Słowa kluczowe
dysfunkcje seksualne
leczenie narkolepsji
Abstrakt
Wstęp: Narkolepsja (NT) może objawiać się nadmierną sennością w ciągu dnia (excessive daytime sleepiness, EDS), katapleksją, halucynacjami hipnagogicznymi (hypnagogic hallucinations, HHG) i hipnopompicznymi (hypnopompic hallucinations, HHP), paraliżem przysennym, orgazmolepsją, które zaburzają funkcjonowanie pacjentów. Celem pracy jest określenie wpływu NT, współwystępujących specyficznych dysfunkcji seksualnych oraz leków stosowanych w terapii NT na życie seksualne.
Materiały i metody: Przeprowadzono przegląd narracyjny z użyciem słów kluczowych: narkolepsja, dysfunkcje seksualne, leczenie narkolepsji oraz deskryptorów czasowych do 17 marca 2024 r., przeszukując bazy PubMed/MEDLINE, Google Scholar, Crossref, Cochrane. W celu weryfikacji jakości przeglądanych artykułów posłużono się sześciopunktową skalą SANRA (Scale for the Assessment of Narrative Review Articles).
Wyniki: Wykazano, że aktywność i satysfakcja seksualna są obniżone nawet u 81,1% pacjentów. U chorych często współwystępują liczne zaburzenia regulacji autonomicznej, w tym układu moczowo-płciowego, powodując dysfunkcje seksualne (erekcji -48% mężczyzn; nawilżenia pochwy -81% kobiet). Orgazmolepsja negatywnie wpływa na seksualne i społeczne relacje u ponad ⅓ badanych. Paraliżowi przysennemu często towarzyszą nieprzyjemne HHG, które przedstawiają wrażenie napaści i molestowania seksualnego. Mogą powodować lęk, cechy zespołu stresu pourazowego (post-traumatic stress disorder, PTSD), obniżony nastrój, a w skrajnych przypadkach prowadzić do prób samobójczych. Spośród leków stosowanych w NT jedynie metylofenidat może zwiększać libido i zmniejszać zaburzenia erekcji.
Wnioski: Orgazmolepsja, dysfunkcje seksualne i autonomiczne w NT znacząco obniżają jakość życia seksualnego pacjentów. Paraliż przysenny z HHG o charakterze seksualnym często negatywnie wpływają na dobrostan psychiczny. Holistyczne podejście z wykorzystaniem interwencji behawioralnych, terapii poznawczo-behawioralnej, edukacji pacjenta i jego bliskich są kluczowe w leczeniu zaburzeń seksualnych w przebiegu NT.
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