I would like to know what is the best way to treat narcolepsy?

Narcolepsy is a disease characterized by irresistible short-term sleep attacks. It is recommended to go to provincial and municipal public hospitals for examination and treatment. More often than not onset in childhood or adolescence. Most patients are accompanied by other symptoms such as cataplexy, sleep paralysis, sleep hallucinations, etc., collectively known as the tetrad of narcolepsy. It is generally not difficult to diagnose based on typical symptoms such as brief episodes of irresistible sleep or cataplexy, sleep paralysis, and sleep hallucinations. It may be genetic and cannot be cured. Guidance and recommended treatment plan 1. Supportive psychotherapy. Parents and I need to understand the nature of the disease, arrange time reasonably, allow the child to take a nap during class, and avoid participating in various dangerous activities. 2. Drug treatment: Ritalin, pemoline, amphetamine, etc. can be used to enhance awakening. Choose a drug, start with a small dose, and increase it until the effect appears or the highest dose. However, it should not be taken for a long time as side effects will be greater. Modafinil is used for treatment abroad, but it is not yet available in China. 3. Chinese medicine treatment: Use medicine under the guidance of a traditional Chinese medicine practitioner. No matter what kind of medicine, it must be taken under the guidance of a doctor. Usual prevention 1. Consciously help children arrange their lives in a colorful way, do interesting things, and try to avoid monotonous activities. 2. Let children maintain an optimistic mood, build confidence in overcoming the disease, and avoid depression and sadness, but they should not be too excited. Because arousal can induce cataplexy attacks. The incidence of narcolepsy is estimated to be 0.03-0.05. It can occur at any age, but the peak incidence is in teenagers, followed by those in their 40s and 50s. The cause and pathogenesis of narcolepsy are not well understood. In the 1980s, Japanese scientists discovered that HLA-DR2 genotypes could be detected in many patients with narcolepsy, the most relevant of which was HLA DQB1*0602. In narcolepsy (Nacrolepsy-Cataplexy, NC) patients with cataplexy, the occurrence rate of this genotype is 95%; about 95% of NC patients have extremely low or even undetectable levels of Orexin-A in the CSF. Siebold C et al speculated that the occurrence of narcolepsy may be related to the immune attack mediated by DQB1*0602-restricted T cells on hypothalamic Orexin neurons. Clinical manifestations: (1) Excessive daytime sleepiness and sleep attacks are often the first symptoms. Patients present with sudden and unpredictable excessive drowsiness and irresistible sleep onset attacks, especially in quiet or monotonous environments. When tired, sleep attacks may occur regardless of occasion and time, even in dangerous environments. Sleep episodes often last less than 1 hour. A short nap can perk you up. (2) Cataplexy attacks are seen in patients aged 65 to 70 years old. It can occur at the same time as a sleep attack or years after the onset of sleep attack symptoms. It is characterized by sudden weakness in the muscles of the whole body and falling down under emotional excitement, fright, fear, anger, etc., with disappearance of reflexes, but clear consciousness, which lasts from seconds to minutes. Cataplexy attacks can also be seen in local muscle groups, such as head droop, slurred speech, and eyelid ptosis. (3) Sleep paralysis is seen in patients aged 15 to 34 years old. It occurs when falling asleep or just waking up. It manifests as inability to move the whole body except for the extraocular muscles and respiratory muscles and speech in a conscious state, which lasts from seconds to minutes. The patient may be extremely frightened. Then wake up completely or fall asleep again. (4) Hypnagogic hallucinations are seen in patients between 10 and 15 years old. It is a vivid dream-like hallucination that occurs during the transition from wakefulness to sleep. The above daytime sleep attacks, cataplexy, sleep paralysis and hypnagogic hallucinations are often collectively referred to as the "tetrad of narcolepsy." Adjuvant treatment for narcolepsy: (1) General treatment: Strictly adhere to work and rest schedules. Avoid caffeinated drinks before going to bed. Strengthen physical activity and various audio-visual stimulation during the day to improve excessive daytime sleepiness, thereby also improving nighttime sleep. At the same time, some evidence shows that taking a reasonable nap during the day can improve mental state.

(2) Drug treatment ① Treatment of somnolence: Traditional central nervous system stimulants, methylphenidate, and the new "awakening agent" modafinil (modafinil) can all reduce the symptoms of excessive daytime sleepiness, and these drugs have obtained Certified for the treatment of polysomnia. Its mechanism lies in activating presynaptic dopaminergic neuron activity. ②Treatment of cataplexy: Antidepressants can improve cataplexy and inhibit REM sleep by activating presynaptic adrenergic neuron activity. Clomipramine, 25 to 75 mg daily, has been widely used in the treatment of this disease. In addition, selective 5-HT reuptake inhibitors such as fluoxetine and combined inhibitors of norepinephrine and 5-HT reuptake such as venlafaxine have certain effects.