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Narcolepsy

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People

with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollableepisodes of falling asleep during the daytime. These sudden sleep attacks may occur during any

type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep

stages and ultimately (after about ! minutes" rapid eye movement (#$%" sleep. &or peoplesuffering from narcolepsy, #$% sleep occurs almost immediately in the sleep cycle, as well as

periodically during the waking hours. It is in #$% sleep that we can experience dreams and

muscle paralysis '' which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of ) and *), but it can become apparent at any age.In many cases, narcolepsy is undiagnosed and, therefore, untreated.

What Causes Narcolepsy?

The cause of narcolepsy is not known+ however, scientists have made progress towardidentifying genes strongly associated with the disorder. These genes control the production of

chemicals in the brain that may signal sleep and awake cycles. ome experts think narcolepsy

may be due to a deficiency in the production of a chemical called hypocretin by the brain. Inaddition, researchers have discovered abnormalities in various parts of the brain involved in

regulating #$% sleep.These abnormalities apparently contribute to symptom development.

-ccording to experts, it is likely narcolepsy involves multiple factors that interact to causeneurological dysfunction and #$% sleep disturbances.

What Are the Symptoms of Narcolepsy?

ymptoms of narcolepsy include

Excessive daytime sleepiness (EDS) In general, $/ interferes with normal activities

on a daily basis, whether or not a person with narcolepsy has sufficient sleep at night.

People with $/ report mental cloudiness, a lack of energy and concentration, memory

lapses, a depressed mood, and0or extreme exhaustion.

Cataplexy This symptom consists of a sudden loss of muscle tone that leads to feelings

of weakness and a loss of voluntary muscle control. It can cause symptoms ranging from

slurred speech to total body collapse, depending on the muscles involved, and is often

triggered by intense emotions such as surprise, laughter, or anger.

Hallucinations 1sually, these delusional experiences are vivid and fre2uently

frightening. The content is primarily visual, but any of the other senses can be involved.

These are called hypnagogic hallucinations when accompanying sleep onset andhypnopompic hallucinations when they occur during awakening.

Sleep paralysis This symptom involves the temporary inability to move or speak while

falling asleep or waking up. These episodes are generally brief, lasting a few seconds to

http://www.webmd.com/sleep-disorders/guide/sleep-101http://www.webmd.com/sleep-disorders/guide/sleep-101http://www.webmd.com/sleep-disorders/guide/sleep-101

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several minutes. -fter episodes end, people rapidly recover their full capacity to move

and speak.

Ho !s Narcolepsy Dia"nosed?

- physical exam and exhaustive medical history are essential for proper diagnosis of narcolepsy.3owever, none of the ma4or symptoms is exclusive to narcolepsy. everal speciali5ed tests,

which can be performed in a sleep disorders clinic or sleep lab, usually are re2uired before adiagnosis can be established. Two tests that are considered essential in confirming a diagnosis of

narcolepsy are the polysomnogram (P6" and the multiple sleep latency test (%7T".

The P6 is an overnight test that takes continuous multiple measurements while a patient isasleep to document abnormalities in the sleep cycle. - P6 can help reveal whether #$% sleep

occurs at abnormal times in the sleep cycle and can eliminate the possibility that an individual8s

symptoms result from another condition.

The %7T is performed during the day to measure a person8s tendency to fall asleep and todetermine whether isolated elements of #$% sleep intrude at inappropriate times during the

waking hours. -s part of the test, an individual is asked to take four or five short naps usually

scheduled two hours apart.

Ho !s Narcolepsy #reated?

-lthough there is no cure for narcolepsy, the most disabling symptoms of the disorder ($/ and

symptoms of abnormal #$% sleep, such as cataplexy" can be controlled in most people withdrug treatment. leepiness is treated with amphetamine'like stimulants, while the symptoms of

abnormal #$% sleep are treated with antidepressant drugs.

There has recently been a new medication approved for those who suffer from narcolepsy with

cataplexy. This drug, called 9yrem, helps people with narcolepsy get a better night8s sleep,allowing them to be less sleepy during the day. Patients with narcolepsy can be substantially

helped '' but not cured '' by medical treatment.

7ifestyle ad4ustments such as avoiding caffeine, alcohol, nicotine, and heavy meals, regulating

sleep schedules, scheduling daytime naps (!') minutes in length", and establishing a normalexercise and meal schedule may also help to reduce symptoms.

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