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When you think of narcolepsy, you probably think of people falling asleep at seemingly random times,
想到嗜睡症，你可能会想到那些随时随地都能睡着的人，
but it’s actually much more than that.
但实际的嗜睡症远不止于此。
It causes hallucinations, insomnia and sleep paralysis and can be triggered by moments of joy.
它还会引起幻觉、失眠和睡眠瘫痪，甚至连高兴都可能触发嗜睡症。
Oh, and the key to understanding it came from studying man’s best friend.
哦，对了，科学家们还是在研究我们人类最好的朋友时碰巧取得了认知这一健康状况的重大突破的。
Narcolepsy is a neurological disorder where your brain loses its ability to control its sleep-wake cycle.
嗜睡症是大脑失去控制睡眠-觉醒周期的能力所造成的神经紊乱现象。
This includes symptoms like cataplexy, a condition that causes uncontrollable muscle weakness or paralysis
像晕厥以及入睡前幻觉都属于嗜睡症的症状范畴，晕厥通常是由兴奋或大笑触发的，
which is often triggered by excitement or laughter,
控制不住的肌肉无力或麻痹现象，
and hypnagogic hallucinations, which is basically when you start to dream before you fall asleep.
而入睡前幻觉差不多就是你还没睡着就已经开始做梦的症状。
That's great.
太好了。
It would be white wine.
这是白葡萄酒吗？
Hello my name is Emmanuel Mignot, I'm a professor at Stanford.
大家好，我叫伊曼纽尔·米诺，是斯坦福大学的教授。
I'm a medical doctor and a researcher and I've been working for 30 years on a sleep disorder called narcolepsy.
我是医学博士，也是一名研究员，30年来我一直在研究一种叫做嗜睡症的睡眠障碍现象。
Narcolepsy is a very strange disorder...
嗜睡症是一种非常奇怪的紊乱现象……
So initially people thought it was even a type of seizure.
最初，人们甚至认为它是癫痫的一种。
But then when people looked they said no, it’s not seizures, they are more sleeping.
但人们仔细看过之后又说，不，这不是癫痫，他们更像是睡着了。
But narcolepsy isn’t really about falling asleep, it’s about not being able to stay awake -
但是嗜睡症的问题不是患者睡着了，而是他们无法保持清醒——
and the role of a specific neuropeptide made in a very small region of the brain.
是他们大脑里一个非常小的区域里合成的某种特殊的神经肽能否工作的问题。
The region that’s called hypothalamus which is just above the optic nerve.
这个区域叫做下丘脑，就在视神经的上方。
So very important, very primitive part of the brain that regulates sleep, appetite, very basic physiology.
所以，它是大脑中非常重要也非常原始的一个组成部分，它控制着睡眠、食欲和一些非常基本的生理机能。
And these cells that produce hypocretin are all there.
而产生下丘脑分泌素的细胞都在这个位置。
Hypocretin, also known as orexin, is a neuropeptide that is responsible for keeping you awake.
下丘脑分泌素，又称食欲素，是一种负责让你保持清醒的神经肽。
Once released, hypocretin travels throughout the brain activating other cells,
一旦被释放，它就会在大脑中四处游走，激活其他细胞，
like those responsible for creating things like dopamine, histamine, serotonin and norepinephrine.
比如负责制造多巴胺，组胺，血清素和去甲肾上腺素的细胞。
These brain cells then start to fire more, releasing their respective chemicals which, in turn, further stimulate your brain.
这些脑细胞就会开始释放更多的化学物质，进一步刺激你的大脑。
And the other thing it does is, and that's a little bit less understood, but it can also control your dreaming,
食欲素的另一个功能，这点是大家很少知道的，但它确实控制了我们的梦，
So is that when this chemical is absent, dreams come too strongly and too fast.
当这种化学物质消失了时，梦就会迅速并且猛烈地出现。
And that's why you have all these weird symptoms of dreaming too much
这也是你为什么会出现做梦过多的奇怪症状，
and the dreams are almost real and sometimes you are paralyzed at the wrong time because you are paralyzed during dreaming.
而且那些梦就跟真的一样，有时甚至会导致你陷入瘫痪状态，因为做梦的时候你确实是出于瘫痪状态的。
So the two main function of this chemical is: one is to stay awake voluntarily
综上所述，这种化学物质的两大功能就是：一是让你自动保持清醒，
and the second one is to control your dreams so that your dreams don't come too fast into wakefulness.
而是控制你的梦，让你不会太快进入清醒状态。
And this chemical is very important...and when it's not there you have narcolepsy.
这种化学物质非常非常重要……没有了它，你就会患上嗜睡症。
It took me 10 years to figure out the cause of narcolepsy in terms of losing the hypocretin cells.
我花了10年时间才弄清楚嗜睡症的原因是食欲素细胞的缺失。
Then it took me 15 years to figure out why the cells were missing.
之后又花了15年的时间才弄清楚这些细胞为什么会缺失。
This is the Pandemic H1N1/09 virus, but you may know it as the swine flu.
这是H1N1/09流感病毒，也就是你可能听过的猪流感病毒。
Dr Mignot and team noticed that during the 2009 swine flu pandemic,
密诺博士和他的团队注意到，2009年猪流感期间，
there was a significant uptick in narcolepsy cases.
嗜睡症病例出现了显著增加的现象。
And that I have to say we discovered by chance that it seems to be the flu that triggers this abnormal reaction…
我不得不说，我们是偶然发现这个情况的，表面上看是流感引发了这种异常反应……
In fact we discovered that there is a piece of this 2009 swine flu that looks very much like hypocretin.
事实上，我们发现，2009年的猪流感病毒有一部分看起来很像食欲素。
And then instead of attacking just the flu, the cells start to attack hypocretin and then it kills the cells that produce it.
所以，我们的免疫细胞不仅会攻击流感病毒，还会开始攻击食欲素并连带杀死产生食欲素的细胞。
And then once the process is started then it starts to be more and more inflamed
这个过程一旦开始，就会变得越来越严重，
and then it kills the hypocretin cell thinking is the flu infected cells
免疫细胞误把食欲素细胞当作流感细胞杀死了，
and then you don't have anymore hypocretin cells
你就没有食欲素细胞了，
and then you have narcolepsy for the rest of your life.
嗜睡症就会缠你一辈子。
The immune system attacking hypocretin producing cells is why many people categorize narcolepsy as an autoimmune disease.
免疫系统攻击合成食欲素的细胞，所以很多人都将嗜睡症归到了自身免疫性疾病一类。
But this response doesn’t happen to everyone who gets the flu virus.
但并不是每个染上这种流感病毒的人都会出现这种反应。
In fact, I like to say that to develop narcolepsy, you have to have a series of bad luck.
事实上，我想说的是，要发展成嗜睡症，你还得有一系列的坏运气。
because really your immune system has to be primed a certain way
因为你的免疫系统必须以某种特定的方式启动，
and you have to get the flu at a certain time together with a certain immune background to, genetic background, to really develop narcolepsy.
你必须在特定的时间患上流感，加上特定的免疫背景，基因背景，才能真正发展成嗜睡症。
So it’s like a perfect storm to develop narcolepsy.
所以，患上嗜睡症就像遇上一场完美的风暴（那么少见）。
But humans aren’t the only ones to develop narcolepsy.
但并非只有人类才会患上嗜睡症。
It can affect dogs and as well as horses and bulls.
狗、马和公牛也会患上这种症状。
In fact, by studying narcolepsy in dogs,
事实上，正是通过研究狗狗的嗜睡症，
Dr Mignot and others were able to initially make the connection between hypocretin and staying awake.
米诺博士他们才开始将食欲素和保持清醒联系起来。
And at the end you know one breakthrough was actually...we found a family of dachshund with narcolepsy.
最后，我们终于取得了突破……我们发现了一个患有嗜睡症的腊肠犬家族。
I still remember the dog. It was Fritz.
我现在还记得那只狗。它叫弗里茨。
Narcolepsy in dogs is a genetic disease, so researchers were able to map the mutation that caused narcolepsy in dog families,
狗类的嗜睡症是一种遗传性疾病，因此，研究人员能够绘制出导致狗狗出现家族性嗜睡的基因突变的图谱，
notably in Fritz, and found a very important mutation.
弗里茨的家族就是个例子，取得了重要的研究突破。
And then finally we discovered that this gene was a mutation in a receptor for a chemical called orexin, or hypocretin.
最后，我们终于发现，这个基因源自一种受体的突变，也即食欲素，又名下丘脑泌素这种化学物质的受体的突变。
From there Dr Mignot and his team were able to focus their study of narcolepsy in humans
从那时起，米诺博士和他的团队终于能专心研究人类的嗜睡症了，
and eventually come to their breakthrough connecting it to the hypothalamus and the swine flu.
最终，他们取得了突破，将其与下丘脑和猪流感联系了起来。
Fritz was really key.
弗里茨在这中间真的发挥了非常关键的作用。
Thanks Fritz...good dog.
谢谢你，弗里茨……好样儿的！
