What a Narcoleptic Dog Can Teach Us About Sleep

Emmanuel Mignot’s new Chihuahua, Watson, is small enough to fit in a handbag, somewhat skittish around strangers and utterly vanquished by a slice of lamb chop.

As I spoke to Mignot on the phone, he held the receiver next to Watson so I could hear for myself. The two of them had been snuggling on Mignot’s leather sofa when I asked what it would take to hear Watson’s narcolepsy in action.

Mignot produced a lamb chop from his refrigerator and offered his pet a bite. I pressed my ear into the phone.

(Parts of this interview aired on the California Report. Listen here.)

It turns out that a narcoleptic Chihuahua doesn’t make a whole lot of noise as it crumples to a cataplexic puddle on the floor.

If you’re a narcoleptic dog, Mignot is the owner you want. As director of Stanford’s Center for Sleep Sciences and Medicine, founded by the legendary sleep researcher William Dement, Mignot helped oversee the country’s first and largest pack of narcolepsy research dogs.

The dogs – about 80 of them at the program’s peak – were mostly Dobermans and Labradors, collected over the years mostly via word-of-mouth.

Narcolepsy in dogs is vanishingly rare. Mignot estimates that about one in a million dogs have the disease compared to one in 2,000 humans. In 1999, Mignot identified the genetic cause of canine narcolepsy: a mutation that blocks a response to hypocretin, a brain chemical that keeps us awake.

But Mignot and others believe another, “sporadic” form of narcolpesy may be caused by an immune reaction, perhaps to the flu. He believes dogs may experience this type as well.

As Mignot, who was born in France, cooed French reassurances to his new companion, Watson sprang back into action, attacking the lamb chop that had been his undoing.

Mignot told me he hopes that narcoleptic dog research – dormant for the last decade or so – might have its own revival to answer new questions about sleep disease.

How did you find Watson?

I received an email from a veterinarian in Vermont, telling me they had a dog with narcolepsy. In this case, [an owner], seeing that the dog was collapsing and falling asleep all the time, didn’t want to keep him. So he had returned the dog to the breeder, who took it to the vet. They didn’t really know what to do with the dog.

It was good timing. You probably know that I had another dog with narcolepsy before, Bear, and he just passed away. So it was almost like a reincarnation of Bear!

I took the plane [to Vermont] and I brought him back. And I have to say he’s really adorable. I would have never thought I’d get a Chihuahua. He’s a crazy little spring on four legs.

Except when he’s asleep, that is…

Yes he’s definitely sleepier than other dogs. There are times when you see he really needs to take a nap.

It’s very cute. You see him fading, like “Oof, I fall asleep” and he kind of crumples, you know? Then he lifts his head again, like he nods, trying to stay awake. And he looks at you with his eyes half closed and you have the feeling like he’s telling you “I love you,” but in fact he’s falling asleep.

Falling asleep a lot is one aspect of narcolepsy. But another symptom is cataplexy, right?

Yes. When Watson gets excited sometimes he becomes completely paralyzed. That happens with good food, but it has to be really good food, like a piece of chicken, or filet mignon. He gets excited and then –boom! — he’s paralyzed. Sometimes it’s just the back legs and he stumbles. Or sometimes he falls on the floor and can’t move for a few seconds.

In humans [who have narcolepsy] it can happen when patients are laughing or joking, but with dogs it’s anything that he’s very happy about. For example it’s not uncommon that [I come home from work and] he’s running around, so happy to see me and then – boom! — he collapses and he can’t move for a few seconds or minutes. That’s called cataplexy. It’s a symptom that’s classic of narcolepsy.

Like going on the beach. We often go to the beach and he runs around and loves to run around and very often, when he’s too happy – poof! – he collapses on the sand. And he’s paralyzed for a few seconds to a minute sometimes.

You make this cataplexy sound cute and charming. But is it painful for him, or stressful?

No, I don’t think it bothers him. He doesn’t fall from very high – I mean, he’s a Chihuahua. So he doesn’t really hurt himself. When he’s down, you can sense sometimes there’s frustration, like his nose is in front of a piece of food, and he’s trying to fight it. But it lasts for only a few seconds.

The best cure is to have him well rested. He has a normal life. It’s not severe enough that he needs to be treated.

Narcolepsy is a lot more stressful for people than for dogs, sounds like.

With humans, if you can nap at any time the disease is much less severe.

I know a few patients who don’t get treated and have special lifestyle where they wake up, work for an hour and a half or so, then take a nap for a half an hour, work a bit more, and so on. If you can live like this, you can almost have a normal life. But in our society it’s usually impossible. That’s why narcolepsy is a terrible disease.

Stanford no longer maintains a pack of narcoleptic dogs for research purposes. Is there anything you can still learn from Watson?

I think there’s still a mystery around narcolepsy that we have not solved. I mean thanks to the dogs, we found the cause of narcolepsy was this lack of this chemical in the brain, called hypocretin – a chemical produced by cells in the brain. When it’s not there you have narcolepsy.

And sometimes this happens because of a genetic mutation. But other times it’s spontaneous?

Yes, we think that in these cases, it’s an immune disease, triggered by the flu. People develop a reaction to the flu that is abnormal and instead of just fighting flu they kind of confuse the flu with the cell that produced this chemical, hypocretin, and destroy it. Then you have narcolepsy. But we still don’t understand this process very well.

Some of the dogs we have probably developed narcolepsy the same way. I wouldn’t be surprised if we discover something new again that helps us understand how the immune system is killing the hypocretin.

With Watson, I don’t know if it’s the genetic form with the mutation, or if it’s the sporadic kind. I have blood samples from all the dogs who were in the colony. It’ll be interesting to sequence all these dogs that have sporadic form and see if we can find something else that will eliminate the human disease.