COGNITIVE DEFICITS IN NARCOLEPTICS: POSSIBLE CAUSES, SIMILARITIES TO ADHD, AND CLASSROOM ACCOMMODATIONS
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Date
2016-06
Authors
Miller, Martina
Journal Title
Journal ISSN
Volume Title
Publisher
University of Oregon
Abstract
Narcolepsy is a sleep disorder affecting more than 1 in 2,000 Americans. It is
characterized by excessive daytime sleepiness, a fast transition into REM sleep, and is
often accompanied by cataplexy (a symptom involving involuntary loss of muscle tone
in awake patients). In most cases the disorder is autoimmune, the immune system
targets and destroys hypocretin ( orexin) producing neurons in the hypothalamus.
Narcolepsy is permanent and irreversible. Treatments consist primarily of
neurostimulant pharmaceuticals designed to keep patients awake during daytime hours;
they do not restore the hypocretin pathway. This pathway is implicated in maintaining
wakefulness, metabolism, and is also a reward pathway that could factor into complex
memory and executive function tasks. Additionally, narcoleptics have altered sleep
stage cycles that are key for memory processing and consolidation. It is not yet known
if or how narcoleptics process memories differently, however, it is known that
narcoleptics exhibit cognitive and attentional deficits. These deficits appear to show
similarities to symptoms of attention deficit hyperactivity disorder (ADHD), which is a
far more common learning disorder. Little is known about appropriate accommodations for narcoleptic students in classroom settings. Current recommendations are vague and
focus only on preventing sleep attacks, not on the cognitive impairments associated
with the disorder. In addition to synthesizing known narcoleptic deficiencies and
discussing their possible classroom implications. For this project, I performed a clinical
review of relevant literature on cognition in narcoleptics. I found no obvious pattern in
task performances between the disorders, but narcoleptic literature was scarce, so
pattern detection was difficult. Furthermore, the results vary widely in the narcoleptic
studies making observed deficits controversial. In addition, I choose two tasks
(Alternating Reactions, and the Dual Task) in which ADHD and narcolepsy seemed to
show similar results and quantitatively compared them. I found supported similarity
only in narcoleptic and ADHD-I and ADHD-H subtypes reaction times. Error rates
were not significantly different on these two tasks either, but when narcoleptics were
compared to ADHD controls, no difference was observed, indicating little support for
similarity claims. Overall more research is needed into the topic and attention must be
paid to replicating previous study finding and reporting hypocretin levels alongside
them. It is difficult to say exactly how much accommodation is needed for narcoleptics
in academic settings, but I feel that executive function support programs that are used to
help ADHD students stay on track should be offered to narcoleptics as well. I hope to
encourage further thought into the status of this underrepresented group; this project
aims to improve the information available on classroom implications of all aspects of
narcolepsy, not just the primary sleep symptoms.
Description
49 pages. A thesis presented to the Department of General Science and the Clark Honors College of the University of Oregon in partial fulfillment of the requirements for degree of Bachelor of Science, Spring 2016.
Keywords
Biopsychology, Nacolepsy, ADHD, Disability, Brain, Sleep, Execution Function