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Narcolepsy: The Disorder That Causes ‘Sleep Attacks’

Narcolepsy: The Disorder That Causes ‘Sleep Attacks’
Narcolepsy, which can be described as hypersomnia or a sleep disorder/attack dominated by excessive daytime drowsiness and sleepiness.
This chronic neurological disorder affects the brain’s ability to control sleep-wake cycle, making individuals with narcolepsy feel rested after waking, yet feel very sleepy most part of the day also experience an uneven and interrupted sleep through the night.

These sudden sleep attacks can occur at any time of the day and in the middle of any activity, whatsoever.

In a typical/normal sleep cycle, a person first enters the early stage of sleep, followed by the deep stage and eventually enters the rapid eye movement (REM), after about 90 minutes. Dreams occur during REM and the brain keeps the muscles paralyzed/limb, preventing people from acting out their dreams.

However, in the case of people with narcolepsy, REM occurs about 15 minutes into sleep and intermittently during waking hours. Also, the dream activity or muscle weakness can occur during wakefulness, resulting in certain symptoms like hallucination and the likes in narcolepsy.

Although narcolepsy occurs often between the ages of 15 and 25, it can become apparent at any age.

What is responsible for Narcolepsy?

While the exact cause of narcolepsy is still unknown, as researchers still continue to seek out the real cause of this order, the general consensus is that it is caused by a lack of the chemical hypocretin (also known as orexin) in the brain.

Hypocretin, a brain protein, is a neurotransmitter responsible for regulating the sleep-wake cycle. It controls whether we are asleep or awake by acting on different nerve groups of nerve or neurons in the brain.

The loss of hypocretin in the brain makes it hard for a person to stay awake, which leads to the autoimmune disease, narcolepsy. Also, it allows REM sleep occur during moments it normally shouldn’t as a person with narcolepsy can enter REM sleep directly from a waking state, rather than the normal progression from being awake to deep sleep to REM sleep.

What are some common symptoms of Narcolepsy

Narcolepsy is attributed to poorly regulated rapid eye movement (REM), with the most prominent symptom being excessive daytime sleepiness. However, how intensely and how often the symptoms occur in individuals can vary. Here are some of the symptoms.

1. Excessive Daytime Sleepiness

Excessive Daytime Sleepiness (EDS) is the most obvious symptom of narcolepsy and is characterized by persistent sleepiness all day with the tendency to doze off at intervals, often at inappropriate times, regardless of how much sleep gotten at night. These are known as sleep attack.

Excessive Daytime Sleepiness can lead to poor concentration, lack of energy, memory lapses, depressed mood and extreme exhaustion.

2. Cataplexy

This symptom is a sudden loss of muscle tone (particularly in the face, neck, and knees) leading to a feeling of weakness and loss of voluntary muscle control.

Some people have a mild weakness like slurred speech, drooping eyelids, head or jaw drop while others collapse completely and are unable to move, speak or even keep their eyelids open, depending on the muscles involved.

However, even during these severe cases, individuals are usually still fully conscious, making it a clear and significant difference between fainting and seizure attacks.
Catalepsy is often triggered by intense emotions such as surprise, anger or laughter.

3. Sleep Paralysis

This is the temporal inability to move or speak while falling asleep or waking up. These episodes are brief and last only from a few seconds to a couple of minutes.
After these episodes end, individuals recover quickly and regain the ability to move and speak immediately.

4. Hallucinations

These hallucinations are vivid and often frightening. These hallucinations can occur while falling asleep or while waking up and can be caused by the blend of wakefulness and dreaming that occurs with REM sleep.

These hallucinations are called hypnagogic hallucinations when accompanying sleep and hypnopompic hallucinations when awakening.

Other symptoms of narcolepsy are fragmented sleep and insomnia as well as automatic behavior. For instance, a person can fall asleep momentarily but continues doing the previous activity like eating, talking or driving, without being conscious of what they are doing.

Often times, they may not recall their actions. For instance, they may store an item in strange locations and then forget where they kept them.

How to treat narcolepsy

Although there is no cure for narcolepsy, it can be controlled with medications and certain lifestyle modifications.

Medication

1.  EDS can be treated with Modafinil or Amphetamine-like stimulants like dexamphetamine, methylphenidate. They are easily available and have high efficacy.
However, they should be used in moderation and according to prescription because they come with certain side effects like irritation, shakiness, disturbances in heart rhythm and the likes.

2.    Cataplexy can be reduced with antidepressants (like tricyclics like imipramine, desipramine and clomipramine as well as selective serotonin and noradrenergic reuptake inhibitors like fluoxetine, and atomoxetine), to suppress REM sleep.

Lifestyle Modifications

Asides medications, certain lifestyle changes like paying attention to sleep hygiene, scheduling daytime naps and the likes.

1. Ensure you take short naps regularly.
2. Maintain a consistent sleep pattern/schedule. Try going to bed and waking up at the same time every day, including during the weekends and holiday. This can improve the quality of your sleep.You can use sleeping aids like a good flannel sheet or a weighted blanket. Here’s a review of the best weighted blankets.
3.    Avoid consuming alcohol or caffeine late at night or in the evening.
4.    Exercise regularly to help maintain a healthy lifestyle and improve the quality of sleep.
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