Materiały źródłowe

• #1 Narcolepsy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

  Narcolepsy is a condition that makes people very sleepy during the day and can cause them to fall asleep suddenly. […] The exact cause of narcolepsy is not known. People with type 1 narcolepsy have low levels of hypocretin (hi-poe-KREE-tin), also called orexin. Hypocretin is a chemical in the brain that helps control being awake and entering REM sleep. […] Hypocretin levels are low in people who have cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn’t known. But experts suspect it’s due to an autoimmune reaction. An autoimmune reaction is when the body’s immune system destroys its own cells. […] It’s also likely that genetics plays a role in narcolepsy. But the risk of a parent passing this sleep condition to a child is very low only about 1% to 2%. […] Narcolepsy may be linked to exposure to the H1N1 flu, sometimes called the swine flu. It also may be linked to a certain type of the H1N1 vaccine that was given in Europe.

• #2 Narcolepsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12147-narcolepsy

  Narcolepsy has four key symptoms. Focusing on sleep hygiene greatly help improve sleep and this conditions effects. […] The causes of narcolepsy depend on the type of narcolepsy you have. However, they all have links to your hypothalamus, a specific area in your brain that helps regulate your sleep and wake times. […] In 1998, researchers discovered orexins, a type of chemical molecule created and used by certain neurons (brain cells) for communication. The neurons that use orexins are in a part of your brain called the hypothalamus, and those neurons are key to how you stay awake. […] According to further research, the most likely reason those neurons stopped working is an autoimmune problem. That means your immune system attacked the neurons that make and use orexins, the orexins themselves or both.

• #3

  https://www.nhs.uk/conditions/narcolepsy/causes/

  Many cases of narcolepsy are thought to be caused by a lack of a brain chemical called hypocretin (also known as orexin), which regulates sleep. […] The deficiency is thought to be the result of the immune system mistakenly attacking parts of the brain that produce hypocretin. […] But a lack of hypocretin is not the cause in all cases. […] In 2010, scientists in Switzerland discovered that some people with narcolepsy produce antibodies against a protein called trib 2. […] Trib 2 is produced by an area of the brain that also produces hypocretin. This results in a lack of hypocretin, which means the brain is less able to regulate sleep cycles. […] These research results may help explain the cause of narcolepsy in many cases, but it does not explain why some people with the condition still produce near-normal levels of hypocretin.

• #4 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. […] Although the causes of narcolepsy are not completely understood, current research suggests that narcolepsy may be the result of a combination of factors working together to cause a lack of hypocretin. […] Autoimmune disorders occur when the body’s immune system turns against itself and mistakenly attacks healthy cells or tissue. When cataplexy is present, the cause is most often the loss of brain cells that produce hypocretin. […] Researchers believe that in individuals with narcolepsy, the body’s immune system selectively attacks the hypocretin-containing brain cells because of a combination of genetic and environmental factors. […] Rarely, narcolepsy results from traumatic injury to parts of the brain that regulate wakefulness and REM sleep or from tumors and other diseases in the same regions.

• #5 The Science of Narcolepsy | Sleep Medicine

  https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-4

  Research has revealed that narcolepsy with cataplexy is caused by a lack of orexins (hypocretins), brain chemicals that help sustain alertness and prevent REM sleep from occurring at the wrong times. […] Genetics, age, and triggering infections or inflammation play important roles in the development of narcolepsy. […] Most likely, it is caused by less severe injury to the orexin neurons, resulting in fewer and less severe symptoms. […] Genetic factors clearly play a role. Most people with narcolepsy have inherited a gene that codes for the human leukocyte antigen (HLA) DQB1*06:02, which is important for immune function. […] These discoveries suggest that narcolepsy is an autoimmune disease in which the immune system accidentally kills off the orexin-producing neurons. […] Researchers are now beginning to identify some of the triggers for this autoimmune attack on the orexin neurons.

• #6 The Etiology of Narcolepsy | Know Narcolespy HCP

  https://knownarcolepsyhcp.com/etiology

  Most people living with narcolepsy have low levels of CSF hypocretin (also known as orexin). In people living with narcolepsy who experience cataplexy (often called narcolepsy type 1), the disorder is usually caused by the selective loss of hypocretin neurons in the hypothalamus, most likely due to an autoimmune process. […] The underlying cause of narcolepsy without cataplexy (often called narcolepsy type 2) is often not known. […] The loss of hypocretin neurons is likely triggered by an autoimmune response in genetically predisposed people. […] Genetic factors play a key role in the development of narcolepsy. Up to 98% of patients with narcolepsy have the human leukocyte antigen (HLA) gene variant HLA-DQB1*06:02, compared with 12% to 38% of the general population. […] In a study that analyzed blood samples from individuals with narcolepsy, autoreactive CD4+ memory T cells that target self-antigens expressed by hypocretin neurons were detected in all participants in the study, regardless of the hypocretin deficiency or the presence of HLA subtype DQB1*06:02. […] Studies have shown an increased rate of narcolepsy onset following seasonal infections like Streptococcus pyogenes, influenza A H1N1 infection, and the H1N1 Pandemrix vaccine.

• #7

  https://www.nhs.uk/conditions/narcolepsy/

  Narcolepsy is often caused by a lack of the brain chemical hypocretin (also known as orexin), which regulates wakefulness. […] The lack of hypocretin is thought to be caused by the immune system mistakenly attacking the cells that produce it or the receptors that allow it to work. […] But this does not explain all cases of narcolepsy, and the exact cause of the problem is often unclear. […] Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause, major psychological stress, an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix).

• #8 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Narcolepsy-Causes.aspx

  The exact cause of narcolepsy is unclear, although in many cases the condition occurs as an autoimmune response. […] In autoimmune disorders, the bodys own antibodies target healthy cells and tissues. In the case of narcolepsy, regions of the brain are attacked that usually release a neurotransmitter involved in sleep regulation called orexin. This leads to a deficiency in orexin and the symptoms of narcolepsy start to develop. In other cases of narcolepsy, however, orexin levels are found to be normal and the cause of narcolepsy remains unclear. […] In 2010, narcolepsy research showed that the areas of the brain that release orexin are attacked by an antibody called trib 2. The resulting decrease in orexin leads to narcolepsy, and in particular narcolepsy accompanied by cataplexy or temporary muscle weakness.

• #9

  https://www.nhs.uk/conditions/narcolepsy/causes/

  Many cases of narcolepsy are thought to be caused by a lack of a brain chemical called hypocretin (also known as orexin), which regulates sleep. […] The deficiency is thought to be the result of the immune system mistakenly attacking parts of the brain that produce hypocretin. […] But a lack of hypocretin is not the cause in all cases. […] In 2010, scientists in Switzerland discovered that some people with narcolepsy produce antibodies against a protein called trib 2. […] Trib 2 is produced by an area of the brain that also produces hypocretin. This results in a lack of hypocretin, which means the brain is less able to regulate sleep cycles. […] These research results may help explain the cause of narcolepsy in many cases, but it does not explain why some people with the condition still produce near-normal levels of hypocretin.

• #10 The Etiology of Narcolepsy | Know Narcolespy HCP

  https://knownarcolepsyhcp.com/etiology

  Most people living with narcolepsy have low levels of CSF hypocretin (also known as orexin). In people living with narcolepsy who experience cataplexy (often called narcolepsy type 1), the disorder is usually caused by the selective loss of hypocretin neurons in the hypothalamus, most likely due to an autoimmune process. […] The underlying cause of narcolepsy without cataplexy (often called narcolepsy type 2) is often not known. […] The loss of hypocretin neurons is likely triggered by an autoimmune response in genetically predisposed people. […] Genetic factors play a key role in the development of narcolepsy. Up to 98% of patients with narcolepsy have the human leukocyte antigen (HLA) gene variant HLA-DQB1*06:02, compared with 12% to 38% of the general population. […] In a study that analyzed blood samples from individuals with narcolepsy, autoreactive CD4+ memory T cells that target self-antigens expressed by hypocretin neurons were detected in all participants in the study, regardless of the hypocretin deficiency or the presence of HLA subtype DQB1*06:02. […] Studies have shown an increased rate of narcolepsy onset following seasonal infections like Streptococcus pyogenes, influenza A H1N1 infection, and the H1N1 Pandemrix vaccine.

• #11 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  The loss of hypocretin neurons in the hypothalamus is the main cause of type 1 narcolepsy. […] A variation in this gene, called HLA-DQB1*06:02, increases the chance of developing narcolepsy, particularly Type 1 narcolepsy. […] Together, this suggests that individuals with the HLA-DQB1*06:02 gene variation are at risk for developing narcolepsy after they are exposed to a specific trigger, like certain infections that trick the immune system into attacking the body. […] Abnormalities in the immune system may play an important role in the development of narcolepsy. […] Further, strep throat and certain varieties of influenza are now thought to trigger narcolepsy in some at-risk individuals.

• #12 Causes of Narcolepsy

  https://www.everydayhealth.com/narcolepsy/causes/

  The thinking is that, as is the case with other autoimmune diseases, in people who are genetically predisposed the bodys immune system mistakenly attacks healthy cells or tissue (in narcolepsy, the neurons deep in the brain that produce hypocretin) in response to an infection. […] In narcolepsy, the H1N1 influenza virus has been identified as one of the triggering infections that could lead to the disease, for example. […] Since hypocretin levels are typically normal in people with type 2 narcolepsy, the cause of type 2 narcolepsy remains unclear. […] And finally, in the rare cases of secondary narcolepsy, brain injury is the cause.

• #13 Narcolepsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12147-narcolepsy

  About 90% to 95% of people with type 1 narcolepsy have a specific genetic mutation (the identifier for this mutation is HLA-DQB1*06:02) that affects their immune system. […] However, people can also develop type 1 narcolepsy after certain viral and bacterial infections, especially strains of H1N1 influenza and bacteria like those that cause strep throat. […] While experts know much of why type 1 narcolepsy happens, thats not the case with type 2 narcolepsy. Experts still dont fully understand why type 2 narcolepsy happens. […] In rare cases, narcolepsy can happen because of damage to your hypothalamus. You can have this kind of damage from head injuries (such as concussions and traumatic brain injuries), strokes, brain tumors and other conditions. […] Narcolepsy isnt contagious. You cant spread it to or catch it from others.

• #14 The Etiology of Narcolepsy | Know Narcolespy HCP

  https://knownarcolepsyhcp.com/etiology

  Most people living with narcolepsy have low levels of CSF hypocretin (also known as orexin). In people living with narcolepsy who experience cataplexy (often called narcolepsy type 1), the disorder is usually caused by the selective loss of hypocretin neurons in the hypothalamus, most likely due to an autoimmune process. […] The underlying cause of narcolepsy without cataplexy (often called narcolepsy type 2) is often not known. […] The loss of hypocretin neurons is likely triggered by an autoimmune response in genetically predisposed people. […] Genetic factors play a key role in the development of narcolepsy. Up to 98% of patients with narcolepsy have the human leukocyte antigen (HLA) gene variant HLA-DQB1*06:02, compared with 12% to 38% of the general population. […] In a study that analyzed blood samples from individuals with narcolepsy, autoreactive CD4+ memory T cells that target self-antigens expressed by hypocretin neurons were detected in all participants in the study, regardless of the hypocretin deficiency or the presence of HLA subtype DQB1*06:02. […] Studies have shown an increased rate of narcolepsy onset following seasonal infections like Streptococcus pyogenes, influenza A H1N1 infection, and the H1N1 Pandemrix vaccine.

• #15 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  The loss of hypocretin neurons in the hypothalamus is the main cause of type 1 narcolepsy. […] A variation in this gene, called HLA-DQB1*06:02, increases the chance of developing narcolepsy, particularly Type 1 narcolepsy. […] Together, this suggests that individuals with the HLA-DQB1*06:02 gene variation are at risk for developing narcolepsy after they are exposed to a specific trigger, like certain infections that trick the immune system into attacking the body. […] Abnormalities in the immune system may play an important role in the development of narcolepsy. […] Further, strep throat and certain varieties of influenza are now thought to trigger narcolepsy in some at-risk individuals.

• #16 Narcolepsy: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/narcolepsy/

  Narcolepsy probably results from a combination of genetic and environmental factors, some of which have been identified, but many of which remain unknown. […] In most cases of narcolepsy with cataplexy, and in some cases without cataplexy, sleep abnormalities result from a loss of particular brain cells (neurons) in a part of the brain called the hypothalamus. […] It is unclear what triggers the death of hypocretin-producing neurons in people with narcolepsy, although evidence increasingly points to an abnormality of the immune system. […] Researchers have identified changes in several genes that influence the risk of developing narcolepsy. […] A variation of the HLA-DQB1 gene called HLA-DQB1*06:02 has been strongly associated with narcolepsy, particularly in people who also have cataplexy and a loss of hypocretins.

• #17 Narcolepsy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

  Narcolepsy is a condition that makes people very sleepy during the day and can cause them to fall asleep suddenly. […] The exact cause of narcolepsy is not known. People with type 1 narcolepsy have low levels of hypocretin (hi-poe-KREE-tin), also called orexin. Hypocretin is a chemical in the brain that helps control being awake and entering REM sleep. […] Hypocretin levels are low in people who have cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn’t known. But experts suspect it’s due to an autoimmune reaction. An autoimmune reaction is when the body’s immune system destroys its own cells. […] It’s also likely that genetics plays a role in narcolepsy. But the risk of a parent passing this sleep condition to a child is very low only about 1% to 2%. […] Narcolepsy may be linked to exposure to the H1N1 flu, sometimes called the swine flu. It also may be linked to a certain type of the H1N1 vaccine that was given in Europe.

• #18 Narcolepsy Types

  https://www.webmd.com/sleep-disorders/narcolepsy-types

  Narcolepsy is a disorder that happens when your brains control of your sleep-wake cycle is faulty. […] Experts dont know exactly how narcolepsy happens. But they believe that it might result from your own immune system attacking the part of your brain that makes hypocretin (orexin), a hormone that regulates sleep. Type 1 narcolepsy is linked to lower levels of this brain chemical. The precise cause of type 2 is unknown. […] Your genes also might raise your risk. Researchers found that people with narcolepsy have changes in certain genes, specifically the T-cell receptor gene and a group of genes called the human leukocyte antigen complex. If a family member has narcolepsy, youre up to 40 times more likely to get it than someone without a family history. Still, narcolepsy is very rare. Any child of yours has only about a 1% chance of inheriting it.

• #19 The Science of Narcolepsy | Sleep Medicine

  https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-4

  Thus, it appears that three factors are important for the development of narcolepsy: Genes that influence the immune system, such as HLA-DQB1*06:02, a triggering factor that activates the immune system, such as infection with strep, and a vulnerable age during which the immune response or some characteristics of the brain make an autoimmune attack on the orexin neurons more likely. […] By gaining a better understanding of this process, researchers hope to develop medications that can stop narcolepsy just as it begins and prevent further injury to the orexin neurons.

• #20 What Causes Narcolepsy? | MyNarcolepsyTeam

  https://www.mynarcolepsyteam.com/resources/what-causes-narcolepsy

  It is important to note that while science is good at finding correlations, or apparent relationships, between factors and disease, correlation does not prove that the factor causes the disease. Many risk factors for narcolepsy have been identified and are being studied, but none have been pinpointed as the cause of narcolepsy. […] One genetic variant in particular, known as human leukocyte antigen (HLA) DQB1*06:02, makes a person between seven times and 25 times more likely to develop narcolepsy. […] Certain infections may trigger the immune system to develop an abnormal response that leads to the development of narcolepsy. […] Environmental factors are considered to be the sole cause of secondary narcolepsy, which is due to physical injury or disruption to the hypothalamus the region of the brain where hypocretin-producing neurons are located. […] Only one specific flu vaccine, Pandemrix, used in some northern European countries circa 2009, has ever been implicated in raising the risk for narcolepsy in some children.

• #21 Narcolepsy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459236/

  Narcolepsy type 1 occurs when nearly all of the neurons that contain orexin (also called hypocretin) are lost. The reason for this is not fully understood, but it is thought to be an autoimmune process possibly triggered by an infection. HLA haplotype DQB1*0602 is present in 95% of narcolepsy type 1 patients, but this is also present in about 20% of the general population without narcolepsy. The cause of narcolepsy type 2 is not entirely clear. Current hypotheses include less destruction of orexin cells, impaired orexin receptor signaling, or an unknown mechanism. Some patients initially diagnosed with narcolepsy type 2 will develop cataplexy, indicating disease progression. Less commonly, trauma and tumors may result in narcolepsy. […] In 2009 there was an increase in the number of cases of narcolepsy type 1 reported in Europe after receiving the European AS03-adjuvanted A(H1N1) pandemic influenza vaccine (Pandemrix) and it was initially thought that the immune response to the adjuvant might have been the cause of the disease. The same adjuvant was, however, also used in Canada but the corresponding increase in reported cases did not occur there. Additionally, there was an increase in the number of reported cases of narcolepsy in non-vaccinated patients after wild A(H1N1) pandemic influenza infection. Antibodies against streptococcal infections have also been associated with the onset of narcolepsy type 1. Although a specific autoantibody that correlates with disease mechanism in narcolepsy has not yet been identified, this does strongly suggest that narcolepsy type 1 may be an autoimmune disease. […] The mechanism of narcolepsy type 2 is less clear, but it is thought that it may be due to a similar but less severe loss of orexin neurons.

• #22 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  The loss of hypocretin neurons in the hypothalamus is the main cause of type 1 narcolepsy. […] A variation in this gene, called HLA-DQB1*06:02, increases the chance of developing narcolepsy, particularly Type 1 narcolepsy. […] Together, this suggests that individuals with the HLA-DQB1*06:02 gene variation are at risk for developing narcolepsy after they are exposed to a specific trigger, like certain infections that trick the immune system into attacking the body. […] Abnormalities in the immune system may play an important role in the development of narcolepsy. […] Further, strep throat and certain varieties of influenza are now thought to trigger narcolepsy in some at-risk individuals.

• #23

  https://www.nhs.uk/conditions/narcolepsy/causes/

  A number of factors may increase a person’s risk of narcolepsy or cause an autoimmune problem. […] Research is yet to confirm whether all of these play a role in narcolepsy. […] Research carried out in 2013 found an association between the flu vaccine, Pandemrix, which was used during the swine flu epidemic of 2009 to 2010, and narcolepsy in children. […] Narcolepsy can sometimes be the result of an underlying condition that damages the areas of the brain that produce hypocretin. […] Narcolepsy resulting from an identifiable underlying condition is called secondary narcolepsy.

• #24 Narcolepsy – Wikipedia

  https://en.wikipedia.org/wiki/Narcolepsy

  The primary genetic factor that has been strongly implicated in the development of narcolepsy involves an area of chromosome 6 known as the human leukocyte antigen (HLA) complex. […] Specific variations in HLA genes are strongly correlated with the presence of narcolepsy (HLA DQB1*06:02, frequently in combination with HLA DRB1*15:01); however, these variations are not required for the condition to occur and sometimes occur in individuals without narcolepsy. […] Type 1 narcolepsy is caused by hypocretin/orexin neuronal loss. […] A link between GlaxoSmithKline’s H1N1 flu vaccine Pandemrix and narcolepsy has been found in both children and adults. […] The autoimmune process is thought to be triggered in genetically susceptible individuals by an immune provoking experience, such as infection with H1N1 influenza.

• #25

  https://www.nhs.uk/conditions/narcolepsy/

  Narcolepsy is often caused by a lack of the brain chemical hypocretin (also known as orexin), which regulates wakefulness. […] The lack of hypocretin is thought to be caused by the immune system mistakenly attacking the cells that produce it or the receptors that allow it to work. […] But this does not explain all cases of narcolepsy, and the exact cause of the problem is often unclear. […] Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause, major psychological stress, an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix).

• #26 Cause of Narcolepsy in Humans | Treatment For Narcolepsy in Las Vegas | Dr. Arce

  https://www.drarceopsychiatricservices.com/narcolepsy-causes-and-treatment.php

  While genetics and chemical imbalances contribute to the cause of narcolepsy in humans, it is essential to recognize the potential role of stress and environmental triggers. […] Stressful life events, such as trauma or significant emotional distress, have been linked to the onset of narcolepsy symptoms in some individuals. […] Additionally, infections, such as the H1N1 influenza virus, have been associated with an increased risk of developing narcolepsy. […] The exact cause of narcolepsy is not fully understood. […] However, research suggests that genetics, chemical imbalances in the brain, and environmental factors may play a role in its development. […] Specific genes, such as HLA-DQB1, are associated with an increased risk of narcolepsy. […] Additionally, a deficiency of the neurotransmitter hypocretin is believed to contribute to the symptoms of narcolepsy.

• #27

  https://www.nhs.uk/conditions/narcolepsy/

  Narcolepsy is often caused by a lack of the brain chemical hypocretin (also known as orexin), which regulates wakefulness. […] The lack of hypocretin is thought to be caused by the immune system mistakenly attacking the cells that produce it or the receptors that allow it to work. […] But this does not explain all cases of narcolepsy, and the exact cause of the problem is often unclear. […] Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause, major psychological stress, an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix).

• #28 Narcolepsy: Causes, Symptoms, and Treatments – Amerisleep

  https://amerisleep.com/blog/narcolepsy/

  Narcolepsy is a rare chronic sleep disorder that disrupts the brains ability to regulate the sleep-wake cycle. […] The root causes of narcolepsy are not fully understood. However, here are some factors associated with the condition. […] Low hypocretin levels are a leading cause of narcolepsy. […] Hypocretin is produced in the region of the brain called the hypothalamus. If the brain is injured and the hypothalamus is affected, hypocretin production will be hindered, disrupting the sleep-wake cycle. […] Genes can make a person more likely to develop narcolepsy. […] Narcolepsy can develop when people are experiencing hormonal changes, for instance, during menopause and puberty. […] Swine flu infections, other streptococcal infections like Strep Throat and Scarlet Fever, and even auto-immune diseases can trigger an autoimmune response, damaging the hypothalamus and hindering hypocretin production. […] Other factors such as significant psychological stress and exposure to environmental toxins also play a role.

• #29 Causes of Narcolepsy

  https://www.everydayhealth.com/narcolepsy/causes/

  The thinking is that, as is the case with other autoimmune diseases, in people who are genetically predisposed the bodys immune system mistakenly attacks healthy cells or tissue (in narcolepsy, the neurons deep in the brain that produce hypocretin) in response to an infection. […] In narcolepsy, the H1N1 influenza virus has been identified as one of the triggering infections that could lead to the disease, for example. […] Since hypocretin levels are typically normal in people with type 2 narcolepsy, the cause of type 2 narcolepsy remains unclear. […] And finally, in the rare cases of secondary narcolepsy, brain injury is the cause.

• #30 Narcolepsy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459236/

  Narcolepsy type 1 occurs when nearly all of the neurons that contain orexin (also called hypocretin) are lost. The reason for this is not fully understood, but it is thought to be an autoimmune process possibly triggered by an infection. HLA haplotype DQB1*0602 is present in 95% of narcolepsy type 1 patients, but this is also present in about 20% of the general population without narcolepsy. The cause of narcolepsy type 2 is not entirely clear. Current hypotheses include less destruction of orexin cells, impaired orexin receptor signaling, or an unknown mechanism. Some patients initially diagnosed with narcolepsy type 2 will develop cataplexy, indicating disease progression. Less commonly, trauma and tumors may result in narcolepsy. […] In 2009 there was an increase in the number of cases of narcolepsy type 1 reported in Europe after receiving the European AS03-adjuvanted A(H1N1) pandemic influenza vaccine (Pandemrix) and it was initially thought that the immune response to the adjuvant might have been the cause of the disease. The same adjuvant was, however, also used in Canada but the corresponding increase in reported cases did not occur there. Additionally, there was an increase in the number of reported cases of narcolepsy in non-vaccinated patients after wild A(H1N1) pandemic influenza infection. Antibodies against streptococcal infections have also been associated with the onset of narcolepsy type 1. Although a specific autoantibody that correlates with disease mechanism in narcolepsy has not yet been identified, this does strongly suggest that narcolepsy type 1 may be an autoimmune disease. […] The mechanism of narcolepsy type 2 is less clear, but it is thought that it may be due to a similar but less severe loss of orexin neurons.

• #31 Narcolepsy type 2 – without cataplexy – Hypersomnia Foundation

  https://www.hypersomniafoundation.org/narcolepsy-type-2/

  Narcolepsy type 2 (NT2) is a long-lasting (chronic) hypersomnia sleep disorder of the brain (neurologic disorder). […] Researchers don’t yet know the cause of NT2, but it isn’t caused by the same problem as NT1. […] Common causes of EDS other than NT2 include: Prescribed medicines causing sleepiness as a side effect, Insufficient sleep, when you regularly don’t get enough good-quality sleep because of work or social reasons, Problems with sleep rhythms (circadian rhythm sleep-wake disorders), such as delayed sleep phase syndrome, Another sleep disorder, such as sleep apnea or narcolepsy type 2, Chronic fatigue syndrome (CFS) or fibromyalgia, Attention-deficit/hyperactivity disorder. […] The MSLT results doctors use to diagnose NT1 and NT2 are the same, so the results don’t help show which sleep disorder you have. Your symptoms, especially cataplexy, can help doctors tell the difference. If your diagnosis still isn’t clear, you may need to follow these steps to tell the difference between NT1 and NT2: Have a blood test for HLA-DQB1*06:02. If this blood test is negative, you most likely have NT2. If this test is positive, you may need step 2. Have a spinal tap to check orexin levels in your cerebrospinal fluid (CSF). If your orexin levels are low, you have NT1. If your orexin levels are normal, you most likely have NT2.

• #32 Narcolepsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12147-narcolepsy

  Narcolepsy has four key symptoms. Focusing on sleep hygiene greatly help improve sleep and this conditions effects. […] The causes of narcolepsy depend on the type of narcolepsy you have. However, they all have links to your hypothalamus, a specific area in your brain that helps regulate your sleep and wake times. […] In 1998, researchers discovered orexins, a type of chemical molecule created and used by certain neurons (brain cells) for communication. The neurons that use orexins are in a part of your brain called the hypothalamus, and those neurons are key to how you stay awake. […] According to further research, the most likely reason those neurons stopped working is an autoimmune problem. That means your immune system attacked the neurons that make and use orexins, the orexins themselves or both.

• #33 Narcolepsy: Causes, Symptoms, and Treatment – HelpGuide.org

  https://www.helpguide.org/wellness/sleep/narcolepsy

  Researchers continue to seek out the root cause of narcolepsy. The general consensus is that your genetics, accompanied by an environmental trigger such as a virus, for example, may affect your brain chemicals and cause the disorder. […] Scientists have discovered that people with narcolepsy are lacking in hypocretin (also called orexin), a chemical in the brain that activates arousal and regulates sleep. Narcoleptics also generally have fewer Hcrt cells (neurons that secrete hypocretin), inhibiting their ability to fully control alertness, which accounts for their tendency to fall asleep. Scientists are working on developing treatments to supplement hypocretin levels to reduce narcolepsy symptoms. […] Type 2 narcolepsy doesn’t involve sudden muscle loss. However, daytime sleeplessness is still an issue with type 2 narcolepsy, and you may also experience some degree of hallucinations, insomnia, and sleep paralysis. Overall, the symptoms are less severe than those in type 1 narcolepsy. It’s possible for type 2 narcolepsy to progress to type 1, suggesting they have a common cause. […] Secondary narcolepsy is the result of a traumatic brain injury, tumor, stroke, or other brain-damaging condition. If the part of the brain that regulates sleep is damaged, a person might suffer from narcolepsy as well as other neurological issues.

• #34 Narcolepsy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459236/

  Narcolepsy type 1 occurs when nearly all of the neurons that contain orexin (also called hypocretin) are lost. The reason for this is not fully understood, but it is thought to be an autoimmune process possibly triggered by an infection. HLA haplotype DQB1*0602 is present in 95% of narcolepsy type 1 patients, but this is also present in about 20% of the general population without narcolepsy. The cause of narcolepsy type 2 is not entirely clear. Current hypotheses include less destruction of orexin cells, impaired orexin receptor signaling, or an unknown mechanism. Some patients initially diagnosed with narcolepsy type 2 will develop cataplexy, indicating disease progression. Less commonly, trauma and tumors may result in narcolepsy. […] In 2009 there was an increase in the number of cases of narcolepsy type 1 reported in Europe after receiving the European AS03-adjuvanted A(H1N1) pandemic influenza vaccine (Pandemrix) and it was initially thought that the immune response to the adjuvant might have been the cause of the disease. The same adjuvant was, however, also used in Canada but the corresponding increase in reported cases did not occur there. Additionally, there was an increase in the number of reported cases of narcolepsy in non-vaccinated patients after wild A(H1N1) pandemic influenza infection. Antibodies against streptococcal infections have also been associated with the onset of narcolepsy type 1. Although a specific autoantibody that correlates with disease mechanism in narcolepsy has not yet been identified, this does strongly suggest that narcolepsy type 1 may be an autoimmune disease. […] The mechanism of narcolepsy type 2 is less clear, but it is thought that it may be due to a similar but less severe loss of orexin neurons.

• #35 Narcolepsy: Causes, Symptoms, and Treatment – HelpGuide.org

  https://www.helpguide.org/wellness/sleep/narcolepsy

  Researchers continue to seek out the root cause of narcolepsy. The general consensus is that your genetics, accompanied by an environmental trigger such as a virus, for example, may affect your brain chemicals and cause the disorder. […] Scientists have discovered that people with narcolepsy are lacking in hypocretin (also called orexin), a chemical in the brain that activates arousal and regulates sleep. Narcoleptics also generally have fewer Hcrt cells (neurons that secrete hypocretin), inhibiting their ability to fully control alertness, which accounts for their tendency to fall asleep. Scientists are working on developing treatments to supplement hypocretin levels to reduce narcolepsy symptoms. […] Type 2 narcolepsy doesn’t involve sudden muscle loss. However, daytime sleeplessness is still an issue with type 2 narcolepsy, and you may also experience some degree of hallucinations, insomnia, and sleep paralysis. Overall, the symptoms are less severe than those in type 1 narcolepsy. It’s possible for type 2 narcolepsy to progress to type 1, suggesting they have a common cause. […] Secondary narcolepsy is the result of a traumatic brain injury, tumor, stroke, or other brain-damaging condition. If the part of the brain that regulates sleep is damaged, a person might suffer from narcolepsy as well as other neurological issues.

• #36 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. […] Although the causes of narcolepsy are not completely understood, current research suggests that narcolepsy may be the result of a combination of factors working together to cause a lack of hypocretin. […] Autoimmune disorders occur when the body’s immune system turns against itself and mistakenly attacks healthy cells or tissue. When cataplexy is present, the cause is most often the loss of brain cells that produce hypocretin. […] Researchers believe that in individuals with narcolepsy, the body’s immune system selectively attacks the hypocretin-containing brain cells because of a combination of genetic and environmental factors. […] Rarely, narcolepsy results from traumatic injury to parts of the brain that regulate wakefulness and REM sleep or from tumors and other diseases in the same regions.

• #37 Secondary narcolepsy: Symptoms, causes, and more

  https://www.medicalnewstoday.com/articles/secondary-narcolepsy

  Secondary narcolepsy is a rare sleep disorder that occurs due to brain damage, specifically to the hypothalamus region. This part of the brain regulates the sleep-wake cycle. […] The cause of secondary narcolepsy is an injury to the hypothalamus. This may occur if a person has experienced a head injury, though other things can also cause damage to this region of the brain. […] Secondary narcolepsy occurs because of damage to the hypothalamus. […] These injuries disrupt the functioning of the hypothalamus, resulting in secondary narcolepsy symptoms. […] Secondary narcolepsy is a sleep disorder that occurs when damage occurs in the hypothalamus, the area of the brain responsible for regulating sleep-wake cycles. This may occur following a TBI, stroke, tumor, or infection.

• #38 Narcolepsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12147-narcolepsy

  About 90% to 95% of people with type 1 narcolepsy have a specific genetic mutation (the identifier for this mutation is HLA-DQB1*06:02) that affects their immune system. […] However, people can also develop type 1 narcolepsy after certain viral and bacterial infections, especially strains of H1N1 influenza and bacteria like those that cause strep throat. […] While experts know much of why type 1 narcolepsy happens, thats not the case with type 2 narcolepsy. Experts still dont fully understand why type 2 narcolepsy happens. […] In rare cases, narcolepsy can happen because of damage to your hypothalamus. You can have this kind of damage from head injuries (such as concussions and traumatic brain injuries), strokes, brain tumors and other conditions. […] Narcolepsy isnt contagious. You cant spread it to or catch it from others.

• #39 Secondary narcolepsy: Symptoms, causes, and more

  https://www.medicalnewstoday.com/articles/secondary-narcolepsy

  Secondary narcolepsy is a rare sleep disorder that occurs due to brain damage, specifically to the hypothalamus region. This part of the brain regulates the sleep-wake cycle. […] The cause of secondary narcolepsy is an injury to the hypothalamus. This may occur if a person has experienced a head injury, though other things can also cause damage to this region of the brain. […] Secondary narcolepsy occurs because of damage to the hypothalamus. […] These injuries disrupt the functioning of the hypothalamus, resulting in secondary narcolepsy symptoms. […] Secondary narcolepsy is a sleep disorder that occurs when damage occurs in the hypothalamus, the area of the brain responsible for regulating sleep-wake cycles. This may occur following a TBI, stroke, tumor, or infection.

• #40 The Science of Narcolepsy | Sleep Medicine

  https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-4

  Thus, it appears that three factors are important for the development of narcolepsy: Genes that influence the immune system, such as HLA-DQB1*06:02, a triggering factor that activates the immune system, such as infection with strep, and a vulnerable age during which the immune response or some characteristics of the brain make an autoimmune attack on the orexin neurons more likely. […] By gaining a better understanding of this process, researchers hope to develop medications that can stop narcolepsy just as it begins and prevent further injury to the orexin neurons.

• #41 Narcolepsy | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/narcolepsy

  The loss of hypocretin neurons in the hypothalamus is the main cause of type 1 narcolepsy. […] A variation in this gene, called HLA-DQB1*06:02, increases the chance of developing narcolepsy, particularly Type 1 narcolepsy. […] Together, this suggests that individuals with the HLA-DQB1*06:02 gene variation are at risk for developing narcolepsy after they are exposed to a specific trigger, like certain infections that trick the immune system into attacking the body. […] Abnormalities in the immune system may play an important role in the development of narcolepsy. […] Further, strep throat and certain varieties of influenza are now thought to trigger narcolepsy in some at-risk individuals.

• #42 Narcolepsy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459236/

  Narcolepsy type 1 occurs when nearly all of the neurons that contain orexin (also called hypocretin) are lost. The reason for this is not fully understood, but it is thought to be an autoimmune process possibly triggered by an infection. HLA haplotype DQB1*0602 is present in 95% of narcolepsy type 1 patients, but this is also present in about 20% of the general population without narcolepsy. The cause of narcolepsy type 2 is not entirely clear. Current hypotheses include less destruction of orexin cells, impaired orexin receptor signaling, or an unknown mechanism. Some patients initially diagnosed with narcolepsy type 2 will develop cataplexy, indicating disease progression. Less commonly, trauma and tumors may result in narcolepsy. […] In 2009 there was an increase in the number of cases of narcolepsy type 1 reported in Europe after receiving the European AS03-adjuvanted A(H1N1) pandemic influenza vaccine (Pandemrix) and it was initially thought that the immune response to the adjuvant might have been the cause of the disease. The same adjuvant was, however, also used in Canada but the corresponding increase in reported cases did not occur there. Additionally, there was an increase in the number of reported cases of narcolepsy in non-vaccinated patients after wild A(H1N1) pandemic influenza infection. Antibodies against streptococcal infections have also been associated with the onset of narcolepsy type 1. Although a specific autoantibody that correlates with disease mechanism in narcolepsy has not yet been identified, this does strongly suggest that narcolepsy type 1 may be an autoimmune disease. […] The mechanism of narcolepsy type 2 is less clear, but it is thought that it may be due to a similar but less severe loss of orexin neurons.

• #43 Narcolepsy type 2 – without cataplexy – Hypersomnia Foundation

  https://www.hypersomniafoundation.org/narcolepsy-type-2/

  Narcolepsy type 2 (NT2) is a long-lasting (chronic) hypersomnia sleep disorder of the brain (neurologic disorder). […] Researchers don’t yet know the cause of NT2, but it isn’t caused by the same problem as NT1. […] Common causes of EDS other than NT2 include: Prescribed medicines causing sleepiness as a side effect, Insufficient sleep, when you regularly don’t get enough good-quality sleep because of work or social reasons, Problems with sleep rhythms (circadian rhythm sleep-wake disorders), such as delayed sleep phase syndrome, Another sleep disorder, such as sleep apnea or narcolepsy type 2, Chronic fatigue syndrome (CFS) or fibromyalgia, Attention-deficit/hyperactivity disorder. […] The MSLT results doctors use to diagnose NT1 and NT2 are the same, so the results don’t help show which sleep disorder you have. Your symptoms, especially cataplexy, can help doctors tell the difference. If your diagnosis still isn’t clear, you may need to follow these steps to tell the difference between NT1 and NT2: Have a blood test for HLA-DQB1*06:02. If this blood test is negative, you most likely have NT2. If this test is positive, you may need step 2. Have a spinal tap to check orexin levels in your cerebrospinal fluid (CSF). If your orexin levels are low, you have NT1. If your orexin levels are normal, you most likely have NT2.

• #44 The Science of Narcolepsy | Sleep Medicine

  https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-4

  Thus, it appears that three factors are important for the development of narcolepsy: Genes that influence the immune system, such as HLA-DQB1*06:02, a triggering factor that activates the immune system, such as infection with strep, and a vulnerable age during which the immune response or some characteristics of the brain make an autoimmune attack on the orexin neurons more likely. […] By gaining a better understanding of this process, researchers hope to develop medications that can stop narcolepsy just as it begins and prevent further injury to the orexin neurons.

• #45 Narcolepsy Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/narcolepsy

  Recent evidence suggests that narcolepsy may be an autoimmune disease, in which the immune system may be tricked into perceiving its own proteins to be antigens. […] Research suggests that an immune attack in narcolepsy may occur against cells containing the brain chemical, hypocretin (orexin). Hypocretin deficiency induces sleepiness and is present in around 90% of people with narcolepsy type 1. […] Some HLAs, particularly the above-mentioned subgroup known as HLA-DQB1*06:02, have been strongly associated with narcolepsy and low levels of hypocretin. Because of the association between HLA-DQB1*06:02 and narcolepsy, an autoimmune basis is suspected to have some role in causing the disease.

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