Narcolepsy

By Joseph Conrad

Narcolepsy disease is a neurological disorder that interferes with quality of wakefulness and sleep. Individuals with narcolepsy illness experience intermittent, sleepiness, and uncontrollable cases of sleeping during the daytime.  The sleepiness may occur as a result of repetition and irresistible sleep attacks [1].

Narcolepsy disease makes a person sleep while driving, eating, standing, or walking.  According to the medical scientists of the United States, Narcolepsy is caused by the brain’s loss of neurons which contain hypocretin that assists the brain to stay alert [2]. Around 90% of United States individuals with narcolepsy disease experience low levels of hypocretin in the cerebrospinal fluid.

Medical professionals who deal with this illness diagnose narcolepsy with Multiple Latency Test (MSLT). MSLT is a daytime nap research that is done after an overnight sleep survey called (polysomnogram) [3]. It records how fast people fall asleep during the daytime. During the MSLT a large number of individuals with narcolepsy disease fall asleep in approximately less than 8 minutes, and regularly in less than 5 minutes.  MSLT also shows a tendency in entering the stage of quick eye movement (REM) sleeping more quickly than common sleepers.

The primary distinguishing characteristics of most cases of narcolepsy disease are EDS and cataplexy:

  • Excessive daytime sleepiness (EDS)

EDS is the most common type of narcolepsy signs and the first to be recognized.  Daytime sleepiness is described as the failure to stay alert and awake during the key waking periods of the day. In this disease, the naps have a tendency to refresh and are short, but sleepiness continues in 2 to 3 hours.

This abnormality varies in severity and can be tricky to differentiate from the sleepiness brought by sleep deficiency and other disorders of the sleep [4]. In some cases of sleepiness, another sign of narcolepsy disease can occur called automatic behavior. This happens when an individual does an action without being aware of what he or she is doing. The work done in this state is a waste and the individual cannot remember what was taking place.

  • Cataplexy

Cataplexy is defined by the medical scientists as the immediate loss of the muscle tone that happens regularly in neck, knees, and face.

There are 3 other symptoms of narcolepsy, although each one can be seen in common sleepers and in individuals with sleep disorders. These symptoms are:

  • Sleep paralysis: for a short while, an individual is incapacitated to move or speak as she or he wakes up or falls asleep. It can also include the sensitivity of being limited to breathe.
  • Hypnagogic hallucination: these are clear perceptual experiences that happen as an individual falls asleep. The experience is a bit wearied because the person has a realistic awareness of the presence of a person or an object that is not there. Hallucinations have the tendency of producing feelings of dread or fear, and they regularly occur collectively with sleep paralysis [5].
  • Disturbed nighttime sleep: Individuals with narcolepsy have the challenge of waking up during the daytime.

Narcolepsy Prevalence

  • Less than 1% of individuals in the United States have Narcolepsy.
  • Around 5% of patients diagnosed incredible labs and sleep centers have Narcolepsy.

Types of Narcolepsy disease

  • Narcolepsy with cataplexy.
  • Narcolepsy without cataplexy.

Risk Groups

  • The disease tends to affect people between the ages of 15 and 25 years of age.
  • Narcolepsy disease affects both women and men, and men being exposed to a higher risk.
  • Narcolepsy with cataplexy is regularly connected with big mass body index.
  • If one of your family members is suffering from Narcolepsy, then you have a higher tendency of being a sufferer of the illness.

Effects

  • When left undiagnosed, Narcolepsy can make a person socially isolated and add to feelings of loneliness.
  • It can lead to a prolonged state of stress leading to depression.
  • Individuals with Narcolepsy are at higher risk for Type II Diabetes.

Treatment of Narcolepsy Disease

Treatment of Narcolepsy involves a combination of treatments.  This illness is a lifelong disease, which needs an ongoing diagnosis [6]. The following medications are used to treat Narcolepsy:

  • Modafinil: this is a stimulant that has been discovered by medical experts in the United States which contains chemical compounds used to replace amphetamines as the first –line diagnosis for EDS. Modafinil is powerful, FDA verified treatment for Narcolepsy with low potential and few side effects for abuse.
  • Other stimulants: Methylphenidate, mazindol, and pemoline can be used to treat Narcolepsy. Selegiline can also be used to treat cataplexy and sleepiness.
  • GHB (gamma- hydroxybutyrate): GHB can assist to boost alertness and is also used for reducing cataplexy.  It tends to take around 6 to 9 weeks before it consecutively lessens the cases of sleepiness. It is a preferred alternative to diagnose cataplexy because it has limited side effects.
  • Other anticatapletic drugs: tricyclic antidepressants previously were used a long time ago to treat cataplexy. Zimeldine, atomoxetine, venlafaxine, clomipramine, and fluoxetine are used nowadays [7].

Preventions of Narcolepsy

  • Trying to minimize or avoid exposure to emotional triggers is one way to prevent narcolepsy disease.  Effective coping strategies and mechanisms to reduce external stressors can be helpful and beneficial.
  • Get adequate sleep: Make sure you get enough sleep at night, usually 8 hours is recommended.
  • Avoid sleeping in a supine position:  do not sleep on your back at your bed. Make sure to sleep by your side because when you strain your spinal code while sleeping on your back it can result in a sleep paralysis.

Narcolepsy is a neurological disorder that affects a certain percentage of the population. It is recommended that Non Profit Organizations, such as The EPIC Foundation, offer necessary support to people who suffer from this illness. Thorough medications and frequent counseling should be given to narcolepsy sufferers. It is also wise and worthy to note people should be taught how to get enough sleep during the night, the right styles of sleeping, and how to overcome stress in a proactive manner.

References

  1. Dauvilliers Y, Baumann CR, Carlander B, et al. CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions. J NeurolNeurosurg Psychiatry. 2014.
  2. HinzeSelch D, Wetter, T, Zhang Y, et al. In vivo and in vitro immune variables in patients with narcolepsy and HLA-DR2 matched controls. Neurology. 2016
  3. Keating G, McClellan K, Jarvis B. Methylphenidate, (OROS formulation). CNS Drugs. 2012
  4. Longstreth W, Koepsell T, Ton T, et al. The epidemiology of narcolepsy. Sleep. 2013
  5. Mahowald M, Bornemann A. Stimulants and narcolepsy. Sleep. 2015
  6. 6Narcolepsy [online]. Bethesda, MD: National Institute of Neurological Disorders and Stroke; 2007 [cited 9 July 2014
  7. 7Ohayon M, Okun M. Occurrence of sleep disorders in the families of narcoleptic patients. Neurology. 2016