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What is narcolepsy?
The five classical signs of narcolepsy are EDS, cataplexy, sleep paralysis, hallucinations, and disrupted sleep.
Narcolepsy is a neurological disorder that affects your ability to sleep and wake up. People with narcolepsy have excessive, uncontrollable daytime sleepiness. They may also suddenly fall asleep at any time, during any type of activity.
About in 1 in 2,000 Americans have some type of narcolepsy.
In the normal sleep cycle, there’s an early stage, then the deeper stage and finally rapid eye movement (REM) sleep, which is typical of 90 minutes. In narcolepsy, the person goes directly into the REM sleep almost immediately.
There are two types of narcolepsy:
- Type 1: This type of narcolepsy is characterized by excessive daytime sleepiness, cataplexy, and deficiency of a chemical substance in the brain known as hypocretin. This substance controls arousal, wakefulness, and appetite.
- Type 2: This type of narcolepsy is characterized by continuous excessive sleepiness without cataplexy.
People with narcolepsy do not sleep more than people without the sleep disorder.
What are the five signs of narcolepsy?
The five classical signs of narcolepsy are:
- Excessive daytime sleepiness (EDS): This can be seen even after getting enough sleep. It is hard to perform any activities.
- Cataplexy: This means a sudden loss of muscle tone. This can cause problems such as slurred speech or total body collapse.
- Sleep paralysis: It is the inability to move upon awakening. Sleep paralysis last for few seconds to several minutes
- Hallucinations: They can occur either during sleep onset (hypnagogic) or during awakening (hypnopompic).
- Disrupted sleep: Sleep may be disturbed at night due to vivid dreams, breathing problems or body movements
What causes narcolepsy?
The exact cause of narcolepsy is unknown; however, specific genes that control the production of hypocretin may be linked with the disease.
Risk factors for narcolepsy include:
- Age between 15 to 25 years
- Family history of narcolepsy
- Infections
- Brain injury or tumor
- Environmental toxins such as pesticides and heavy metal
What are the narcolepsy-related conditions?
There are many conditions or behavior associated with narcolepsy that include:
- Restless leg syndrome: It is a sleep disorder in which there’s an irresistible urge to move your legs.
- Sleep apnea/Snoring: It’s a sleep disorder that disrupts breathing while sleeping.
- Automatic behavior: In this, you may fall asleep while doing some activities like, walking, driving, or talking. You carry on the activity while asleep and wake up without any memory of the activity.
How does a physician diagnose narcolepsy?
The diagnosis of narcolepsy involves:
- Your doctor might perform a physical examination and may ask about your medical history and sleep history.
- Polysomnogram is a sleep study that requires you to stay at a sleep center overnight.
- Multiple sleep latency tests (MSLT) measures your day time sleepiness.
- Hypocretin level measurement involves measuring your hypocretin level.
How can narcolepsy be treated?
Narcolepsy doesn’t have any cure. But treatments that can ease the symptoms include:
- Stimulants to treat sleepiness. This includes methylphenidate, modafinil, armodafinil, solriamfetol, amphetamines.
- Antidepressants
- Xyrem (sodium oxybate) to treat cataplexy and EDS
- Wakix (pitolisant) to treat day time sleepiness
Some lifestyle changes which can manage the symptoms are:
- Refrain from caffeine, alcohol, and nicotine
- Have small meals throughout the day rather than heavy meals at once.
- Maintain a sleep schedule; follow proper sleep hygiene, 7.5-8 hours of sleep every night.
- Exercise daily for 20 to 30 minutes
- Take power naps (15 to 20 minutes) during the day
How long does narcolepsy last?
Narcolepsy is a life-long disorder and cannot be cured completely. However, it usually does not exacerbate with age.