Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns

Emily C Barker,1 Julie Flygare,2 Shalini Paruthi,3,4 Katherine M Sharkey5– 7 1Case Western Reserve University School of Medicine, Department of Pediatrics, Cleveland, OH, USA; 2Project Sleep, Los Angeles, CA, USA; 3Sleep Medicine and Research Center, St. Luke’s Hospital, St. Loui...

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Autores principales:	Barker EC, Flygare J, Paruthi S, Sharkey KM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	narcolepsy cataplexy sleepiness hypersomnia solriamfetol pitolisant sodium oxybate children pregnancy lactation stigma Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/71aec5b33e934115ad4f4c362bf537dd
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spelling	oai:doaj.org-article:71aec5b33e934115ad4f4c362bf537dd2021-12-02T11:40:08ZLiving with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns1179-1608https://doaj.org/article/71aec5b33e934115ad4f4c362bf537dd2020-07-01T00:00:00Zhttps://www.dovepress.com/living-with-narcolepsy-current-management-strategies-future-prospects--peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Emily C Barker,1 Julie Flygare,2 Shalini Paruthi,3,4 Katherine M Sharkey5– 7 1Case Western Reserve University School of Medicine, Department of Pediatrics, Cleveland, OH, USA; 2Project Sleep, Los Angeles, CA, USA; 3Sleep Medicine and Research Center, St. Luke’s Hospital, St. Louis, MO, USA; 4Saint Louis University School of Medicine, Departments of Medicine and Pediatrics, St. Louis, MO, USA; 5Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA; 6Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA; 7Rhode Island Hospital, Providence, RI, USACorrespondence : Katherine M SharkeyAlpert Medical School, Brown University, 233 Richmond Street, Providence, RI 02906 Tel +1 401-863-2450Fax +1 401-863-2940Email Katherine_Sharkey@brown.eduAbstract: Narcolepsy is a neurological disorder of the sleep-wake cycle characterized by excessive daytime sleepiness (EDS), cataplexy, nighttime sleep disturbances, and REM-sleep-related phenomena (sleep paralysis, hallucinations) that intrude into wakefulness. Dysfunction of the hypocretin/orexin system has been implicated as the underlying cause of narcolepsy with cataplexy. In most people with narcolepsy, symptom onset occurs between the ages of 10 and 35 years, but because the disorder is underrecognized and testing is complex, delays in diagnosis and treatment are common. Narcolepsy is treated with a combination of lifestyle modifications and medications that promote wakefulness and suppress cataplexy. Treatments are often effective in improving daytime functioning for individuals with narcolepsy, but side effects and/or lack of efficacy can result in suboptimal management of symptoms and, in many cases, significant residual impairment. Additionally, the psychosocial ramifications of narcolepsy are often neglected. Recently two new pharmacologic treatment options, solriamfetol and pitolisant, have been approved for adults, and the indication for sodium oxybate in narcolepsy has been expanded to include children. In recent years, there has been an uptick in patient-centered research, and promising new diagnostic and therapeutic options are in development. This paper summarizes current and prospective pharmacological therapies for treating both EDS and cataplexy, discusses concerns specific to children and reproductive-age women with narcolepsy, and reviews the negative impact of health-related stigma and efforts to address narcolepsy stigma.Keywords: narcolepsy, cataplexy, sleepiness, hypersomnia, solriamfetol, pitolisant, sodium oxybate, children, pregnancy, lactation, stigmaBarker ECFlygare JParuthi SSharkey KMDove Medical Pressarticlenarcolepsycataplexysleepinesshypersomniasolriamfetolpitolisantsodium oxybatechildrenpregnancylactationstigmaPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 453-466 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	narcolepsy cataplexy sleepiness hypersomnia solriamfetol pitolisant sodium oxybate children pregnancy lactation stigma Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	narcolepsy cataplexy sleepiness hypersomnia solriamfetol pitolisant sodium oxybate children pregnancy lactation stigma Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Barker EC Flygare J Paruthi S Sharkey KM Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
description	Emily C Barker,1 Julie Flygare,2 Shalini Paruthi,3,4 Katherine M Sharkey5– 7 1Case Western Reserve University School of Medicine, Department of Pediatrics, Cleveland, OH, USA; 2Project Sleep, Los Angeles, CA, USA; 3Sleep Medicine and Research Center, St. Luke’s Hospital, St. Louis, MO, USA; 4Saint Louis University School of Medicine, Departments of Medicine and Pediatrics, St. Louis, MO, USA; 5Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA; 6Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA; 7Rhode Island Hospital, Providence, RI, USACorrespondence : Katherine M SharkeyAlpert Medical School, Brown University, 233 Richmond Street, Providence, RI 02906 Tel +1 401-863-2450Fax +1 401-863-2940Email Katherine_Sharkey@brown.eduAbstract: Narcolepsy is a neurological disorder of the sleep-wake cycle characterized by excessive daytime sleepiness (EDS), cataplexy, nighttime sleep disturbances, and REM-sleep-related phenomena (sleep paralysis, hallucinations) that intrude into wakefulness. Dysfunction of the hypocretin/orexin system has been implicated as the underlying cause of narcolepsy with cataplexy. In most people with narcolepsy, symptom onset occurs between the ages of 10 and 35 years, but because the disorder is underrecognized and testing is complex, delays in diagnosis and treatment are common. Narcolepsy is treated with a combination of lifestyle modifications and medications that promote wakefulness and suppress cataplexy. Treatments are often effective in improving daytime functioning for individuals with narcolepsy, but side effects and/or lack of efficacy can result in suboptimal management of symptoms and, in many cases, significant residual impairment. Additionally, the psychosocial ramifications of narcolepsy are often neglected. Recently two new pharmacologic treatment options, solriamfetol and pitolisant, have been approved for adults, and the indication for sodium oxybate in narcolepsy has been expanded to include children. In recent years, there has been an uptick in patient-centered research, and promising new diagnostic and therapeutic options are in development. This paper summarizes current and prospective pharmacological therapies for treating both EDS and cataplexy, discusses concerns specific to children and reproductive-age women with narcolepsy, and reviews the negative impact of health-related stigma and efforts to address narcolepsy stigma.Keywords: narcolepsy, cataplexy, sleepiness, hypersomnia, solriamfetol, pitolisant, sodium oxybate, children, pregnancy, lactation, stigma
format	article
author	Barker EC Flygare J Paruthi S Sharkey KM
author_facet	Barker EC Flygare J Paruthi S Sharkey KM
author_sort	Barker EC
title	Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
title_short	Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
title_full	Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
title_fullStr	Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
title_full_unstemmed	Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns
title_sort	living with narcolepsy: current management strategies, future prospects, and overlooked real-life concerns
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/71aec5b33e934115ad4f4c362bf537dd
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Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns

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