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Narcolepsy: The Most Common Cause of Hypersomnia

What is narcolepsy?

Do you feel excessive sleepiness during the daytime? Do you get sleepy easily in a calm environment at any time of the day? If the answer to these questions is yes then you may be suffering from hypersomnia and the most common cause of this condition is narcolepsy.

Narcolepsy is the most common neurological disorder that disrupts sleep/wake pattern leading to hypersomnia.

We will examine what causes narcolepsy and how to cure it.

   Narcolepsy: the commonest cause of hypersomnia

What is narcolepsy?

Narcolepsy is defined by ICSD as irresistible urges to sleep occurring on a daily basis for at least three months with the following laboratory findings present…

  • On the multiple sleep latency test (MSLT), mean sleep latency is ≤8 minutes and two or more sleep-onset rapid eye movement (REM) periods are found in patients who have had at least 6 hours of sleep the night before the test
  • CSF hypocretin-1 levels ≤110 pg/mL (or one-third of mean control values) are also considered to be diagnostic

The DSM criteria for narcolepsy includes:

  • Irresistible attacks of refreshing sleep that occur daily over at least three months
  • The presence of cataplexy and/or recurrent rapid eye movement intrusions in the transition between sleep and wakefulness as manifested by sleep paralysis and hypnopompic or hypangogic hallucinations

Narcolepsy may be associated with cataplexy. This is defined as a transient loss of muscle tone that occurs suddenly in response to strong emotion. That is, during sleep, a paralysis-like condition may occur.

What are the types of narcolepsy?

Your narcolepsy may be one of three types.

These are:

1.Narcolepsy with cataplexy

This is the most frequent neurological cause of hypersomnia. The classic tetrad of symptoms (described later) is seen in this type of patient

2. Narcolepsy without cataplexy

The occurrence of EDS (excessive daytime sleepiness) and irresistible episodes of sleep without associated cataplexy. Other features may also be present, eg automatic behavior, hypnic hallucinations or sleep paralysis. Nocturnal sleep is usually less disturbed than in narcolepsy with cataplexy

3. Narcolepsy due to a medical condition

A consistent chronological link with the presumed underlying causative medical condition is found

What causes narcolepsy?

To understand narcolepsy, you need to have some idea about normal sleep cycles. Human sleep pattern cycles through two stages: REM (rapid eye movement) sleep and non-REM sleep. When you fall asleep, sleep is light and gradually become deeper. Both light and deep stages are part of non-REM sleep. The first stage of REM sleep comes after 90 minutes of sleeping. This is the dreaming portion. With narcolepsy, the REM pattern of sleep starts immediately after sleeping and even occurs randomly in the  daytime. This means that the normal sleep/wake pattern is disrupted.

The exact mechanism is not clear but there are some known causes. Narcolepsy with cataplexy is linked to a loss of hypothalamic neurons that contain hypocretin. An underlying autoimmune process may lead to the elimination of the hypocretin cells. Several studies show that narcolepsy with cataplexy is associated with human leukocyte antigen (HLA) subtypes DR2/DRB1*1501 and DQB1*0602. First-degree relatives of patients with these subtypes have a 10- to 40-fold increased risk for narcolepsy with cataplexy

What are the symptoms of narcolepsy?

The classical ‘tetrad’ of symptoms are helpful for diagnosis but suffered by only a minority of patients with narcolepsy.

These are: 1) excessive sleepiness; 2) cataplexy; 3) sleep paralysis; 4) hypnagogic hallucinations.

  • Excessive daytime sleepiness and associated cataplexy (sudden bilateral loss of muscle tone with preserved consciousness triggered by a strong emotional reaction such as laughter or anger) are by far the most common complaints. More often a cataplectic attack will be partial, eg involving jaw muscles (difficulty with articulation), facial muscles (grimacing), or thigh muscles (brief unlocking of the knees). Attacks vary from seconds to minutes, with a frequency of a few a year to several a day, and (very rarely) repeated ‘status cataplecticus’.
  • Other REM sleep phenomena also occur but are not necessary for the diagnosis to be made. These include sleep paralysis (sometimes up to 10 minutes long) and vivid hallucinations on falling asleep (hypnagogic) or, less commonly, waking up (hypnopompic).
  • Sleep may also be disturbed due to frequent awakenings, disturbing dreams, sleep-talking and REM-related sleep behaviors (from phasic muscle twitching to more dramatic dream enactment).
How does it affect people?

Narcolepsy may  impact seriously on your education, work, relationships, ability to drive or recreational activities and can have negative effects on self-esteem and mood.

How to cure narcolepsy?

There are, fortunately, effective treatments available for narcolepsy.

  • Daytime somnolence can be treated with stimulants (modafinil, methylphenidate, dexamfetamine). It’s possible, also, to use sodium oxybate.
  • Cataplexy is treated with TCAs (clomipramine 10–75mg/day is licensed) or SSRIs (and possibly other antidepressants: venlafaxine, nefazodone, mirtazapine, atomoxetine). These drugs may also improve your REM-related symptoms, hypnagogic/hypnopompic hallucinations and sleep paralysis. Note: abrupt withdrawal of antidepressants may potentially cause cataplectic episodes or even status cataplecticus. So, never discontinue your drugs, without consulting your physician. Sodium oxybate is newly licensed for cataplexy, is not associated with a rebound cataplexy on withdrawal but can cause significant side-effects (nausea, nocturnal enuresis, confusional arousals, headache) and there is also a danger of abuse.
  • Other treatments for poor sleep and REM-related symptoms are benzodiazepines (e.g. clonazepam) and possibly sodium oxybate are helpful.

Be aware that these drugs are not for over the counter use. Consult your doctor and he will choose the best suitable drug for you.

Besides drug treatment, some behavioral treatments are also worthwhile. The following advice may be helpful for you:

Establish good sleep habits for narcolepsy:

  1. Maintain a regular sleep schedule. Estimate how long you need to sleep and try to follow that. Most adults require 6-8 hours and teens 9-10 hours per day
  2. Develop a consistent sleep schedule
  3. Take regular daytime naps. It will help you to improve mood and alertness. A short sleep of 15-20 minutes will refresh you but don’t make it much longer. Find out the best time for a nap and stick to it
  4. Make your bedroom comfortable for sleeping. Keep TVs, computers and cell phones out of your bedroom
  5. If you wake up at night, don’t engage with your smartphone or TV. Restrict yourself from social media like Facebook
  6. Avoid caffeine in the evening
  7. Don’t take any medication without consulting your doctor. Many drugs are associated with sleep cycle interruptions

Stay active:

A boring, inactive period will make anyone sleepy. It is more harmful when you have narcolepsy. Try to keep yourself busy. Do some interesting work in your leisure time

Control your diet:

A heavy meal stimulates sleep. When you have narcolepsy, this may also provoke cataplexy. Try to keep you meal size smaller. You may increase your frequency of eating to compensate.

Get help from your family:

If your cataplexy is related to specific stimulations like laughing, joking or crying, try to avoid these situations. Discuss with your friends and family.

Remember that for any neurological disorder the success of treatment depends mostly on the patient. The doctor can only prescribe you but cure depends on your compliance to treatment.

So, try to follow any prescriptions and advice. Most importantly, establish good sleeping habits.

Have a nice sleep!

Top 25 Tips and Tricks To Help You Get a Better Sleep!

Sleep apnea has become a global concern these days.

There are numerous reasons behind that and researchers are constantly revealing new things about this sleeping disorder.

This article will help you by showing 25 key ways to enjoy a better sleep in the night.

You will also get a short explanation to learn how it works.

Reading on and learn to work with sleeping disorders effectively…

Top 25 tips and tricks to help you get a better sleep 1

Top 25 tips to get a better sleep

Here is a list of 25 top tips which can help everyone to sleep better…

1. Try to be mindful

Be mindful as much you can. You can talk with others to become mindful

2. Allow thoughts & emotions to play

Never restrict your emotions and allow them to pervade you gradually

3. Lead a life

Don’t be bored. Try to lead a healthy, structured life

4. Be punctual

Punctuality promotes a good sleeping routine

5. Don’t fight with your sleep

If you find it difficult to sleep on a particular night, relax rather than fighting against it

6. Make your own heaven

Try to develop a good environment around you in the bedroom

7. Get a good pillow

Pillows are really very important. Get a comfortable pillow, neither too hard nor too soft

8. Think twice before purchasing your bed

Beds also play a crucial role in sleeping. Try to buy a large bed where you have enough space to roll over

9. Assess your sleeping posture

Try to figure out your sleeping posture by enlisting the help of others. It can help you to discuss the issue meaningfully with your doctor

10. Consider snooze foods to eat

Snooze foods are always considered as a good option for patients those suffer from sleeping disorders. So try to have some on hand

11. Keep your PC away from sleep

Don’t pass too much times on your computer and keep it away from you while trying to sleep

12. Use blue lights inside of your bedroom

You can use dim blue lights in your bedroom to create a pleasant, relaxed environment

13. Try to realize your circadian rhythm

Not everyone can sleep at a fixed time. So try to understand which particular time suits you best

14. Adapt with working hours better

Work in working hours with more focus and don’t allow yourself to sleep when working

15. Give your eyes a rest

Take a short nap occasionally and allow your eyes to have some rest

16. Use sleep diaries

Using sleeping diaries is advised by many doctors

17. Fix a time to workout

Workout are great for tiring you out and helping you to sleep. Make time to exercise however busy you are

18. Consider implementing the 20 minutes rule 

Twenty minute rule is going viral these days. Break tasks down into 20 minute chunks

19. Try alternative therapies

There are alternative therapies like acupuncture or massage. Try those too

20. Discuss things with your sleeping partner

Get help from your sleeping partner to craft a useable formula for you both

21. Don’t push yourself too much with routine

Routine is good to follow but never overdo things for the sake of achieving something.

22. Spend a healthy day to have a healthy night

Be busy in the day time so you can get good sleep during the night

23. Meditate and calm down

Meditation is a wonderful way to calm down your body and mind

24. Talk with your doctor

Get assistance from your doctor if in any sort of confusion regarding your sleeping habits

25. Breath deeper

Try to have some long deep breaths from time to time so your lungs can practice pumping properly

Now you know the top 25 natural tips to get a better sleep.

But, from the expert’s point of view, there is one more way and this can work even more efficiently…

Yes, that is using a sleep apnea therapy which involves a good CPAP machine. This can eventually help you to make your breathing regular and thus you can sleep like a baby whatever your age.

If you can harness all of the tips above in your everyday life, getting a good sleep will not remain a difficult task any more.

So, focus as much as you can and try to implement those tips gradually for maximum success.

Insomnia : An Overview

What is insomnia?

Have you ever suffered from a difficulty in falling asleep or frequent night time awakenings? For most people, the answer is yes.

Insomnia (or sleep disturbance) is a common symptom with a prevalence rate of 30-40% in the general population. But a single episode of sleep disturbance is not a serious problem. The rate of significant insomnia disorder is only 5-10%.

So, what is insomnia and when should it be called clinically significant?

Here we will examine the causes and best treatment options.

How to cure insomnia -

What is insomnia?

Persistent problems falling asleep, maintaining sleep or poor quality of sleep for at least 3 days a week for one month is considered clinically significant insomnia. It is most commonly a symptom rather than a disease itself. It may be due to any specific underlying diseases or without any identifiable causes.

What are the types of insomnia?

If insomnia is temporary, it is termed as acute insomnia.

When it’s persistent and mostly due a specific cause it is known as chronic insomnia.

It may also be classified as primary or secondary depending on the causes.

  1. Primary insomnia: no identifiable cause
  2. Secondary insomnia: due to an underlying disease.
What are the causes of insomnia?

Your insomnia may be a result of wide range of factors. Here are some probable causes:

Causes of Primary insomnia:

  • Psychophysiological insomnia: difficulty initiating and maintaining sleep with associated somatized tension anxiety; over-concern with the inability to sleep, and learned sleep prevention
  • Paradoxical insomnia: also called ‘sleep state misperception’: patient complains of little or no sleep without objective evidence of sleep disturbance
  • Adjustment sleep disorder: sleep disturbance temporally related to stress, conflict or environmental change causing emotional arousal. The disorder usually resolves once the stress is no longer present
  • Inadequate sleep hygiene: clinically significant disruption of the normal sleep/wake schedule due to a wide range of daily living activities (eg level of coffee consumption or frequent late nights)
  • Idiopathic insomnia: Rare, lifelong inability to sleep adequately

Secondary or comorbid causes of insomnia

  • Sleep disorders classified elsewhere: sleep-related breathing disorders; circadian rhythm disorders; sleep-related movement disorders
  • Insomnia due to medical condition: pain (arthritis, peptic ulcer, headache), respiratory disorders (COPD, cystic fibrosis, asthma), diabetes, Parkinson’s disease, endocrine disorders (Addison’s disease, Cushing’s syndrome)
  • Insomnia due to mental disorder
  • Drugs and alcohol

Several drugs may cause insomnia. As an example, antidepressants (MAOIs, SSRIs, venlafaxine or reboxetine); anti-Parkinsonian medication; bronchodilators (aminophylline, theophylline or pseudoephedrine); cardiovascular medication (β-blockers, clonidine, high-dose digoxin, verapamil); chemotherapy agents; corticosteroids/anabolic steroids; NSAIDs (high-dose); stimulants (dexamfetamine methylphenidate, amphetamines, cocaine, caffeine, nicotine); levothyroxine withdrawal/dependency (hypnotics, opiates, alcohol, or cannabis)

What are the symptoms of insomnia?

You will suffer from various problems if your sleep is affected…

  1. Difficulty in falling asleep
  2. Trouble with maintenance of sleep
  3. Excessive daytime sleepiness
  4. Irritability
  5. Inability to concentrate
  6. Inadequate sleep quality or duration
  7. The problem persists in spite of having the opportunity to sleep
How does it affect people?

Insomnia is a risk factor for developing depressive, anxiety and substance abuse disorders. Insomnia is associated with motor vehicle accidents, work absenteeism, and reduced quality of life.

How to cure insomnia?

There are effective treatments available for insomnia. In the case of secondary insomnia you need to receive treatment for the underlying disease first. For primary insomnia, both pharmacological and non-pharmacological treatments are available.  The best treatment for insomnia is non-pharmacological. If still the problem persists, your doctor will advise you some drugs.

How can I get rid of insomnia without drug therapy?

There are several pointers you can follow to improve your quality of sleep. Try to follow the advice below.

  1. Cognitive behavioral therapy (CBT)

The aim of CBT is to break the cycle of insomnia. Poor sleep quality leads to stress and makes you anxious about not being able to sleep. This, in turn, causes further tension and anxiety which makes your sleeping habits poorer and can lead to the development of dependency on sleeping pills… Then a worsening of insomnia and so the vicious cycle goes on. Contact a psychiatrist for proper advice regarding CBT.

  1. Maintain sleep hygiene

        Establish good sleep habits:

  • Control environmental factors (noise, light, temperature)
  • Avoidance of caffeine-containing drinks after about 4pm
  • Not smoking for at least an hour before bed
  • Regular exercise (not late at night)
  • Avoid drugs causing insomnia

      Stimulus control:

  • Go to bed only when sleepy; avoid other activities (with the exception of sex) whilst in bed. If sleep does not occur, do not remain in bed for more than 10–20 minutes, get up and go to another room (without turning on all the lights), returning to bed only when sleepy
  • Establish a regular time to get up with no more than 1 hour variation (even at weekends and during holidays)
  • Sleep restriction if your sleep is fragmented… A sleep restriction strategy may help you to reduce total time spent in bed and improve the quality of sleep by consolidation. Try to maintain a sleep-wake diary
What are some medications available for insomnia?

There are different groups of drugs available for insomnia.

This, though, is the last option only if non-drug treatment does not work for you. Contact your doctor and he will assess your conditions to exclude any secondary causes. If any underlying disease is present, it must be treated first.

The drugs available are benzodiazepines like clonazepam, diazepam, bromazepam as well as non-benzodiazepines like zolpidem, zopiclone or zopeplon. The drug most suitable for you will be selected by your doctor.

To conclude, insomnia may be a tiresome experience but it’s not incurable. If not properly treated, it may affect your daily life severely. Don’t panic as it will just worsen the problem.

Contact your doctor as soon as possible to choose the best treatment for your insomnia and lead a happy life.

Top 3 Best CPAP Mask Reviews 2016

Getting the best CPAP mask is crucial.

You need to be able to breathe comfortably and in a hygienic way.

There are a vast number of products on the market. This is why getting the best machine requires a deep knowledge of the contemporary market and the internal mechanisms so you are aware of how these masks generally work.

ResMed Mirage Quattro

Top 3 Best CPAP Mask Reviews 2016

If you read CPAP mask reviews, you’ll be well aware of the many products offered by ResMed and Respironics.

Here are some CPAP masks that you might find useful…

  • ResMed Mirage Quattro™ Full Face Mask Complete System
  • Respironics Wisp Nasal CPAP Mask Assembly Kit
  • Respironics Wisp Nasal CPAP Mask Assembly Kit

Top 1: ResMed Mirage Quattro™ Full Face Mask Complete System
Resmed Mirage Quattro Full Face Mask Complete System - Best CPAP mask

You can look at it here.

https://www.amazon.com/Mirage-Quattro-Full-Face-System/dp/B01H5TMG7I

Features
  • This mask is made using advanced technology that can resist internal mold growth due to top class materials
  • The tube of this mask also has mold protection technology
 Benefits
  • Highly durable. You can use it for several months
  • Utmost hygiene is possible with this mask You can clean it easily with soap and water or using a CPAP cleaner
  • This mask slips very rarely during the night time
  • It is very comfortable to use even for longer time periods
 Cons
  • It is not a good pillow for side sleepers
  • Some people consider it overpriced
 Who is the product best for?

This really is a great pillow for CPAP machine users. People of all ages can benefit from it. Though it is manufactured in many sizes, the mid-size mask is most popular according to the CPAP mask reviews.  For side sleepers, using this mask could be difficult. People who breath through their mouth should consider this mask. While breathing, your nose needs to be kept under pressure otherwise air will definitely escape from it. That’s where this particular mask can help by providing coverage of both mouth and nose.

Top 2: Respironics Wisp Nasal CPAP Mask Assembly Kit
Respironics Nuance Pro Gel Nasal Pillow Mask - Best cpap mask

You can check it out here:

https://www.amazon.com/Philips-Respironics-Nuance-Pro-Mask/dp/B01HA4WHGS

Features
  • Air enters the nostrils directly. The mask does not cover the nose
  • You can get it in white and blue stripes
  • There are different sizes available
  • Side cushion of the mask is really comfortable
 Benefits
  • It’s a cheap mask that only costs around 66 dollars
  • There is no shipping charge. Standard warranty is offered from the manufacturer with a speedy delivery service
  • Your nose shape will not distort due to side pressure
  • No chance of breaking the pressure seal
  • Cleaning the mask is very easy  with warn water and mild soap
  • The chance of mold growth is nominal if you maintain it properly
  • This mask is machine cleanable
 Cons
  • Some people might find it difficult to fit the mask at first though by reading the manual this problem can be resolved
  • This mask does not come pre-assembled
 Who is the product best for?

According to CPAP mask reviews, Respironics Wisp Nasal CPAP Mask Assembly Kit can be used by almost anyone though it is particularly good for the side sleepers. If you are a side sleeper and feeling discomfort with your current mask you should give this one a  try. For an old man this mask can be highly effective.

Top 3: Respironics Wisp Nasal CPAP Mask Assembly Kit
Wisp Mask with Fabric Frame and Headgear - Best cpap mask

You can look at it here. 

https://www.amazon.com/Philips-Respironics-Wisp-Nasal-System/dp/B01GINOS8

Features
  • The cushion of this mask fit over the tip of the nose to deliver effective sleep therapy
  • This mask is designed in such a way that it can fit closer to your nose
  • It is possible to adjust the air inflow while using this mask as you will receive larger sized cushions with the purchase
  • The frame of this mask is made of fabric as its name suggests
  • Three sizes are available with this mask so you can choose the one that fit you best
Benefits
  • If you lose the straps and inflate the cushion with air, you can easily get a pleasing seal over your face
  • The price of this mask is very reasonable and you can use it for a long time
  • Warranty is available from the manufacturer
  • Easy cleaning is possible
Cons
  • For creating a seal, it would be risky to over-tighten the mask
  • Some people have complaints this mask put spots over their noses after few days of usage
Who is the product best for?

If you want to cover less of your face while breathing, Respironics Wisp Nasal CPAP Mask Assembly Kit is a great solution. As per the CPAP mask reviews, obese people will get more comfort while using this mask. But the fact is, it’s great for everyone regardless of size or age. Many people often don’t want to cover the entire face while breathing and this is why this mask should be considered.

Conclusion

ResMed and Respironics are the two giant names of the industry that produces CPAP masks and other accessories.  You can get excellent products from either brand.

Once you are prescribed to start taking CPAP therapy, it is safe to choose any one of the above mentioned masks. Just find out how they can improve your life and think about which one is best for you.

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