Other conditions

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Narcolepsy is also associated with several conditions apparently unrelated to sleep.

1 Migraines. These occur in around 75% of subjects.

2 Obesity. An increase in weight and appetite is an early and often the initial symptom of narcolepsy, particularly in children. It is associated with a reduction in hypocretin production which stimulates appetite, and a reduction in leptin which is an appetite suppressant. Initially there is an increase in appetite, particularly for carbohydrates, but later in the natural history food intake appears to be reduced, although some subjects retain a craving for carbohydrate food during the night. The fall in serum leptin is probably due to a reduction in sympathetic activity and there is also a loss of the nocturnal increase in leptin. In general, carbohydrates appear to have a tendency to promote sleep in narcolepsy.

3 Type 2 diabetes mellitus.

4 Thyroid disorders.

5 Hypotension. There is a relative increase in para-sympathetic compared to sympathetic activity in narcolepsy, with a tendency towards a lower blood pressure, body temperature and metabolic rate, which contrasts with conditions in which there is sleep fragmentation in which there is increased sympathetic activity.

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