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Narcolepsy is a chronic neurological disorder that impairs the ability to regulate sleep–wake cycles, and specifically impacts REM (rapid eye movement) sleep. [1] The pentad symptoms of narcolepsy include excessive daytime sleepiness (EDS), sleep-related hallucinations, sleep paralysis, disturbed nocturnal sleep (DNS), and cataplexy. [1]
Pitolisant is indicated in adults for the treatment of narcolepsy. [3] [4] Narcolepsy is a chronic sleep disorder that causes overwhelming daytime drowsiness. [4] Pitolisant is also indicated to improve alertness and reduce excessive daytime sleepiness in adults with obstructive sleep apnea. [5] [12]
Insufficient quality or quantity of night time sleep [5] Obstructive sleep apnea [6] Misalignments of the body's circadian pacemaker with the environment (e.g., jet lag, shift work, or other circadian rhythm sleep disorders) [7] Another underlying sleep disorder, such as narcolepsy, sleep apnea, [8] idiopathic hypersomnia, or restless legs syndrome
Medical treatment starts with education about sleep stages and the inability to move muscles during REM sleep. People should be evaluated for narcolepsy if symptoms persist. [ 22 ] The safest treatment for sleep paralysis is for people to adopt healthier sleeping habits.
Filorexant was studied for but was not found to be effective in the treatment of diabetic neuropathy, migraine, and major depressive disorder in phase 2 clinical trials. [35] [36] [37] Seltorexant is under development for treatment of major depressive disorder however and is in phase 3 trials for this indication. [38]
The endogenous orexin neuropeptides, orexin A and orexin B, are involved in the regulation of sleep–wake cycles and act to promote wakefulness. [33] [16] [7] Deficiency of orexin signaling is thought to be the primary cause of the sleep disorder narcolepsy. [33] [16] Disturbances in orexin signaling may also be involved in insomnia. [33]
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