Narcolepsia e hipersomnia idiopática

Narcolepsy is a chronic disease produced by a dysfunction of the  hypocretine (orexin) system usually secondary to a loss of the  hypothalamic hypocretinergic neurons. Clinically, patients show diurnal  hypersomnia together with symptoms of REM sleep dysregulation  (cataplexy, sleep paralysis and hypnagogic hallucinations) and fragmentation  of nocturnal sleep. The association of hypersomnia with  cataplexy is highly suggestive of narcolepsy, but it does not occur in  every patient, similarly to what happens with the presence of three or  more sleep onset REM periods in the multiple sleep latency test (MSLT).  Low levels of hypocretin in the cerebrospinal fluid have a high sensitivity  and specificity for narcolepsy and can be helpful in the diagnosis.  The treatment is symptomatic: hypersomnolence with stimulants  and cataplexy with antidepressants. It is possible that in the near  future hypocretine agonists will be available to treat the disease.  Idiopathic hypersomnia is a disorder of unknown cause characterized  by hypersomnolence in the absence of other symptoms. It is diagnosed  only after excluding other possible causes of hypersomnia. Treatment  is also symptomatic, with stimulants.