about falling asleep frequently during the day at inopportune times. About three-quarters of narcoleptics are at the mercy of emotional reactions that trigger their body to physically experience muscle paralysis. So imagine being happily excited or, conversely, suddenly frightened, and all of the sudden your body freezes against your will and you can't move.

And imagine this heartbreaking, agonizing disorder coming uncontrollably from within you. From your own immune system.

It's long been thought that narcolepsy is an autoimmune disorder whereby an individual's immune system goes haywire; rather than targeting just foreign invaders and germs, it instead turns against the body and begins attacking certain cells. Although this has never been definitively proven, we now have more evidence showing that narcolepsy indeed may be blamed on a misfiring immune system.

Researchers at the University of Lausanne, Switzerland, have now identified auto-antibodies (immune molecules that target a natural protein in the body rather than a protein from an infectious agent) that target a natural protein called Trib2 in narcolepsy patients who experience paralysis linked to their emotions. This clearly suggests that narcolepsy could be an autoimmune disorder. Normally, the immune system can distinguish between "self" and "not self" and only attacks those tissues that it recognizes as foreign, or "not self."  But when it comes to narcolepsy, it seems we could have a mutiny on our hands.

And the fact that it's an autoimmune disorder makes it all the more challenging to treat and attempt to cure. What are the signs of narcolepsy?

• Excessive daytime sleepiness is typically the first symptom of narcolepsy. It's the overwhelming need to sleep when you prefer to be awake.
• Narcolepsy is typically associated with a sudden weakness or paralysis often initiated by laughter or other intense feelings, sleep paralysis -- an often frightening situation where you are half awake yet cannot move -- and intensely vivid and scary dreams occurring at the onset or end of sleep.
• A narcoleptic may also experience "automatic behavior," in which you perform routine or boring tasks but can't remember doing so later.

The cure? There isn't one yet. For people with narcolepsy, naps are especially important. A nap can actually replace a dosage of a stimulant medication. Autoimmune disorders in general are difficult to cure. Other illnesses that are also considered autoimmune disorders include type-1 diabetes, rheumatoid arthritis, lupus and multiple sclerosis.

The good news from this latest study is that it gives us a little more insight into this strange and perplexing disorder. What's more, if we can confirm narcolepsy as an autoimmune disorder, then we can examine it as such to eventually find a cure, or perhaps identify a better way to treat and manage the disorder.

For more information about narcolepsy, visit The Narcolepsy Network.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

This post on narcolepsy is also available at Dr. Breus's official blog, The Insomnia Blog by Sleep Doctor Michael Breus, PhD.

 

 

 

Follow Dr. Michael J. Breus on Twitter: www.twitter.com/thesleepdoctor

Comments

[SelenesRaven]

07:21 PM on 07/17/2010

I have a particularly severe case of narcolepsy with cataplexy, diagnosed by Emmanuel Mignot himself (if you don't know who that is, you obviously haven't done your research). Now I would like to correct the number of misinformed people who have commented on here. Narcolepsy is a NEUROLOGICAL sleep disorder, it is NOT caused by sleep deprivation, it's caused by the cessation of hypocretin production within the brain (duh). Also, Dr. Breus is a psychologist not a neurologist, which doesn't make him particularly qualified to talk about this, and narcolepsy as an autoimmune disorder has pretty much been confirmed already, so why the question mark? Also why write on article on this now? This is not news, the confirmation I'm referring to took place in summer of 2009, when Dr. Mignot announced it publicly.

[lostfan13]

11:26 PM on 07/10/2010

One of my friends has this-- and he's in the military, too. He used to just doze out while driving. I can't believe the military doctor cleared him to serve despite this dangerous condition.

I certainly would not have thought it was an autoimmune disorder, though. Pretty interesting stuff.

[Willow712]

07:15 PM on 07/10/2010

Funny story: I had been talking to my daughter (34) about the sleep tests, and I thought I probably had sleep apnea or something like that. But never thought of narcolepsy. I called her after my diagnosis and said, "Yes, I don't have apnea. I have narcolepsy." She put her hand over the phone, and yelled out to her husband, "Lyle, my Mom has necrophilia!"

[Willow712]

12:20 PM on 07/10/2010

Thank you for writing this. When I tell someone I have narcolepsy, I usually add, "And I don't fall over into my soup asleep." I have Narcolepsy and alpha wave intrusion. I was waking 16 times an hour at night, yet falling into REM sleep within 2.5 minutes on the MLST.

I don't nap. I take Xyrem every night, and I sleep between 8 and 9 hours at night. I was seeing HH when I was 4 years old. Yet I was not diagnosed with "Classic Narcolepsy" until I was 54. I was diagnosed with depression, depression where I slept too much. and did I say depression? I have taken every antidepressant known to man. I realize people tend to sleep more when depressed, but that does not usually mean they sleep through every movie, book and conversation.

And have recently been diagnosed with fibromyalgia, which my rheumatologist tells me can be caused by disrupting your sleep cycle.
Again, thanks for the post. We need to get the word out that narcolepsy is not something weird, and we need to educate our Doctors about it.

[superfrog]

05:20 AM on 07/10/2010

Narcolepsy is a sleep disorder brought about by a lack of sleep. A person with narcolepsy dose not have a normal sleep cycle. During the onset of the sleep cycle and toward the end of the sleep cycle the narcoleptic go’s into a hypnagogic state ( this is a state in-between sleep and wakefulness ). During this hypnagogic state the narcoleptic experiences vivid dreams. Several years ago when I started conducting ( Lucid Dreaming ) experiments as part of my night time meditation practice. I would close my eyes and concentrate on the varying shades of gray that I could see when my eyes were closed. I would then try to identify any shapes that I could make out in the darkness. As soon as a shape appeared to me I would slowly start following the edge of the shape with my eyes. At some point my eyes would rapidly move along the edge of the shape this is called REM ( Rapid Eye Movement ). This rapid eye movement stimulates your visual cortex and you start to see geometrical patterns and sparks of light called ( Phosphenes ). At some point these sparks of light will give away and you will be in a dream state. At this point I started to realize that the dreams I was experiencing during the onset of my dream cycle and toward the end of my dream cycle were more like out of body experiences rather then normal dreams.

[superfrog]

05:16 AM on 07/10/2010

As the days and weeks progressed I started having more and more of these out of body experiences and each time i had one it would last for a longer period of time. After about four weeks of this I started to experience EDS ( Excessive Daytime Sleepiness ) even though I thought i was getting enough sleep at night. I then started experiencing Cataplexy ( Muscular weakness and speech paralysis ) and having Hallucinations ( Hearing and seeing things that are not there ). Since I was not getting enough sleep at night my mind started taking micro naps during the day. A micro nap is a momentary sleep episode one moment your mind is awake the next moment it is asleep. The cataplexy was caused when ever my mind fell asleep one second i’m talking fine and the next second speech paralysis. The Hallucinations happened the same way one day when i was standing in line at the bank my mind took a micro nap. During this micro nap i saw a deer by a stream then my mind would wake up and now the deer is standing in the bank. I cured my narcolepsy by changing my sleep pattern when ever my mind would go into this hypnagogic state i would wake myself up and stay awake for about 45 minutes then go back to sleep. Now when ever I go into this hypnagogic state i limit the time i stay there.

[superfrog]

04:31 PM on 07/10/2010

Continued......

Narcolepsy is not caused by a misfiring immune system. The misfiring immune system is a symptom of long term sleep deprivation. Since the Narcoleptic is not getting enough sleep when ever they experience a emotional reaction to something their brains get easily overloaded and this triggers a sleep response.

[Qsi Kat]

12:08 AM on 07/10/2010

And all this time I thought that Narcolepsy meant snitching on an epileptic doing drugs!

[wackette]

09:51 AM on 07/10/2010

... that's funny, Kat.

[Qsi Kat]

12:05 AM on 07/10/2010

Wow! All this time I thought Narcolepsy meant snitching on an epileptic doing drugs!

[booki]

06:00 PM on 07/09/2010

wow, if u know someone who has narcolepsy, and are not aware of it.....
it can be scary.
i worked a Vanderbilt Univ and one of the profs had it...
and would fall asleep in my office....
scared me to death, as he fell asleep in the middle of a sentence.

[shazzz]

05:12 PM on 07/09/2010

Thank you, Dr. Breus, for spreading awareness of narcolepsy, in particular the fact that a person with narcolepsy has no control over the symptoms. In narcolepsy, falling asleep is not a choice we make. Our brains shut down on us against our will. It can happen during any and all circumstances, including the most physically demanding activities. As our brains get sleepier we lose judgment, coordination, memory formation, etc.. Sleep is the only antidote. So, don't ever think of people with narcolepsy as lazy or unmotivated. With treatment most do fairly well and often have a long history of over-achieving.

[Sleepsci]

03:57 PM on 07/09/2010

There are also many other lines of evidence pointing to an autoimmune basis for narcolepsy- a disease that affects about 1/2000 individuals- not rare disease, but definitely "under the radar". Many autoimmune diseases share underlying factors. Help raise funds for important research by voting to fund the "Narcolepsy Participation in International ImmunoChip Project" every day in July at Pepsi Refresh Everything
http://www.refresheverything.com/narcolepsyimmunochipproject