What is narcolepsy?
Before we can help you to answer the question, am I a narcoleptic, we nee first to understand a little about the disease. Narcolepsy is a chronic brain disorder that results in poor control or even no control of the body’s natural sleep cycles.
If you have narcolepsy, then at times during the day you will frequently experience bouts of extreme sleepiness that simply cannot be resisted effectively. The attacks can last from a few seconds to several minutes and are a real safety issue, when we are at work, driving, operating machinery or out on the street. But that’s not even the worst part of this debilitating condition.
People who suffer from narcolepsy also sometimes experience a sudden loss of muscle tension, rendering them limp and unable to move. Cataplexy can also induce hallucinations.
Another characteristic of narcolepsy is poor sleep quality, although sufferers do not typically sleep more hours than anyone else in a twenty-four hour period – their sleep is simply distributed wrongly. Poor quality sleep is characterised by frequent waking in the night, of which sufferers may be unaware – see our articles on sleep-apnea for further information on this disturbing phenomenon.
So what is a normal night’s sleep? We have several articles (such as this) on this site which investigate this issue, but in a nutshell, a night of normal sleep for an adult consists of four to six sleep cycles, with each cycle made of two phases:
- Non Rapid Eye movement Phase (NREM)
- Rapid Eye movement Phase (REM)
Each sleep cycle is typically an hour and a half to just under two hours, starting with NREM and moving to the REM phase after an hour and a quarter, typically.
The NREM phase is further divided into sleep of increasing depth, which we measure indirectly with EEG machines which measure the electrical signals generated by the brain – what most of us all ‘brain-waves’.
REM sleep on the other hand is associated with increased brain activity and temporary paralysis of many of the body’s muscles. On waking from REM sleep, people generally remember the dreaming experience.
Transitions from NREM to REM Sleep
So what moves us from NREM to REM sleep? This is not precisely known, because as with almost all phenomena associated with the brain, the process is distributed across many regions.
Transitions from NREM to REM sleep are controlled by interactions among groups of neurons (nerve cells) located in different parts of the brain. What we do know is that sufferers of narcolepsy often transit to REM sleep within a few minutes of going to sleep – which is a significant difference to the normal process.
Who gets narcolepsy?
Anyone – male or female at any age. Symptoms often first appear in childhood or adolescence, but can actually appear at any time in life.
How long Does Narcolepsy Last?
Sadly, narcolepsy often remain with any person for the rest of his/her life.
How many people are affected by Narcolepsy?
Narcolepsy combined with cataplexy affects about one in three thousand Americans – more than one hundred thousand Americans alone.
How can I tell if I have narcolepsy? What are the Symptoms?
The most common symptom of narcolepsy (except extreme daytime sleepiness) is cataplexy, which effects in about seventy percent of narcolepsy sufferers. The next most common symptom is hallucinations.
What is Excessive Daytime sleepiness (EDS)?
EDS is usually the most commonly experienced and noticed symptom of narcolepsy. EDS causes problems with normal daytime activities even if the sufferer appears to be sleeping normally. EDS is often described by sufferers as a horrible, debilitating lethargy combined with a sort of mental fog that makes thinking clearly very difficult. On waking from these episodes, sufferers usually feel refreshed for an hour or sometimes a little longer.
EDS can be caused by sleep apnea, depression, and a range of other conditions. It can also be caused by alcohol, cigarettes, sleep deprivation and some medications.
Falling Asleep During the Day – What is Automatic Behavior?
These involuntary sleep periods are often quite brief and last only a few seconds. A most striking feature of these ‘catnaps’ is that many sufferers display automatic-behaviour, which means that they do something that is second nature to them – write notes, put on lipstick, drive and so on. They never remember doing these things and they do not do them well – which in man y cases is extremely dangerous.
What Is Cataplexy?
Cataplexy is a sudden loss of muscle tension and control while awake. This can happen to sufferers at any time and is often (but not always) associated with previous episodes of EDS. In severity, cataplexy can range from a very temporary slight muscle weakness to physical collapse and an inability to move or speak – but the sufferer is ALWAYS CONSCIOUS – even if he/she can’t keep his/her eyes open.
What triggers Catalepsy?
Mp>Strange though is may seem, catalepsy may be triggered by laughter (!), strong emotions, severe stress and any generally heightened emotional state. There is a common element here between catalepsy and the effects of REM sleep on muscle activity.
What is Sleep Paralysis?
Sleep Paralysis is defines as the temporary inability to move or speak while falling asleep or waking up.
What causes narcolepsy?
Narcolepsy seems to have several root causes, one of which is physical – low levels of the neurotransmitter hypocretin in the brain. It does not appear to be directly genetically inherited, but it does seem to appear in family clusters. Traumatic brain injuries can also trigger narcolepsy, affecting its ability to produce hypocretin in the normal amounts.
Can Narcolepsy be Cured?
Sadly, no; however, the symptoms may be alleviated with medicines and a few lifestyle changes. There is no way yet to get the brain to produce more hypocretin, but EDS and cataplexy are sometimes treated with two drugs (approved by the FDA) – modafinil and oxybate. There are side effects though and full counselling by your medical practitioner is required before any course of treatment is adopted.
How can I change my daily routines to cope with narcolepsy?
Drugs alone are not enough to treat narcolepsy and so many sufferers try to accommodate their need for sleep during the day with short naps whenever they feel an attack coming on.
One thing you can do is to improve the quality of your sleep at night – there are a whole range of articles on this site that will help you. Here’s just one.
In general, you should –
• go to bed and wake up at the same time every day
• Avoid imbibing alcohol and coffee at least two hours before bedtime
• Eat supper early and don’t east heavy meals before going to bed at all
• Stop smoking
• Exercise regularly – this always help with the quality of sleep
Join a Support Group
The Narcolepsy Network is a great starting point for you and provides a state by state breakdown of narcolepsy support groups. Good luck and all the best to you.