We’re Taking the First Steps Toward a Cure for Narcolepsy
On top of this genetic background, there may have been some bad timing too. People with narcolepsy are slightly but significantly more likely to be born in March (as, indeed, I was). This so-called ‘birth effect’ is seen in other autoimmune disorders and is probably explained by a seasonally variable infection at a particular moment in development. In the case of narcolepsy, it seems that those of us born in March are just a little bit more vulnerable than others.
While other infections during my childhood, hormonal fluctuations and emotional stress may also have played a part, it was in late 1993 that I probably encountered a key pathogen – an influenza virus or Streptococcus perhaps. It was this that took me to an autoimmune tipping point and resulted in the rapid dismantling of my orexin system. In short, most cases of narcolepsy are probably the result of an unfortunate combination of events that create the perfect immunological storm.
Around this time, the Doberman project in Stanford was on the verge of unravelling the genetic basis of narcolepsy in this breed. The man tasked with hunting down the mutation responsible was Emmanuel Mignot, who subsequently succeeded Dement as director of the Stanford Center for Sleep Sciences and Medicine. We meet in his office there, joined by Watson, a narcoleptic Chihuahua he adopted a few years ago. “It’s such a silly breed,” he says, holding down Watson’s ears to prevent them from burning, then setting him on the floor. “Not one I would ever have chosen myself.”
At first, Watson is wary of me, keeping his distance and growling. When I get down to his eye level, he yaps and jumps in at me, then out, pretending he is fiercer than he is. I can empathize, even across the gulf that separates his species from mine. I know about the excessive daytime sleepiness. I know about the cataplexy, how it feels to have emotions short a neurological circuit in the brainstem and cause a muscular collapse (just as occurs in the rapid eye movement, or REM, stage of sleep, when most dreaming takes place). I wonder if Watson suffers the total terror of sleep paralysis and the supernatural hallucinations that often accompany it.
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