![]() However, there is no simple equivalence between serum and CSF hypocretin level and only the latter is reliable for diagnosis of narcolepsy type 1. In narcoleptic individuals, CSF hypocretin level lower than 110 pg/ml is included in the diagnostic criteria for narcolepsy. Researchers found a lower serum hypocretin in 36 women with PCOS compared to the control group. PCOS may occur at a young age in girls who develop early pubarche and thelarche. EDS has been commonly reported in up-to 80% of this population, irrespective of their Body Mass Index (BMI). PCOS is one of the most common endocrinopathies diagnosed by Rotterdam criteria requiring at least two of these three features: 1) Oligo- or anovulation, 2) Clinical and/or biochemical signs of hyperandrogenism, and/or 3) Polycystic ovaries by ultrasound. ![]() In one study recruiting 26 narcoleptic patients with cataplexy and 9 narcoleptic patients without cataplexy, 23 individuals (88.5%) with narcolepsy-cataplexy had low CSF hypocretin levels, compared to only one in the non-cataleptic group (11.11%) had a low hypocretin level. Low hypocretin is thought to occur in high incidence in type 1 compared to type 2. Other causes of hypersomnia should be ruled out (i.e., medication or other substances as well as OSA or sleep phase disorders). This is in contrast to type 2 which lacks cataplexy but has MSLT narcolepsy criteria and either normal or undocumented hypocretin levels. In the international classification of sleep disorders - third edition, two types of narcolepsy exists: type 1 is diagnosed in the presence of cataplexy and either mean sleep latency test (MSLT) characteristics (i.e., short mean sleep latency < 8 minutes and two or more sleep onset REM however one SOREM criteria can be replaced by REM occurring in the first 15 minutes of Polysomnography ) or Cerebrospinal Fluid (CSF) hypocretin deficiency (levels below 110 pg/ml or < 1/3 of means of normal subjects). Some individuals with narcolepsy have associated low or deficient hypocretin, a brain peptide that helps maintain alertness and regulates rapid eye movement sleep cycles. Other symptoms include sleep paralysis, hypnagogic and/or hypnopompic hallucinations, and disrupted nighttime sleep. Individuals presenting with a sudden loss of muscle tone associated with strong emotions are diagnosed with narcolepsy with cataplexy. Narcolepsy is a disorder that affects sleep-wake cycles, causing individuals to experience periods of excessive daytime sleepiness (EDS), and sleep attacks. Polycystic ovarian syndrome, Obstructive sleep apnea, Hypocretin, Narcolepsy, Cataplexy Authors present one case presentation supported by three other published cases and literature review about this comorbidity. ![]() Low or deficient hypocretin level as well as other hormonal abnormalities might explain this association. However, it is not clear if these two disorders sporadically coexist or are commonly occurring and missed. Both disorders share common comorbidities including obesity, Obstructive Sleep Apnea (OSA), and excessive daytime sleepiness (EDS). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Ī relationship between Polycystic Ovarian Syndrome (PCOS) and narcolepsy has not been well examined. Karim Sedky, Psychiatry Medical Student Clerkship Director and Associate Professor, Department of Psychiatry, Cooper Medical School of Rowan University, 401 Haddon Ave, Suite 346 E and R building, Camden, NJ 08103, USA, Tel: 85, Fax: 85.Ĭitation: Lee D, Kolta B, Sedky K (2017) Polycystic Ovarian Syndrome and Narcolepsy: A Coincidental Relationship?. ![]() Polycystic Ovarian Syndrome and Narcolepsy: A Coincidental Relationship?ĭanielle Lee 1, Bishoy Kolta 2 and Karim Sedky 3*ġSecond Year Medical Student, Cooper Medical School of Rowan University, USAĢThird Year Psychiatry Resident, Cooper Medical School of Rowan University, USAģPsychiatry Medical Student Clerkship Director and Associate Professor of Psychiatry, Cooper Medical School of Rowan University, USA
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