Narcolepsy Sleep Disorder; Options for Current and Future Therapies

Narcolepsy is one of the rarest sleep disorders, which is often confused with other sleep disorders.

Today, thousands of Americans are suffering from narcolepsy disorder, which affects both adults and children.

Read on to understand narcolepsy causes and disease, its symptoms, and treatment options to help the patients.

What is narcolepsy disorder?

Narcolepsy refers to a sleep disorder that keeps interpreting sleep-wake cycles. The primary narcolepsy causes is excessive daytime sleepiness (EDS), which is a result of the brain’s inability to regulate the sleep and wakefulness cycle in the required manner.

Normal sleep develops via a series of multiple stages with rapid eye movements (REM), followed by sleep in the final stage.

However, for people suffering from narcolepsy, REM is not regular and can be experienced within minutes after sleeping. In comparison to people who do not suffer from narcolepsy and have a normal sleep cycle, the REM time is much lower in patients suffering from narcolepsy.

Patients suffering from narcolepsy experience REM quickly, and the key reason for this is the brain issues that disrupt the person’s sleeping pattern. Moreover, this disruption may also lead to other narcolepsy symptoms, such as daytime sleepiness.

Narcolepsy Sleep Disorder; Types

As per the international classification of sleep disorders edition (ICSD-3), the narcolepsy sleep disorder is divided into two types- Narcolepsy type 1 (NT1) and Narcolepsy type 2 (NT2).

  • Narcolepsy Type 1

NT1 is related to the narcolepsy with cataplexy symptom, a sudden failure of muscle tone. Earlier, NT1 was known as narcolepsy with cataplexy.

The effects of narcolepsy with cataplexy are not experienced by all patients who are diagnosed with narcolepsy type 1. Different parameters predict the chances of a patient having NT1, such as reduced hypocretin level (a chemical controlling wakefulness in the human body).

  • Narcolepsy Type 2

Earlier, NT2 was commonly known as narcolepsy without the presence of cataplexy. People who have NT2 experience similar symptoms as NT1 patients. However, patients suffering from NT2 do not have low hypocretin levels or cataplexy.

If a patient having NT2 later shows low hypocretin-1 levels or cataplexy, they are diagnosed with NT1. This difference in diagnosis has been reported in only 10% of narcolepsy cases.

Available Narcolepsy Therapy and Treatment Options

Narcolepsy therapy and treatment can be classified into the following two categories:

  • Behavioral approaches use changes in daily habits and lifestyles to control symptoms and decrease the chance of additional emotional and physical challenges that usually affect people suffering from narcolepsy.
  • Medications can also be prescribed to manage narcolepsy symptoms. The usage of medication therapy is called pharmacotherapy.

For most patients suffering from narcolepsy, treatment includes both medical and behavioral approaches. A variety of therapies reduce extreme daytime sleepiness. However, a recent market survey claims that such therapies are not effective for every patient.

Patients suffering from NT1 and NT2 often have similar symptoms, and as a result, similar therapies and treatments are recommended for both cases. A core difference between NT1 and NT2 is that patients with NT2 do not need therapies for cataplexy because such symptoms are only observed in patients suffering from NT1.

The companies already operating in the narcolepsy therapeutics market are now shifting their focus from present treatment options to personalized treatment options.

Key players in the global narcolepsy therapeutics market, such as Takeda Pharmaceuticals Co. Ltd, Bio project Pharma, and Jazz Pharmaceuticals PLC, are investing heavily in the research and development-related activities for their therapeutic products.

The global narcolepsy therapeutics market is also growing due to several other factors, such as low satisfaction with available therapies, rising uptake of narcolepsy awareness programs, and improving diagnosis.

According to a BIS Research report, the global narcolepsy therapeutics market is expected to reach $4,912.3 million by 2032 from a market value of $915.2 million in 2021, growing at a CAGR of 15.93% during the forecast period 2022–2032.

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Future Narcolepsy Therapy Options

A permanent treatment option for narcolepsy sleep disorder may be available in the near future by replacing the defective chemical hypocretin present in the brain with normal chemical hypocretin. Currently, researchers are focusing and working on different genes that are said to be responsible for causing narcolepsy.

A similarity was observed between the genes of dogs and genes of humans suffering from narcolepsy. It was discovered that in the brains of the dogs and humans experiencing the condition, there was an inadequacy of hypocretin.

Research is being done to analyze the development of treatment measures that involve the use of hypocretin doses on narcoleptic and cataleptic dogs. However, it may take time to use this treatment on humans.

Conclusion

Narcolepsy sleep disorder is not a general condition and is commonly caused due to reduced hypocretin levels. Nevertheless, it is under-recognized by medical providers and the public. Often, narcolepsy patients experience protracted uncertainties in their diagnosis.

Testing for narcolepsy disorders depends on the clinical history and behavior testing of the patient, but the continuous advances in biomarkers, such as neuroimaging and CSF hypocretin-1 levels, may make narcolepsy disorders easier to analyze and highlight the pathophysiologic distinctions between NT1 and NT2.

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