Narcolepsy is a chronic sleep disorder where your brain struggles to keep up with regular sleep and wake cycles. Patients with narcolepsy may experience sudden and intense periods of fatigue and drowsiness during the day as well as suddenly falling asleep. If you have narcolepsy, you may really struggle to stay awake during the day, depending on the severity. Although people suffering from narcolepsy may feel rested after waking up, they may feel very tired throughout the day.
This sleep disorder can make day to day life hard and interrupt routines. Some with narcolepsy might even experience hallucinations and weaker muscles.
Narcolepsy - seized by sleep
Narcolepsy is a term derived from a two Greek words that mean "seized by sleep."
People who have narcolepsy usually start having symptoms as teenagers, but do not realize they have the disease for 10 years or more. Understood by parents, teachers, roommates, bosses, and spouses, narcolepsy can have devastating effects on its sufferers' personal and professional lives.
Causes and Consequences of Narcolepsy
Narcolepsy is hereditary. It causes an unusual sensitivity to white blood cells in the brain. Abnormal interactions with white blood cells in nerve tissue leads to destruction of neurotransmitters the brain needs for normal sleep. Narcolepsy is caused by genes that you can get from one parent or both parents. If you get just one gene for narcolepsy, you are likely to have milder symptoms. If you get two genes for narcolepsy, you are likely to have more severe symptoms.
Narcolepsy is a relatively uncommon disease. Among African-Americans, only 0.02% (1 in every 5,000 people) of the population has the condition. Among Caucasians in the United States, that figure is 0.07%, about one in 1,500 people. Among Japanese living in Japan, however, the figure is about 0.18%, still 1 in 500 people. Narcolepsy is also relatively more frequent in the Philippines and Indonesia. The condition is more common in males than in females.
Children who have narcolepsy have predictable problems at sleepovers and at camps. Ridicule from peers during cataleptic ("frozen stare") attacks can be devastating.
Adults who have narcolepsy almost always experience stressful relationships, sexual dysfunction, and difficulty holding a job, either from the disease itself or from its treatment. Since narcolepsy causes memory lapses, they may exercise bad judgment on the job, and they may be incorrectly labeled as lazy, inattentive, or lacking motivation. Employees who have narcolepsy are frequently falsely accused of drug use. At least 24% of people who have narcolepsy lose at least one job on account of their disease.
Symptoms of Narcolepsy
The most easily recognizable symptom of narcolepsy is daytime drowsiness. The disease is not diagnosed unless daytime drowsiness has been a problem for at least 3 months. In healthy people, daytime drowsiness is only a problem when there has been lack of sleep or during boring situations. People with narcolepsy may fall asleep while they are eating, talking, or driving, and these "sleep attacks" can occur without warning. Narcoleptics are usually able, however, to take short and refreshing naps up to 8 or 10 times a day. Usually these naps are accompanied by dreams.
Another common symptom of narcolepsy is catalepsy. This condition was once misunderstood as "being stricken down with fear." The muscles suddenly go limp and the person can literally fall to the ground. The most common triggers for catalepsy are anger and laughter.
Narcolepsy also causes sleep paralysis. The narcoleptic can still breathe, and blink his or her eyes, but cannot move other muscles. The "spell" can be broken by touching the narcoleptic, and events of sleep paralysis are less likely if the bed is uncomfortable.
Narcoleptics often experience vivid hallucinations (with sight, sound, touch, and smell) as they are going to sleep and as they are waking up.
Most people who have narcolepsy are obese. Children with narcolepsy are often misdiagnosed as having ADHD.
Medical Treatments for Narcolepsy
The most commonly prescribed wake up agent is a drug called modafinil, which is sold under the trade name Provigil. If you were to read the product literature for modafinil, you would notice the statement, "The mechanism of action is not understood." Scientists know that the drug works on the same centers of the brain as the more commonly prescribed medication venfalaxine (Effexor), but they do not understand exactly how the drug affects narcolepsy. Nonetheless, modafinil is FDA-approved. It can cause severe headaches.
When modafinil-induced headaches are a problem, doctors will usually offer armodafinil (Nuvigil). This drug is identical to modafinil except for the way it polarizes light; it contains the same number of atoms bonded in the same way except for a left-to-right rotation. Armodafinil does not cause headaches but can cause nausea, vomiting, and diarrhea.
Doctors also treat narcolepsy with antidepressants, including some older depressants such as Elavil (amitryptyline) that have very few modern uses. These drugs induce general sleepiness all the time, although they may help prevent attacks of sleepiness in the middle of driving, eating, or talking. Elavil is infamous for causing weight gain.
Paradoxically, doctors treat catalepsy not with an antidepressant but with a general depressant, sodium oxybate, which is sold under the trade name Xyrem. As is the case with Provigil, its mechanism of action is not understood, but it is the only FDA-approved medication for treating this symptom of narcolepsy.
Xyrem is not an easy drug to take. It can cause bedwetting, and it is not effective if it is taken within six hours of eating. This medication can cause liver damage; when liver damage occurs doctors usually cut the dose in half.
There are no FDA-approved treatments for narcolepsy in children.
Read More: Relaxation Techniques For Sleep Disorders
Natural Treatments for Narcolepsy
The single most important thing a person who has narcolepsy can do to keep the condition under control is to get regular sleep, about 8 hours a night. Simply making sure to get enough sleep greatly reduces the frequency of symptoms during the day. Scheduling short (10-20 minute naps) during the day will also help.
Avoiding high-sugar foods helps prevent daytime drowsiness. Narcoleptics of all ages need to avoid alcohol and recreational drugs.
Utterly essential to the treatment of narcolepsy is avoiding situations where injury is inevitable. Unless the condition is very well controlled, it is critical to avoid driving, operating machinery, playing most sports, or using stairs. Anytime suddenly falling to the ground could cause an injury, the situation may have to be avoided until the condition is controlled. The good news is, most people with narcolepsy eventually get enough control over their condition that they can drive, work, raise families, and enjoy social and recreational activities.
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