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SolveYourProblem Article Series: Sleep Disorders
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Sleep Disorder: Narcolepsy

Narcolepsy is one of the most unusual and least common of all sleep disorders. Narcolepsy is a medical condition and sleep disorder that causes chronic and uncontrollable instances of daytime sleepiness. A person with narcolepsy can experience the sudden onset of sleepiness and fall asleep at a moment's notice. They may drop whatever they happen to be holding, become limp, and fall to the floor in sleep. Narcolepsy is classified as a chronic neurological disorder. It is thought that narcolepsy is caused by the brain's inability to adjust normal sleep-wake cycles. The cause for this irregularity remains unknown.

In addition to the sudden onset of uncontrollable sleepiness, individuals who suffer from narcolepsy may also experience three distinct symptoms. The first is cataplexy, which refers to bouts of irregular muscle weakness or paralysis that occurs without loss of consciousness. The second symptoms are hypnopompic and hypnogogic hallucinations, which refer to hallucinations experienced while waking up or falling asleep. The third symptom related to narcolepsy is sleep paralysis. With the frequent disruptions of sleep patterns, narcolepsy can wreak havoc on an individual's quality of life. Narcolepsy patients complain of feeling consistently fatigued and irritable.

Narcoleptic "sleep attacks" can occur several times a day, with each attack lasting anywhere from a few seconds to almost an hour. Most bouts of sudden sleepiness occur during long meetings and lectures. Most individuals that suffer from narcolepsy report feeling refreshed and revived upon reawakening. Some narcolepsy patients also report that the narcoleptic attacks can be strongly hallucinogenic, or simply slightly irritating.

It is estimated that 25 people out of every 100,000 people in the United States suffer from narcolepsy, with an estimated 125,000 individuals diagnosed with the disorder. The disorder is thought to strike individuals with a genetic predisposition, since it is most commonly repeated in certain families. Usually, narcolepsy develops during adolescence, with most individuals diagnosed between ages ten and twenty. However, some individuals are diagnosed in early childhood, and some elderly may experience the sudden onset of sleep attacks as well. Some studies indicate that the effects of narcolepsy wane with age, although this remains in dispute.

Narcolepsy is usually diagnosed through a description of symptoms and by reviewing the results of an electroencephalogram (EEG). In many cases, a medical professional will advise the patient be examined during a sleep lab. Unfortunately, there is no "cure" for narcolepsy. The primary treatment for narcolepsy involves making several lifestyle adjustments, including getting regular exercise, avoiding stimulants, and incorporating regular naps into the individual's daytime schedule. Indeed, taking two to three short naps (15 to 20 minutes in length) have been shown to help individuals control excessive daytime sleepiness. Individuals with narcolepsy may need to negotiate with their employers to allow for regular naps during the regular workday.

Individuals with narcolepsy can also greatly benefit from maintaining a daily exercise regime. Just exercising for 20 minutes a day can help control sleep attacks, improve the quality of nighttime sleep, and help control a healthy weight (excessive weight may contribute to the severity of narcoleptic symptoms). Getting regular sleep during the normal nighttime hours is also important in controlling the effects of narcolepsy. Stimulants should be avoided for several hours before bedtimes, including alcohol, caffeine, and cigarettes.

Drugs commonly prescribed to individuals with narcolepsy include stimulants such as ephedrine or amphetamines. Antidepressant drugs, such as migraine, are sometimes also used to control the cataplexic attacks that often accompany bouts of daytime sleepiness. Over the counter drugs and caffeine are not shown to prove effective in combating the drowsiness caused by narcoleptic sleep attacks. In 1999, a new drug was approved by the FDA to treat excessive daytime sleepiness. The drug, Modafinil, has proved effective in suppressing excessive daytime sleepiness, but it does not treat the cataplexy, paralysis, or hallucinations caused by narcolepsy.

While narcolepsy itself does not cause any medical problems or risks, sudden bouts of severe daytime sleepiness pose the danger of causing accidents. Narcolepsy can interfere with the performance of everyday tasks, reduce overall productivity, and disrupt with normal nighttime sleep patterns. Also, recent research indicates that narcolepsy may be linked to blood pressure and depression. Narcolepsy patients can greatly improve their quality of life by maintaining normal and healthy sleep schedules, and by taking medications to combat the effects of cataplexy and excessive drowsiness.

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by : 2006

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