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What is Narcolepsy by Sydney Gibson

Posted by at 11:12 pm 0 Comment Print

Narcolepsy is a sleep disorder, often identified with overwhelming exhaustion and the inability to stay awake. Symptoms of narcolepsy include: excessive daytime sleepiness, cataplexy, sleep paralysis, and hallucinations. Normally symptoms occur between the ages of ten and twenty-five, but can worsen with age. Typically the first symptom to appear is daytime sleepiness. People with narcolepsy can fall asleep without warning, or wake up after napping and feel suddenly tired again. Cataplexy, another symptom of narcolepsy may occur when a person is feeling intense emotions. Cataplexy is an uncontrollable weakness of the muscles and may last up to a few minutes. Cataplexy may cause a person to drop to the ground uncontrollably if they are standing. However, not all people with narcolepsy experience cataplexy. People with narcolepsy also experience frightening symptoms such as hallucinations and sleep paralysis. Patients may wake up or fall asleep unable to speak or move for a few minutes or perceive dreams as reality and become frightened.

Currently, the causes of narcolepsy are unknown; however, more research is being developed on the disorder. Sometimes, narcolepsy is hard to diagnose, and patients are normally referred to a sleep specialist to confirm the diagnosis. Methods of diagnosing narcolepsy include: information on sleep history, a polysomnogram, sleep studies, and a hypocretin test. Patients normally have to stay overnight in a sleep center where they are observed for numerous factors by a team of sleep specialists. During a polysomnogram specialists measure the electrical activity in the brain and heart and the movement of muscles and eyes. During this test, breathing is also monitored. During a multiple sleep latency test patients are asked to take naps during the day, two hours apart. While they are asleep specialists will monitor sleep patterns and stages. People with narcolepsy fall immediately into REM sleep rather than slowly progressing through NREM sleep to REM sleep. Another test called a hypocretin test, can be administered to measure the levels of hypocretin in the fluid surrounding the spinal cord. During a hypocretin test a spinal tap is conducted to withdraw the fluid sample. Normally people with narcolepsy have low levels of hypocretin which regulates REM sleep. Other sleep disorders can cause excessive sleepiness, so performing these tests can help doctors rule out other sleep disorders that the patient may have.

There is no cure for narcolepsy, but with a combination of drugs and lifestyle modifications, symptoms can be managed. Lifestyle changes such as avoiding alcohol and caffeine, incorporating exercise, taking daily naps, and maintaining a regular sleep scheudule may reduce symptoms. There are also a number of drugs used to treat narcolepsy. Common drugs are: Ritalin to reduce daytime sleepiness and increase alertness, Provigil and Nuvigil to decrease daytime sleepiness, tricyclic antidepressants and SSRI’s to reduce the frequency of cataplexy, and Xyrem a medication used to help the patient get quality sleep at night so the patient is not as fatigued during the daytime. Xyrem is the only drug approved by the FDA for cataplexy.  With a combination of drugs and lifestyle modifications a sleep specialist can come up with a specialized treatment plan to help the patient as much as possible.

With the limited amount of research and treatment options for narcolepsy, patients may have complications in their daily lives. Unfortunately there is a public misunderstanding of narcolepsy, and people may not understand the constant fatigue that comes with the disorder. People may view a patient as lazy and it could possibly harm work and personal relationships. Also, intense emotions can trigger cataplexy, causing people with narcolepsy to avoid emotional interactions out of fear cataplexy might occur. People with narcolepsy also tend to be more overweight than the normal person. Weight gain can be caused by numerous factors such as inactivity or hypocretin deficiency. It is extremely important for a person with narcolepsy to have support from those around them at all times. It may help to inform family members, close friends, and even an employer of the condition. A person with narcolepsy and cataplexy should be cautious, especially when operating a vehicle.

 

References

http://www.webmd.com/sleep-disorders/guide/narcolepsy?page=2

http://www.mayoclinic.org/diseases-conditions/narcolepsy/basics/definition/con-20027429

http://www.webmd.com/sleep-disorders/narcolepsy-treatment

 

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