Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. According to the U.S. Centers for Disease Control and Prevention (CDC) National Health & Nutrition Survey (NHANES), about 9% of children in the US meet criteria for ADHD with similar numbers reported in other countries. Although boys are more commonly diagnosed, ADHD is also common in girls, who often go undiagnosed.
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months to a degree that is greater than other children of the same age. These symptoms will interfere with the child's function in two or more settings, such as home and school.
In most cases, ADHD is best treated with a combination of medication and behavior therapy. Good treatment plans will include close monitoring with follow-up doctor office visits to provide any changes needed along the way.
Research shows that behavioral therapy is an important part of treatment for children with ADHD. ADHD affects not only a child's ability to pay attention or sit still at school, it also affects relationships with family, friends/peers, and how well they do in their classes. Behavioral therapy is a treatment option that can help reduce these problems for children and should be started as soon as a diagnosis is made.
Medications can affect children differently, where one child may respond well to one medication, but not to another. When determining the best treatment, a doctor might try different medications and doses, so it is important for parents to work with their child's doctor to find the medication that works best for their child.
Once believed to only affect children, ADHD is now known to persist into adolescence and adulthood in the majority of cases. Approximately 4-5% of adults worldwide are affected with ADHD. Most adults with ADHD remain undiagnosed and untreated.
While approved stimulant medications have been shown to be effective and safe for the treatment of ADHD, stimulants have been shown to have high potential for abuse and addiction and are scheduled as Class II controlled substances by the U.S. Drug Enforcement Administration (DEA) and other similar agencies outside the U.S. Consequently, it is important to develop safe and effective alternative formulations of stimulants to reduce risk of abuse.
Narcolepsy is a sleep disorder characterized by excessive sleepiness, sleep paralysis, hallucinations, and in some cases episodes of cataplexy (partial or total loss of muscle control, often triggered by a strong emotion such as laughter). Narcolepsy occurs equally in men and women and is thought to affect roughly 1 in 2,000 people. The symptoms appear in childhood or adolescence, but many people have symptoms of narcolepsy for years before getting a proper diagnosis.
People with narcolepsy feel very sleepy during the day and may involuntarily fall asleep during normal activities. In narcolepsy, the normal boundary between awake and asleep is blurred, so characteristics of sleeping can occur while a person is awake. For example, cataplexy is the muscle paralysis of REM sleep occurring during waking hours. It causes sudden loss of muscle tone that leads to a slack jaw, or weakness of the arms, legs, or trunk. People with narcolepsy can also experience dream-like hallucinations and paralysis as they are falling asleep or waking up, as well as disrupted nighttime sleep and vivid nightmares.
Narcolepsy with cataplexy is caused by the loss of a chemical in the brain called hypocretin. Hypocretin acts on the alerting systems in the brain, keeping us awake and regulating sleep wake cycles. In narcolepsy, the cluster of cells that produce hypocretin—located in a region called the hypothalamus—is damaged or destroyed. Without hypocretin, the person has trouble staying awake, and experiences disruptions in the normal sleep-wake cycles.
Currently there is no cure for narcolepsy, but medications and behavioral treatments can improve symptoms for people so they can lead normal, productive lives.
Narcolepsy is diagnosed by a physical exam, taking a medical history, as well as conducting sleep studies. If you do have narcolepsy, the most effective treatment is often a combination of medications and behavioral changes.