Narcolepsy is a long-term disorder of the nervous system that leads to irregular sleep and can have an impact on an individual’s quality of life. It’s rare and is estimated to affect about 1 out of 2,000 persons. The signs of narcolepsy start within the ages of 10 and 25 years and may not be recognized right away.
Narcolepsy causes drowsiness during the daytime and sleep attacks. In most circumstances, it also causes loss of muscle control, often called cataplexy. Narcolepsy isn’t a dangerous disorder by itself, however, episodes can lead to accidents, injuries, or deadly occasions.
The cause is unknown. Yet, most individuals with narcolepsy and cataplexy have a reduced amount of a brain protein referred to as hypocretin. One of the vital roles of hypocretin is regulating your sleep-wake cycles.
Scientists believe low hypocretin levels may be generated by several causes. A gene mutation has been recognized to lead to low levels of hypocretin. It’s believed that this hereditary deficiency, together with an immune system that attacks normal cells, contributes to narcolepsy. Other causes are stress, exposure to toxins, and illnesses.
There are two forms of narcolepsy: Type 1 is narcolepsy with cataplexy, and Type 2 is narcolepsy without cataplexy. Type 1 is essentially the most common. Cataplexy, particularly in kids, can be confused with seizure activity.
Sleep specialists point symptoms of narcolepsy to poorly regulated rapid eye movement (REM) sleep. Symptoms may include the following:
- Excessive daytime drowsiness
- Cataplexy or the sudden, temporary loss of muscle tone triggered by intense emotions, such as excitement, laughter, anger, and fear
- Hallucinations while asleep
- Sleep paralysis
- Narcolepsy also can also be connected to other sleep problems, like obstructive sleep apnea, restless legs syndrome, and insomnia.
If you have extreme daylight sleepiness or some common signs and symptoms of narcolepsy, speak to your doctor. Daytime sleepiness is usual in sleep disorders. Your medical professional will ask you about your medical history and accomplish a physical exam. The health care professional will commonly require a sleep study and other tests to consider the right diagnosis.
Some common sleep studies include the following:
The Epworth Sleepiness Scale (ESS) is a sleep questionnaire
ActiGraph, or other monitoring programs, can track how you fall asleep. This device is worn like a wristwatch and is also used alongside a sleep diary.
A polysomnogram requires that you spend the night in a medical facility. You’ll be monitored even as you sleep with electrodes hooked up to your scalp to measure brain activity, heart rate and rhythm, eye movement, muscle movements, and respiration. This test may additionally observe sleep apnea.
A multiple sleep latency test determines how long it takes for you to fall asleep for the duration of the day. It additionally looks at how rapidly you enter REM sleep. This test is probably given the day after a polysomnogram. You’ll need to take 4 to 5 naps for the duration of the day, two hours apart from each other.
A spinal tap, or lumbar puncture, is used to obtain cerebrospinal fluid to quantify hypocretin levels. Hypocretin in cerebrospinal fluid is expected to be low in individuals with narcolepsy. For this test, your doctor will insert a thin needle between two lumbar vertebrae.
Narcolepsy has no remedy. It’s an ailment that lasts a lifetime. The intention of therapy, then, is to manage symptoms and boost daytime functioning. Stimulants, lifestyle changes, and averting hazardous activities are all important in treating this disease.
The doctor may give medicines such as the following:
- Stimulants like armodafinil, modifinil and methylphenidate
- Tricyclic antidepressants
- Serotonin-norepinephrine reuptake inhibitors, such as venlafaxine
- Selective serotonin reuptake inhibitors, such as fluoxetine