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In the 1960s, the discovery of rapid eye movement sleep at sleep onset led to improved understanding of core sleep\u2010related disease symptoms of the disease (excessive daytime sleepiness with early occurrence of rapid eye movement sleep, sleep\u2010related hallucinations, sleep paralysis, rapid eye movement parasomnia), as possible dysregulation of rapid eye movement sleep, and cataplexy resembling an intrusion of rapid eye movement atonia during wake. The relevance of non\u2010sleep\u2010related symptoms, such as obesity, precocious puberty, psychiatric and cardiovascular morbidities, has subsequently been recognized. The diagnostic tools have been improved, but sleep\u2010onset rapid eye movement periods on polysomnography and Multiple Sleep Latency Test remain key criteria. The pathogenic mechanisms of narcolepsy type 1 have been partly elucidated after the discovery of strong HLA class II association and orexin\/hypocretin deficiency, a neurotransmitter that is involved in altered rapid eye movement sleep regulation. Conversely, the causes of narcolepsy type 2, where cataplexy and orexin deficiency are absent, remain unknown. Symptomatic medications to treat patients with narcolepsy have been developed, and management has been codified with guidelines, until the recent promising orexin\u2010receptor agonists. The present review retraces the steps of the research on narcolepsy that linked the features of the disease with rapid eye movement sleep abnormality, and those that do not appear associated with rapid eye movement sleep.<\/jats:p>","DOI":"10.1111\/jsr.14277","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:54:03Z","timestamp":1719968043000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Narcolepsy and rapid eye movement sleep"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-6470","authenticated-orcid":false,"given":"Francesco","family":"Biscarini","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna  Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Barateau","sequence":"additional","affiliation":[{"name":"Sleep\u2010Wake Disorders Unit, Department of Neurology Gui\u2010de\u2010Chauliac Hospital, CHU Montpellier  Montpellier France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine\u2010Levin Syndrome  Montpellier France"},{"name":"Institute for Neurosciences of Montpellier University of Montpellier, INSERM  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pizza","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna  Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-0472","authenticated-orcid":false,"given":"Giuseppe","family":"Plazzi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio\u2010Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0683-6506","authenticated-orcid":false,"given":"Yves","family":"Dauvilliers","sequence":"additional","affiliation":[{"name":"Sleep\u2010Wake Disorders Unit, Department of Neurology Gui\u2010de\u2010Chauliac Hospital, CHU Montpellier  Montpellier France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine\u2010Levin Syndrome  Montpellier France"},{"name":"Institute for Neurosciences of Montpellier University of Montpellier, INSERM  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"American Academy of Sleep Medicine. 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