Narcolepsy in a 12-month-old-boy

Sleep disorders in childhood

Childhood sleep-wake disorders are common and associated with significant impairment of quality of life. The recent discovery of hypocretin deficiency as the pathophysiologic basis for narcolepsy-cataplexy is likely to spur the development of hypocretin analogs for definitive treatment [82,83]. The link between disrupted sleep and daytime learning and childhood inattention is a challenging area of mind-brain interaction in which further progress is likely, once methodologic issues have been sorted out. The recent recognition of genetic influences in the control of circadian rhythms also may spur the development of specific therapies for circadian rhythm disorders. In many ways, sleep medicine is benefiting from recent progress in the basic neurosciences, genetics, and technology.

Narcolepsy in children

Core symptoms of narcolepsy are similar in children compared with adults, but expression may be different due to more severe manifestations, maturational factors, and the significant impact of symptoms on behavior and academic performance. Diagnosis of narcolepsy in children is often challenging and requires a detailed history followed by polysomnography and the Multiple Sleep Latency Test. Management involves a comprehensive approach, including patient and family education and emotional support; behavioral strategies, such as good sleep hygiene and planned naps; and pharmacologic intervention. Despite dramatic progress recently in understanding the etiology of human narcolepsy through molecular genetic investigations, the disorder remains a chronic and often disabling disease with major impact on the lives of children and their families.