Narcolepsy is a chronic sleep disorder. It is characterized by excessive daytime drowsiness and sudden, irresistible episodes of sleep. People with narcolepsy may have difficulty staying awake for long periods, regardless of the circumstances. This can lead to significant disruptions in daily routines. The prevalence of narcolepsy is estimated to be around 1 in 2,000 in the United States and Western Europe, but the disorder may be underdiagnosed, particularly in those with mild symptoms. Although it’s a rare condition, everybody needs to know what this condition entails, how you can recognize it, and what you should do if you suspect you’ve narcolepsy, as the condition can have serious consequences.
What Is Narcolepsy?
Narcolepsy is a chronic neurological disorder that disrupts the body’s sleep-wake cycle. It is characterized by excessive and uncontrollable daytime sleepiness, as well as the tendency to fall asleep suddenly during any type of activity. In a normal sleep cycle, an individual progresses through the early stages of sleep, followed by deeper stages, and finally rapid eye movement (REM) sleep after about 90 minutes. However, people diagnosed with narcolepsy may enter REM sleep almost immediately upon falling asleep, and sometimes even while they are awake.
Types
There are two types of narcolepsy: type 1 and type 2. Type 1, also known as narcolepsy with cataplexy, is characterized by low levels of the brain hormone hypocretin and the presence of cataplexy. Cataplexy means the sudden muscle weakness triggered by strong emotions. This type is diagnosed based on the patient’s report of cataplexy and excessive daytime sleepiness on a specialized nap test. Type 2, also known as narcolepsy without cataplexy, is characterized by excessive daytime sleepiness but does not typically involve muscle weakness triggered by emotions. Symptoms of Type 2 narcolepsy tend to be less severe and individuals typically have normal levels of hypocretin. In addition to the typical symptoms of narcolepsy, individuals with narcolepsy type 2 may also have severe neurological problems and sleep for extended periods (more than 10 hours) each night.
Narcolepsy is a rare condition that is still little known to the public, so it is important to raise awareness of this sleep disorder. The condition can have serious complications. The most common complications are: feeling unheard because people have no knowledge (and understanding) of the disease, both at work and privately. In addition, it can have a major impact on intimate relationships. It also poses a risk of being physically harmed during a sleep attack, for example having a sleep attack behind the steering wheel. Last, but certainly not least, people with narcolepsy also have an increased risk of getting overweight (or obese), as their metabolism is low.
Causes of Narcolepsy
The cause of narcolepsy is not fully understood. People with type 1 have low levels of the chemical hypocretin, which plays a role in regulating wakefulness and REM sleep. The exact cause of the loss of hypocretin-producing cells in the brain is unknown. It is believed to be related to an autoimmune reaction. Genetics may also be a factor in the development of narcolepsy, although the risk of a parent passing the disorder to a child is very low, at about 1%. Some research suggests a potential association between narcolepsy and exposure to the H1N1 flu virus. Type 2 can occur as a result of an injury to the hypothalamus, a region in the brain that helps regulate sleep.
Symptoms of Narcolepsy
Narcolepsy is a disorder characterized by four main symptoms, although not all people with narcolepsy experience all four. The four symptoms include:
- Excessive daytime sleepiness: This is a common symptom, often described as “sleep attacks”
- Sudden muscle weakness (cataplexy): This can range from mild weakness affecting one side of the body to more severe muscle weakness.
- Sleep-related hallucinations: These occur immediately upon falling asleep or just before waking up.
- Sleep paralysis: This is a temporary inability to move or speak upon waking up, although the individual may be fully or partially aware.
It is important to note that the severity of these symptoms can vary from person to person. In addition, there are other symptoms (and behaviors) common in patients. These include:
- Automatic movements
- Amnesia or forgetfulness
- Sudden outbursts around sleep attacks
- Changes in rapid eye movement (REM) sleep
A professional healthcare provider may suspect narcolepsy based on the presence of specific symptoms. To make a definitive diagnosis, specialized diagnostic tests are needed. These tests are necessary because this condition shares symptoms with other brain and sleep-related conditions. Before undergoing the main diagnostic tests for narcolepsy, a healthcare provider will typically ensure that the individual is getting sufficient sleep by tracking their sleep-wake pattern. This may involve the use of simple sleep-tracking methods. Additional tests for diagnosing the condition are a sleep study, lumbar puncture, MSLT, and maintenance of wakefulness test.
Treatment Options
Once all these tests have been done and the diagnosis is, indeed, narcolepsy, the right treatment plan can be set up. There are several ways to treat it. Most of these treatments focus on excessive daytime sleepiness. Medication options include:
- Wakefulness medications
- Amphetamines and amphetamine-like stimulants
- Antidepressants
- Sodium oxybate
- Histamine-affecting drugs
Although currently available medications may help some people with narcolepsy achieve a more consistent level of alertness. It’s not always possible to fully normalize alertness in all patients through drug therapy alone. It’s important for patients to also make lifestyle changes to manage the condition. Some strategies that may be helpful include:
- Take short naps
- Maintain a regular sleep pattern
- Avoid caffeine or alcohol (before bed)
- Quit/avoid smoking
- Exercise every day
- Don’t eat large/heavy meals before bedtime
- Relax before bedtime
Narcolepsy is a rare but serious condition with possible life-threatening complications. Make sure to contact your professional healthcare provider when you suspect you’re suffering from this! The right treatment can help you feel better. For more information on narcolepsy and possible treatment options, continue your online search here:
