Narcolepsy, a neurological disorder that causes overwhelming daytime drowsiness and sleep attacks, was first recognized as a clinical disorder in 1880. Doctors discovered the fundamentals of the condition over a period of many years, and scientists are still learning new information about narcolepsy to this day. There is no known cure for the condition, though there are a range of treatments.
Discovering Narcolepsy: The Early Days
While narcolepsy symptoms have probably been around since the beginning of time, the recorded history of the condition is believed to date as far back as the 17th century, with Oxford physician Thomas Willis. While he did not use the word "narcolepsy," he wrote about patients experiencing "a sleepy disposition who suddenly fall fast asleep." Interestingly, Willis also suggested caffeine as a treatment for narcolepsy, and stimulants have played a big part in the therapy of narcolepsy throughout history.
Westphal and Fisher
In the 1870s, two German doctors, Westphal and Fisher, first described the symptoms of what would soon after be named narcolepsy. They noticed a set of circumstances in which their patients would unexpectedly fall asleep at random times throughout the day. These patients also experienced other symptoms such as dream-like hallucinations while they were awake and "automatic behavior," which caused them to perform daily tasks while they were still asleep.
Dr. Westphal was the first to clinically describe narcolepsy as a physical disorder, which often manifests along with cataplexy, a fixation of the eyes and episodes of sudden loss of muscle tone while a person is awake.
Narcolepsy was recognized as a clinical disorder in 1880 by a French doctor named Gélineau, who is credited with naming the disorder. To get the French name narcolepsie, he combined two Greek words: narke, meaning numbness, and lepsis, meaning attack. The disorder is aptly named as suffers experience "sleep attacks" following intense emotional experiences, such as laughing and screaming.
Gélineau failed to differentiate between actual sleep attacks and the muscle weakness that causes patients to stumble or collapse, instead suggesting a common physiological trigger for both symptoms. He also connected the symptoms of excessive daytime sleepiness, cataplexy, and sleep paralysis as relating to one specific disorder. Using the term "narcolepsy" to mean all disorders that caused daytime sleepiness means that his definition included illnesses, such as lethargic encephalitis, that were not actually sleep disorders.
20th Century Progress
In 1902, a doctor named Loëwenfeld was the first physician to separate the pathology of muscle weakness and sleep attacks. He named this muscle weakness "cataplexy."
In 1907, Dr. William Gowers sought in his book, The Border-Land of Epilepsy, to differentiate narcolepsy as a unique disorder. He insisted that it was separate from other conditions that could cause excessive daytime sleepiness.
Yoss and Daly
In 1957, Mayo clinic doctors Robert Yoss and David Daly officially united the four classic narcolepsy symptoms:
- Excessive sleepiness during daytime hours
- Sleep paralysis
- Hypnagogic hallucinations
His work firmly established the "narcoleptic tetrad" as the definitive diagnostic criteria for narcolepsy.
In 1970, Dr. William Dement established the first sleep disorders clinic in San Francisco, following an overwhelming local response to his recruitment efforts for a narcolepsy study. In 1973, he first observed narcolepsy in dogs and established a research colony of animals with canine narcolepsy. These efforts eventually led to the first documented genetic transmission of the disorder. This breakthrough quickly led to the isolation of a potential genetic cause for narcolepsy, an avenue of research that scientists are still exploring.
21st Century Narcolepsy Research
Still want to know more about the discovery of narcolepsy? Keep in mind that scientists learn more about this sleep disorder every day. The medical community still doesn't know exactly what causes narcolepsy to develop, and researchers are hard at work trying to solve the mystery.
Here are a few recent narcolepsy-based studies:
- A possible link between narcolepsy and Parkinson's disease - These two neurological disorders share some common traits that may shed light on both of them.
- Potential risk for narcoleptics who smoke - Since narcoleptics fall asleep without notice, they have an increased risk of injury and death by burning.
- Changes in body temperature and their effect on narcoleptic sleepiness - Direct manipulation of skin temperature in narcoleptics can affect levels of vigilance and sleepiness.
- Whether narcolepsy is caused by environmental factors - If a person is genetically predisposed, narcolepsy may be caused by environmental exposures long before the disorder becomes apparent.
- Narcoleptics more likely to develop an eating disorder - Narcoleptics have been linked to symptoms of eating disorders.
More to Learn
While narcolepsy has been recognized as a clinical condition since the 19th Century, there is still much to be learned about the condition and the associated symptoms. As additional breakthroughs are made, hope increases that its causes will be better understood, providing a basis for the development of improved treatments - and hopefully cures - for the debilitating disorder.