SLEEPING DISORDERS: NARCOLEPSY
Narcolepsy : What is it about?
This is a rare case that has been noticed by Psychologists and has been brought on board for awareness because it is not often diagnosed.
The reason is not for you to wear a lab coat or a suit and go to a hospital to look for patients. It is for us to be observant about the people around us. So when these things occur, we all will know how to help in the little way we can.
So let’s dive into it.
Narcolepsy is some how similar to Insomnia but quite different from it.
While Insomnia is the inability to fall asleep or stay asleep at night, Narcolepsy is a neurological disorder that affects your ability to wake and sleep. It is mainly characterized by excessive sleepiness, sleep paralysis, hallucinations and so on. I will list them as we progress.
There is what we call cataplexy. This episode occurs in most cases.
Narcolepsy occurs equally in men and women and is thought to affect roughly 1 in 2,000 people. The symptoms appear in childhood or adolescence, but many people have symptoms of narcolepsy for years before getting a proper diagnosis.
In many cases, narcolepsy isn’t diagnosed and therefore isn’t treated..
People with this disorder, feel very sleepy during the day and involuntarily sleep during normal daily activities. In narcolepsy, the normal boundary between awake and asleep is blurred, so characteristics of sleeping can occur while a person is awake.
For example, cataplexy is the muscle paralysis of REM (Rapid Eye Movement) sleep occurring during waking hours. It causes sudden loss of muscle tone that leads to a slack jaw, or weakness of the arms, legs, or trunk. People with narcolepsy can also experience dream-like hallucinations and paralysis as they are falling asleep or waking up, as well as disrupted nighttime sleep and vivid nightmares.
There are two types of narcolepsy,
Narcolepsy with cataplexy
Narcolepsy without cataplexy.
Narcolepsy with cataplexy is caused by the loss of a chemical in the brain called hypocretin. Hypocretin acts on the alerting systems in the brain, keeping us awake and regulating sleep wake cycles. In narcolepsy, the cluster of cells that produce hypocretin—located in a region called the hypothalamus—is damaged or completely destroyed.
Without hypocretin, the person has trouble staying awake, and also experiences disruptions in the normal sleep-wake cycles.
Without cataplexy, This person will not have too much trouble staying awake but may be affected with some of the other symptoms like hallucinations, disrupted sleep and sleep paralysis.
So lets move to symptoms.
2. Sleep paralysis
3. Excessive Daytime sleepiness(EDS)
1. Hallucinations: These delusions can happen at any time and are often vivid and frightening. They’re mostly visual, but any of the other senses can be involved. If they happen as you’re falling asleep, they’re called hypnagogic hallucinations. If they happen when you’re waking up, they’re called hypnopompic hallucinations.
2. Sleep Paralysis: You may be unable move or speak while falling asleep or waking up. These episodes usually last a few seconds to several minutes.
3. Disrupted sleep: You might have a hard time staying asleep at night because of things like vivid dreams, breathing problems, or body movements.
4. Excessive Daytime Sleepiness (EDS): In general, EDS makes it harder to do everyday activities, even if you got enough sleep at night. The lack of energy can make it hard to concentrate. You have memory lapses and feel depressed or exhausted.
5. Cataplexy: This can cause problems ranging from slurred speech to total body collapse, depending on the muscles involved. It’s often triggered by intense emotions such as surprise, laughter, or anger.
It is has not been finalised.
Scientists are trying to find causes for this thing and they think it may involve multiple things that affects the brain and disturbs rapid eye movement. Experts are finding genes linked to the disorder. These genes control the production of chemicals in your brain that may signal sleep and awake cycles.
And they think it is because the brain finds it difficult to make this chemical hypocretin.
There is no cure for nacroelpsy… there are treatment to help ease the symptoms.
Lifestyle changes: Stay away from caffeine, alcohol and nicotine.
Eat smaller meals more often rather than heavy meals.
Control your sleep schedule. I talked about sleep diary the last time, it will help in this case.
Schedule daytime naps (10 to 15 minutes long).
Follow an exercise and meal schedule.
Stimulants to treat sleepiness(only when prescribed)
Antidepressants to treat problems with REM sleep
(Only when prescribed)
Sodium oxybate (Xyrem) to treat cataplexy
Pitolisant (Wakix) or Solriamfetol (Sunosi) to help you stay awake for longer periods