What We Should Know About Narcolepsy

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What we should know about narcolepsy


The sleep-vigilia cycle is regulated by an oscillatory mechanism, also called "flip-flop" mechanism. In this mechanism five hormones intervene: hormones that keep us awake (wake on, rem off), norepinenial, serotonin, histamine, hypocretin/orexin, hormones that keep us asleep (wake off, rem On) and acetylcholine. The name difference between Hippocretina and Orexin is only due to its discoverer. Both are the same peptide. It is secreted in lateral hypothalamus neurons, these neurons are very few compared to the total in our system, but they have very broad projections, which extend throughout the brain. 


Narcolepsy with cataplejia, narcolepsy is a chronic sleep disorder, characterized by excessive daytime drowsiness, cataplejia, sometimes sleep paralysis;whose density in the population is 50 in 1000. Géllineau Syndrome, thus was first described in 1879 by Géleau;In 1930.  Von Economomo was the first to suggest that the disease was caused by an injury or dysfunction in the hypothalamus. Later the canine narcolepsy in standford: in dogs, narcolepsia is due to genes.

This was discovered by crossing canine subjects that showed symptoms of the disease until canine subjects with narcolepsia developed. However, in humans this is very rare. Genetic factors, it is believed that it is due to the HLA DQBI*06: 02, which destroys hypocretinérgic neurons.  There is a hypothesis that narcolepsy is an autoimmune disease, that is, that it is the body itself that destroys the lateral hypothalamus neurons. In a study, 85% of patients with narcolepsia tested positive for the HLA DQBI*06: 02.

But 25% of common people (without manifest narcolepsia). Therefore, this gene is related to the disease, but it seems that it is inactive and we need to have something to activate this gene to develop the disease. The relationship of the activation of this gene with multiple diseases and traumatic experiences has been studied, but no conclusion has not yet been found, no significant relationship between these diseases and the activation of the gene has been found. 

Symptomatology, a state of propensity to fall asleep and that remains at greater or lesser intensity during the day, access to dreams or micro-people: brief, irresistible (they cannot avoid falling asleep in any way), but refreshing (that is, youwake up more rested than when you fell asleep). When the activities are very routine, it has been observed that the tasks that they imply unconsciously and with a very bad performance (similar to sleepwalking) have continued (similar). They do not maintain attention. 

Cataplejia, is defined as the loss of sudden muscle tone triggered by intense emotions and without loss of consciousness. It is the best marker as a diagnosis of the disease almost always maintains consciousness in a cataplejia episode. Main triggers of cataplejia: intense emotions (especially positive), pain, orgasms. It causes high levels of anxiety and the people who suffer from it are very likely to develop social phobia, due to the fear that causes them to suffer some cataplejia in public. 

Accessory symptomatology, sleep paralysis and hypnagogical hallucinations (that is, at the beginning of the night) or hypnopompic (that is, at the end of the night). These hallucinations are not psychotic, that is, they do not speak to you, but you notice that someone has entered the room, that he touches on your side … it is not yet known what triggers them, but they think of stress or drugs. Night sleep, SOREMP presence has been detected. Although they thought that at night these people with narcolepsia were going to sleep well, since it seems that they are tired all day.

It is not so in reality, they do not sleep well because what causes the disease is a mismatch in the sleep modulation system. Lucid dreams: they are dreams in which you know you are dreaming and you can modulate that dream. They can learn, that is, you can train to have a lucid dream. In Psychology, people are trained to have lucid dreams in nightmare treatment. The dream. “Dreams are a mental activity that occurs while we sleep, characterized by sensory and motor images that are lived as distinctive cognitive forms.

Since they are impossible and very unlikely in time, space, in person or in the dream actions. These actions are accompanied by emotional states (joy, sadness, fear, disgust, anger) that, sometimes, for their intensity, produce a sudden awakening. Memory for the contents of dreams is evanescent and tends to disappear as soon as we wake up ”(Hobson and Stickgold). The dream is a dynamic state, that is, neurons are still active although playing a different role from the state of vigil. 

Throughout our lives we spent a third sleeping and a sixth dreaming;being necessary for our health because while we sleep, memory is consolidated, energy is stored and the temperature is regulated among many other functions. The dream and vigil are regulated by the circadian cycle, which is controlled by the internal biological clock regardless of external variables. The vigil-sueño cycle is regulated by a set of neurotransmitters: histamine, orexin, serotonin, norepinephrine, gaba, acetylcholine, dopamine. 

Our day to day is based on a cycle of vigil-soup: vigil status, dream of slow waves/ no rem: without rapid ocular movements. STAGE 1 → SOMNOLENCY, THETA WAVES (47HZ): Transition from sleeping vigil. Stage 2 → Beta Waves (13Hz): It consists of 50% of sleep hours. Stage 3 → Theta and Delta Waves. Stage 4 → Delta Waves This sleep cycle with four stages lasts between 90-120 minutes of sleep. Dream Rem, in this seminar we are going to focus on ReM sleep because it is where both nightmares and lucid dreams that we are going to talk about next. 

This phase is characterized by cortical activation and rapid ocular movement, contrary to the non -rem sleep where this movement does not occur. REM dream is focused at the bridge level or bump. The Pontino Tegment is the one that contains a series of ascending cells and fibers (Sara = Ascending Reticular Activating System). In turn, if the inhibition of the locus ceruleus centers did not occur, it would not be achieved to reach the REM dream. This sleep phase is longer during the stages of childhood and adolescence thus favoring the maturation and development of the central nervous system. 

Typical alterations during this phase are usually: lucid dreams, archetypal and nightmares, of which two of them will speak next. What are nightmares?Through nightmares we can get deeper into our own dreams produced during the REM phase. Thanks to them, we can live terrifying dreams with convincing details and with truly distressing content producing a sense of fear of the person who experiences it causing its awakening and its subsequent memory. 

The origin of the nightmares has been varying a lot over the centuries, they began being experiences of the souls of the dreamers for other worlds, they continued to be experiences with the demon itself (the word nightmare comes from: demon), until reaching ourcentury and our culture, considering them something unimportant and imaginary. During nightmares, situations can be unlimited, anything that one imagines can happen, and in turn, we are alone in this danger situation where our personal fears are recreated. 

Once the subject realizes that it is a dream can either direct the situation or if he prefers, wake up. This type of sleep is not only frequent in children, but also in adulthood. Those dreamers who live it in a regular basis often have high stress, little imagination and poor viso-spatial coordination. Freud, through his psychoanalytic theory, has tried to explain the nature of this type of dreams;the nigthmares. Freud began this theory trying to introduce them in an approach where dreams are representations of superego’s wishes. 

This is because for him, nightmares were an obstacle to achieving a dream theory. After taking this step, he totally changed his theory focusing on nightmares as a cause of trauma. Revonsuo, unlike Freud, focuses on its evolutionary meaning favoring the survival of these dreamy types with threatening and negative content in each of its nightmares. “A modern therapy to overcome nightmares is training in lucid dreams, where one recognizes that the dream is the product of their mind and is not real.

So that one demands the monsters of their dreams to be his friends.”(Laberge). What are lucid dreams? Lucid dreams happen, just like nightmares, during the REM phase. They are based on a sleep mode where the subject is aware of what he is dreaming and therefore is able to control, create and transform that situation being able to build his own argument during that time. This plot contains a context that is stable and dependent on the situation that is being lived. During this phase the brain reflects on its own vigil while sleeping. 

This type of sleep is also remarkable a bidirectional communication between lucid dream and vigil, being possible to remember it when awakening. Lucid dreams intensify and highlight self-reflection, inherent in all human cognitive activity, especially meditation. They constitute a subjective and physiological reality at the same time, and therefore paradoxical, since despite demanding an activation of the vigil’s central nervous system, they are definitely a phenomenon of sleep. According to Laberge.

Lucid dreams are useful for self-explore psychologically and we could all have these dreams, except those people who are not able to differentiate reality during the state of vigil and their imagination. Also, thanks to lucid dreams, the person would benefit because he "would become more aware". On the other hand, thanks to these dreams, the learning of movements sequences would be facilitated as Daniel Erlachar, from the University of Heidelberg, has been able to demonstrate.

Through a study on the learning rate of motor movements in athletes. One of the characteristics of the people who suffer these lucid dreams are a high imagination and physical balance, next to a low stress. Three parts appear: reference to metacognitive state or context. Semantic contextual frame or declarative expectations. When during lucid dreams you get to think "I am dreaming", the first two elements are activated, being the second (the semantics), which would really make sense of sleep. 

Expectations and beliefs would be produced, which are fundamental in their decision -making during this period. Meta frame or action of the effectors, in this phase the consciousness of the dreamer would be configured, their behavior and their way of acting both in the state of vigil and during sleep. Nightmare treatment. Lucid dreams as we have seen throughout the seminar serve for the treatment of nightmares, and in turn for the investigation of consciousness. 

Through this type of sleep according to Laberge and Rheingold, fears can be faced, because the dreamer is the main responsible for what happens in each nightmare, controlling the situation and without happening at all bad. This type of treatment implies a lucid dream preparation, being accessible both spontaneously or through autosugestion. A form of training to access lucid dreams is the one proposed by Zadra, Donderi and Phil: “The repetition of about 5-10 times a day of the following question:“ Am I dreaming?" "I’m awake?"" I’m already asleep?"


Preferably close to the moment of the beginning of the dream, thus obtaining a habit that will also occur throughout the dream.”According to Laberge and Gackenbach, this training would achieve its maximum point in those dreamers with chronic nightmares. After two studies, a decrease in nightmares was obtained as a result, which was their initial objective. In future research, lucid dreams may also have an important role in reducing anxiety or reaction to certain phobic stimuli of everyday life.

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