Hopp til hovedinnhold

Narkolepsi

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Kronisk søvnforstyrrelse karakterisert ved uttalt søvnighet på dagtid med søvnanfall, og ofte katapleksi, hypnagoge hallusinasjoner og søvnparalyse. Arvelige faktorer kan være av betydning
Forekomst: 
Det er beregnet å være ca. 2000-2500 pasienter her i landet. Er uvanlig hos barn, men symptomene starter ofte i ungdomsalder
Symptomer:
Symptomene er økt søvnighet og anfallsvis svært sterk søvntrang på dagtid. Typisk er også katapleksi, hypnagoge hallusinasjoner og søvnparalyse
Funn:
Den fysiske undersøkelsen er normal
Diagnostikk:
Tester i søvnlaboratorium anbefales for sikker diagnose
Behandling:
Behandlingen består av informasjon og tilrettelegging i arbeid eller skole. Medikamentell behandling er aktuelt mot søvnigheten og mot katapleksi og hypnagoge hallusinasjoner
  • NevSom har kompetansesenteransvar for blant annet narkolepsi - nettsted 
  • Nasjonal kompetansetjeneste for søvnsykdommer (SOVno) - nettsted  
  1. Zeman A, Britton T, Douglas N, et al. Narcolepsy and excessive daytime sleepiness. BMJ 2004; 329: 724-8. PubMed  
  2. Guilleminault C, Brooks SN. Excessive daytime sleepiness. Brain 2001; 124: 1482-91. PubMed  
  3. Scammell TE. Narcolepsy. N Engl J Med. 2015; 373:2654-62. pmid:26716917 PubMed  
  4. Britton T, Douglas N, Hansen A, Hicks J, Howard R, Meredith A, et al. Guidelines on the diagnosis and management of narcolepsy in adults and children. Ashtead: Taylor Patten Communications, 2002 (available at www.sleeping.org.uk or www.primarycaresleep.com).
  5. Overeem S, Mignot E, van Dijk JG, Lammers GJ. Narcolepsy: clinical features, new pathophysiologic insights and future perspectives. J Clin Neurophysiol 2001; 18: 78-105. PubMed  
  6. Billiard M. Diagnosis of narcolepsy and idiopathic hypersomnia: an update based on the international classification of sleep disorders, 2nd edition. Sleep Med Rev 2007; 11: 377–88.
  7. Silber MH, Krahn LE, Pankratz VS. The epidemiology of narcolepsy in Olmstead County, Minnesota: a population-based study. Sleep 2002; 25: 197-202. PubMed  
  8. Longstreth WT Jr, Koepsell TD, Ton TG. The epidemiology of narcolepsy. Sleep 2007; 30: 13. pmid:17310860 PubMed  
  9. Heier MS, Evsiukova T, Wilson J, et al. Prevalence of narcolepsy with cataplexy in Norway. Acta Neurol Scand 2009; 120: 276-80. PubMed  
  10. Sand T, Schrader H. Narkolepsi og andre hypersomnier. Oversiktsartikkel. Tidsskr Nor Legeforen 2009; 129: 2007-10. Tidsskrift for Den norske legeforening  
  11. NevSom - Nasjonalt kompetansesenter for nevroutviklingsforstyrrelser og hypersomnier. Narkolepsi. Nettsiden publisert 24.01.2018 og sist oppdatert 23.03.2020 legehandboka.no  
  12. Ruge Møller L, Østergaard JR. Narkolepsi hos børn - en overset diagnose. Ugeskr Læger 2005; 167: 2390-3. PubMed  
  13. Mignot E, Lammers GJ, Ripley B, et al. The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Arch Neurol 2002; 59: 1553. doi:12374492
  14. Dauvilliers Y, Montplaisir J, Molinari N, et al. Age at onset of narcolepsy in two large populations of patients in France and Quebec. Neurology 2001; 57: 2029. pmid:11739821 PubMed  
  15. Allele Frequency Net Database: Søk gjort 23.03.20. www.allelefrequencies.net  
  16. Mignot E. Genetic and familial aspects of narcolepsy. Neurology 1998; 50: Suppl 1 (S16-22). pmid:9484418 PubMed  
  17. National institute for health and welfare. Association between Pandemrix and narcolepsy confirmed among Finnish children and adolescents. Sept. 1, 2011.
  18. Sarkanen T, Alakuijala A, Partinen M. Clinical course of H1N1-vaccine-related narcolepsy. Sleep Med 2016; 19: 17-22. pmid:27198942 PubMed  
  19. Søvnsykdommen narkolepsi blant barn og unge etter pandemien 2009/2010. Folkehelseinstituttet 2013
  20. Pace-Schott EF, Hobson JA. The neurobiology of sleep. Nat Rev Neurosci 2002; 3: 591-605. PubMed  
  21. Hobson JA, Pace-Schott EF. The cognitive neuroscience of sleep. Nat Rev Neurosci 2002; 3: 670-93. PubMed  
  22. Nishino S, Ripley B, Overeem S, Lammers GJ, Mignot E. Hypocretin (orexin) deficiency in human narcolepsy letter. Lancet 2000; 355: 39-40. PubMed  
  23. Peyron C, Faraco J, Rogers W, Ripley B, Overeem S, Charnay Y, et al. A mutation in a case of early onset narcolepsy and a generalised absence of hypocretin peptides in human narcoleptic brains. Nat Med 2000; 6: 991-7. PubMed  
  24. Thannickal TC, Moore RY, Nienhuls R, Ramanathan L, Gulyani S, Aldrich M, et al. Reduced numbers of hypocretin neurons in human narcolepsy. Neuron 2000; 27: 469-74. PubMed  
  25. Scammell T. The neurobiology, diagnosis and treatment of narcolepsy. Ann Neurol 2003; 53: 154-66. PubMed  
  26. Tafti M, Hor H, Dauvilliers Y, et al. DQB1 locus alone explains most of the risk and protection in narcolepsy with cataplexy in Europe. Sleep 2014; 37: 19-25. pmid:24381371 PubMed  
  27. Miyagawa T, Tokunaga K. Genetics of narcolepsy. Hum Genome Var 2019; 8: eCollection 2019. pmid:30652006 PubMed  
  28. Judd BG, Sateia MJ. Classification of sleep disorders. UpToDate 2017 - last updated may 2015. www.uptodate.com  
  29. Guilleminault C, Pelayo R. Nacolepsy in children. Paediatr Drugs 2000; 2-9.
  30. Merrill S, Wise MD. Childhood narcolepsy. Neurology 1998; 50(suppl 1): S37-S42.
  31. McKenna L, McNicholas F. Childhood onset narcolepsy. Eur Child Adolesc Psychiatry 2003; 12: 43-7. PubMed  
  32. Babiker MO, Prasad M. Narcolepsy in children: a diagnostic and management approach. Pediatr Neurol 2015; 52: 557-65. pmid:25838042 PubMed  
  33. Daniels E, King MA, Smith IE, Shneerson JM. Health-related quality of life in narcolepsy. J Sleep Res 2001; 10: 75-81. PubMed  
  34. Standard of Practice Committee, American Academy of Sleep Medicine. Practice parameters for the treatment of narcolepsy. Sleep 2001; 24: 451-66. PubMed  
  35. Dauvilliers Y, Lecendreux M, Lammers GJ, et al. Safety and efficacy of pitolisant in children aged 6 years or older with narcolepsy with or without cataplexy: a double-blind, randomised, placebo-controlled trial. Lancet Neurol 2023; 22: 303-311. pmid:36931805 PubMed  
  36. Rogers AE, Aldrich MS, Lin X. A comparison of three different sleep schedules for reducing daytime sleepiness in narcolepsy. Sleep 2001; 24: 385-91. PubMed  
  37. Scammell TE, Benca R. Treatment of narcolepsy. UpToDate 2013 UpToDate  
  38. US Modafinil in Narcolepsy Multicenter Study Group. Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy. Neurology 2000; 54: 1166-75. Neurology  
  39. Vignatelli L, D'Alessandro R, Candelise L. Antidepressant drugs for narcolepsy. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD003724. DOI: 10.1002/14651858.CD003724.pub3. DOI  
  40. Alshaikh MK, Tricco AC, Tashkandi M, et al. Sodium oxybate for narcolepsy with cataplexy: systematic review and meta-analysis. J Clin Sleep Med 2012; 8: 451-8. pmid:22893778 PubMed  
  • Bjørn Bjorvatn, professor dr.med., Institutt for global helse og samfunnsmedisin, Universitetet i Bergen, og leder av Nasjonal kompetansetjeneste for søvnsykdommer, Haukeland Universitetssykehus
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL