What is narcolepsy?

Narcolepsy is a sleeping disorder that triggers the urge to fall asleep suddenly during the day. It is usually impossible to resist. The condition might not be common, but most people know about the symptoms and how they come about. Narcolepsy is quite treatable; however, the condition can still result in total disruption of one's life, ability to work and social relationships.

What are the symptoms of narcolepsy?

The symptoms below are most usually seen with narcolepsy. However, those affected can have varied experiences with the symptoms. Such symptoms can also include:

• Excessive daytime sleepiness (EDS): A drive to sleep at times when it is not appropriate.
• Cataplexy: Sudden loss of muscle control, ranging in severity from mild weakness to total collapse.
• Sleep paralysis: Temporary inability to speak or move for about a minute while falling asleep or waking up.
• Hypnologic hallucinations: Intenseand often frightening dreams and noises reported when falling asleep.

Other symptoms include:

• Automatic behavior: Involuntary performance of routine tasks, with no awareness or memory of doing so.
• Disordered night-time sleep and frequent arousals.

Coping with the situation may involve other difficulties such as:

• Inducing extreme fatigue and energy depletions, along with depression
• Concentration and remembering issues
• Visual focus problems
• Eating binges
• Weak Limbs
• Difficulties with alcohol handling

Symptoms get worse in patients, at whatever age onset, over a period of 2-3 decades from the first appearance. Many older patients notice that some of the daytime symptoms lessen after the age of 60.

Who does narcolepsy affect?

Doctor usually diagnoses narcolepsy in people ranging from 5 to approximately 50 years old. However, it seems to manifest from infancy through early adulthood.

What causes narcolepsy?

Narcolepsy is typically caused by a deficiency of the brain chemical hypocretin (also known as orexin), which controls wakefulness.

The exact cause of a lack of hypocretin is often thought to be the result of an immune system reaction that is mistakenly attacking cells that make it or receptors that enable it to work properly.

But this does not explain all cases of narcolepsy and the exact nature of the problem is often obscure.

The following have been suggested as possible triggers for narcolepsy:

• Hormonal changes which can occur in puberty and the menopause
• Severe psychological stress
• An infection, such as swine flu, or the medicine used to vaccinate against it (pandemrix)

How is narcolepsy diagnosed?

In addition to a complete medical history and physical examination, the lab tests that are done to confirm the diagnosis and facilitate treatment are the following:

• Sleep at an overnight polysomnogram (PSG): A sleep specialist will observe you during an entire night of sleep.
• Multiple sleep latency test (MSLT): This evaluates how fast you fall asleep and how quickly you reach rapid eye movement (REM) sleep.
• Genetic blood test: It screens for genetic mutation that is often found in the individual who is likely to have narcolepsy.

In most cases, narcolepsy is diagnosed only 10-15 years after the first symptoms appear.

How is narcolepsy treated?

Specific treatment will be determined by your healthcare provider based on:

• Your age, overall health, and medical history
• Severity of the disease
• Your tolerance for specific medicines, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Narcolepsy treatment will keep you awake and alert during most of the day. It will also minimize the time you have muscle loss. Ideally, this would accomplish by taking as little medication as possible.

• Medicines : Central nervous stimulants usually speed up prescribed excessive sleepiness. Antidepressants sometimes assist with muscle control.
• Nap therapy: Control sleepiness and to a degree, maintain lucidity with two or three short naps during the day.
• Well-planned diet
• Regular exercise
• Psychosocial intervention

No medical therapy or treatment reverses or can cure narcolepsy. Antidepressants tricyclics have proven beneficial in alleviating cataplexy for most people. Drug therapy should be supplemented by behavioral strategies. Many patients with narcolepsy take short, regularly scheduled naps at times when they tend to feel sleepiest. Improving the quality of nighttime sleep can combat excessive daytime sleepiness and help relieve persistent feelings of fatigue.

None of the currently available drugs allows patients with narcolepsy to maintain a fully normal state of alertness at all times. However, excessive daytime sleepiness and cataplexy are controllable in most patients using drug therapy. The course of treatment is often adjusted when the symptoms change.

What are the complications of the narcolepsy treatment?

Many drugs to treat narcolepsy or its symptoms interact with other drugs. Some possible complications include hypertension and irregular heart rhythms, among others, with any kind of stimulant medication. Sodium oxybate is especially hazardous if taken with other medications that inhibit how your central nervous system works, and it must never be taken with alcohol.

Generally, your healthcare provider would be the best person to advise you on what side effects, complications, or medication interactions to watch out for or avoid. They can tailor this information to your specific case and situation, accounting for your health history and personal circumstances.

How do I take care of myself or manage my symptoms?

You shouldn't self-diagnose or self-treat narcolepsy. After all, the symptoms of this condition commonly occur with other dangerous conditions, such as sleep apnea or epilepsy. This condition can also make some activities like driving or swimming dangerous, so you should always see a healthcare provider to get a diagnosis and treatment.

What is the recovery period for this treatment?

The recovery time or when effects of treatments for narcolepsy will be felt depends on many things. Your healthcare provider is the one to tell you what to expect for your case, including what will be the timeline concerning how soon you should feel the medication take effect or when your symptoms have changed.

How can I reduce my risk or prevent narcolepsy?

Narcolepsy occurs unpredictably in virtually everyone. Consequently, it cannot be helped so as to reduce your chance of developing it or prevent it from happening.

When to seek medical attention?

Seek medical attention if you feel the sleepiness during the daytime is interfering with your personal or work life.

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