This model assumes that REM sleep is an anti-stress filter that is affected by narcolepsy, such that it does not fully filter the activating information of these processes, which thereby increase as a result of the occurrence of high emotional arousal that cannot be processed. The second model attempts to explain the relationship between REM sleep disorders and cataplexy. Thus, while recognizing the important contribution of precipitating factors (e.g., conditions that trigger cataplexy, passive situations, sleepiness, sleep deprivation, and so on) to the overall illness, the model also permits the possibility of symptom modification through learning. It attributes these response differences to the unique individual learning histories whereby some patients are able control their cataleptic symptoms because they have learned to regulate their emotions. The model notes that while some individuals may manifest symptoms under specific circumstances, others might be asymptomatic in the presence of the same stimuli. The model presumes that the internal factors (i.e., predisposing factors) are constant while it is the external risk factors which chronically maintain the illness.Ĭognitive factors are also taken into account. This model provides the basis for designing a structured intervention program by identifying the interaction between external risk factors (i.e., those associated with disease symptoms that might be precipitants and triggers) and internal risk factors (i.e., predictors of narcolepsy such as biological factors, orexinergic neuron deficits, and so on). The cognitive-behavioral model of narcolepsy first identifies the basic elements which make up the clinical syndrome, and then describes the causal factors (both intrinsic and extrinsic) that either precede or modify the production of symptoms. Explanatory psychological models of narcolepsyĭuring this review, two theoretical psychological models were identified that provide the rationale for CBT’s use for narcolepsy. The analysis did not examine a study design effect because of the disparity between the measures and methods used across the papers included.ģ.1. Thus, descriptions of the studies and the relevant conclusions with regard to their quality, conclusions, and contributions were preferred. The remaining papers were classified based on the type of study and behavioral measures used as well as the sample, method, and results.Īn assessment of the level of evidence was not included because some studies were not adequate. In all, 30 papers were collected, with an additional 7 which were discarded because they were not related to CBT. When necessary, certain authors and associations were contacted for additional published and unpublished materials. CBT and narcolepsy were used as keywords. The papers cited in the reference lists of previous reviews on this topic were also examined. Several key sources of non-indexed literature were also searched. Drug therapy has been highly recommended and supported by well-designed research that shows its effectiveness.Ĭonversely, the implementation of CBT (i.e., the systematic application of the principles and learning techniques needed to evaluate and improve behavior) has not been well studied with regard to narcolepsy, most likely becauseĪ search was conducted using MEDLINE, PsycINFO, ScienceDirect, and Springer databases as well as conference proceedings and relevant journals. The treatment of choice for narcolepsy consists of prescribing stimulants to control EDS and antidepressants to treat parasomnias and associated cataplexy. Furthermore, narcolepsy is associated with an increased risk of work-related and transit accidents, sexual dysfunctions, neuropsychological alterations (increased reaction time, decreased executive functioning), and an overall significant reduction in quality of life. Because this disease is chronic, patients and their families have trouble coping with it. ĭifferent consequences of narcolepsy have been described. These symptoms include excessive daytime sleepiness (EDS i.e., sudden sleep attacks during the day), cataplexy (i.e., the loss of muscle tone during intense emotions), sleep paralysis (i.e., feeling unable to move when waking up), hypnagogic hallucinations (i.e., active hallucinations prior to the onset of sleep), and dream pattern alterations as well as secondary symptoms that accompany the disorder, such as automatic behaviors and cognitive deficits. Narcolepsy consists of a set of core symptoms known by many authors as “narcoleptic tetrad”. One study reported that this disease affects 1 in 2000 individuals. Narcolepsy is a disabling sleep disorder that significantly affects overall patient functioning.
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