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 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…
The DSM criteria for narcolepsy includes:
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.
Your narcolepsy may be one of three types.
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
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
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.
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.
There are, fortunately, effective treatments available for narcolepsy.
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:
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!