Narcolepsy

When the brain fails to regulate the wake-sleep cycles, it can manifest as a neurological disorder known as Narcolepsy. During the night, we experience sleep cycles, starting with the light sleep cycle of the alpha (non-REM) phase. Within 90 minutes we go deeper in to sleep and enter Rapid Eye Movement (REM) sleep. It is in the first stage of REM sleep where we dream. Throughout the evening, we alternate between stages of REM and non-REM sleep.

 

With narcolepsy, people fall asleep and wake up in REM sleep. They also experience involuntary fragments of REM sleep during the day. During this phase of sleep, the muscles are in a state of paralysis in order to prevent our bodies from acting out our dreams. This is why narcolepsy is associated with an inability to move. Although narcoleptics are constantly sleepy, they don’t sleep more than the average person. Their amount of sleep is normal but they have no control of when and where it occurs. Some researchers think that factors influencing narcolepsy may be brain injuries, autoimmune disorders, infections or low levels of histamines—a substance in the blood that promotes wakefulness. Other factors may include environmental toxins such as pesticides, weed killers, heavy metals and second-hand smoke. Heredity is not considered a significant factor in narcolepsy. If you think you may have narcolepsy be sure to discuss it with your doctor. It might be helpful to keep a sleep diary for 2 weeks and bring it to your appointment as a point of reference.

 

Signs and Symptoms of narcolepsy may include:

 

• The first symptom is usually excessive daytime sleepiness. One may fall asleep while having a conversation, driving, eating and other ill-suited activities.

• Cataplexy is a condition associated with narcolepsy. It’s a sudden loss of muscle tone while awake, and can be triggered by emotions such as laughter, anger or surprise. It can last for seconds or minutes, and can affect just one muscle group, your whole body, or result in slurred speech. The person remains conscious throughout the event, and may experience anything from limb weakness to having their knees buckle, or dropping an object from their hand.

• Hallucinations or very vivid or bizarre dreams can be experienced while falling in and out of sleep. That’s because the person is skipping over the early non-REM stages of sleep and going right into the REM phase where we dream. These dreams often incorporate the persons waking environment, making the dreams seem even more realistic.

• Sleep paralysis is the temporary inability to move your body during sleep-wake transitions. It can be momentary or last a few minutes. Often the person experiences hallucinations simultaneously.

• Nighttime restlessness such as leg spasms.

 

Facts about narcolepsy:

• It affects both sexes equally and symptoms advance with age.

• In developed countries, the incidence of narcolepsy is about the same as Multiple Sclerosis or Parkinson’s Disease.

• Symptoms usually first show up in teens and young adults and often go undiagnosed until they progress, since most individuals don’t consider ‘sleepiness’ to be a characteristic of a disease.

• Narcoleptic people tend to be more accident-prone and have more difficulty with interpersonal relationships. Because of their condition, they tend to feel alienated, depressed and uncomfortable around people. 

• Hypocretin is a chemical in the brain that promotes wakefulness. Studies have found that people with narcolepsy have low levels of this chemical, although the cause is unclear.

• Medication can sometimes exhibit some of the same symptoms as narcolepsy, so be sure to contact your physician to discuss what you are experiencing.

 

 

Treatment

Your doctor will go over your complete medical history and may decide to refer you to a Sleep Center for evaluation. There is no acknowledged standard treatment for narcolepsy, but a medical professional can help control symptoms. Behavioral therapies and counseling are key to getting on the road to feeling better.  Sometimes stimulants or anti-depressants are prescribed, although they often cause side effects.