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Narcolepsy
   

Narcolepsy is a chronic and incurable brain disorder in which the brain cannot regulate sleep-wake cycles. Narcoleptics do not sleep well at night and have abnormal REM sleep. On the other hand, they may fall asleep without warning during normal daytime activities including talking, walking, driving, and cooking.

Narcolepsy affects many areas of a sufferer’s life, including:

  • Physical safety
  • Mental health
  • Social relationships
  • Professional development
  • Family life

 


Narcoleptics should wear a medical ID to alert others to their condition in case they suddenly fall asleep or cannot move or speak.

Symptoms of Narcolepsy

An estimated 200,000 Americans suffer from narcolepsy. Most people begin to display the following symptoms between the ages of 10 and 25:

  • Excessive daytime sleepiness
  • Abnormal REM sleep
  • Vivid and frightening dreams while asleep and hallucinations upon waking
  • Cataplexy, or sudden loss of muscle control when laughing or experiencing other strong emotions
  • Nighttime wakefulness
  • Sleep paralysis

About 25 to 50% of narcolepsy sufferers are unable to move or talk at the beginning or end of sleep.

Causes of Narcolepsy

Scientists are still working to discover the root cause of narcolepsy. They have discovered that narcoleptics are lacking in a brain chemical called hypocretin, which regulates sleep. Exactly why this is so is likely a combination of genetics and an environmental trigger such as a virus.

Diagnosing Narcolepsy

Narcolepsy can be difficult to diagnose because its most common symptom is daytime sleepiness. Because this is also a symptom of depression and of other sleep disorders, narcolepsy is often misdiagnosed.

If your physicians suspect you have narcolepsy, they will order several tests to confirm the diagnosis:

  • A nocturnal polysomnogram to measure your brain, heart, muscle, and eye activity while you sleep
  • A multiple sleep latency test to measure how long it takes you to fall asleep during the day
  • A spinal fluid analysis to test hypocretin levels in your spinal fluid
  • An Epworth Sleepiness Scale questionnaire

Treating Narcolepsy

Narcolepsy can’t be cured, but it can be treated. Treatment usually consists of a combination of behavior modification and medication.

Behavior modification

People with narcolepsy can help control their symptoms by:

  • Taking a few 15-minute naps at the same time each day
  • Avoid caffeine, alcohol, and nicotine
  • Exercising regularly

Medication

Medications can help alleviate the symptoms of narcolepsy so you can stay awake during the day and sleep better at night. A combination of stimulants and antidepressants is often used: stimulants to help you stay awake and antidepressants to reduce cataplectic attacks.

  • Methylphenidate (Ritalin) and Modafinil (Provigil) reduce daytime sleepiness and improves alertness
  • Fluoxetine (Prozac), Clomipramine (Anafranil) and Imipramine (Tofranil) reduce the frequency of cataplexy
  • Sodium Oxybate (Xyrem), reduces both daytime sleepiness and cataplexy. However, it has a history of abuse as a recreational drug and is therefore only recommended for people who do not respond to other medications

These drugs may become ineffective if you use them continuously for a long period. Your healthcare provider may suggest you take a “drug holiday” one day each week.

     
 
 
     

                     
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