In television sitcoms or gag shows, you'd often see a person suddenly falling asleep in the middle of a conversation or household chore. There seems to be a funny thing about people dozing off at the wrong time. But in reality, narcolepsy is no laughing matter.
What Is Narcolepsy?
Narcolepsy refers to a chronic condition of the central nervous system characterized mainly by excessive daytime sleepiness. This symptom is present in 100 percent of patients suffering from this disease.
Other symptoms of narcolepsy include cataplexy or loss of muscle tone, hypnagogic hallucinations or distorted perceptions, and sleep paralysis.
In some cases, a narcoleptic can also experience disturbed nocturnal sleep and automatic actions carried out with no conscious awareness. Symptoms vary depending on the gravity of the condition.
When Does It Occur?
It often starts in teenagers and young adults. Occurrence is almost equal among men and women. When this happens, the very first symptom you would notice is excessive daytime sleepiness. The other symptoms that follow can occur months or years after the excessive daytime sleepiness.
What Causes Narcolepsy?
The latest discovery on narcolepsy causes is on the abnormal structure and function of hypocretin neurons. These have been located in the hypothalamus part of the brain of narcoleptic patients. Normally, they secrete neurotransmitter substances called hypocretins. The abnormalities in these neurotransmitters may be accounted for the daytime sleepiness and disturbed REM sleep.
Other than this, narcolepsy has also been associated with a certain form of human leukocyte antigen, which is a genetically determined protein found on the surface of the white blood cells.
Another theory is that the autoimmune reaction is triggered by an external factor in the environment such as an infection or trauma. When this happens, the normal brain cells are attacked by the body's immune system, damaging the neurons and inhibiting the release of neurotransmitter chemicals.
Moreover, heredity has also been considered as a possible cause of narcolepsy. Although, there is no consistent pattern of heredity that is seen in patients with narcolepsy, experts say that people with narcoleptic relatives are at higher risk of this condition along with other sleep related disorders such as increased daytime sleepiness, increased REM sleep, and so on.
How Is Narcolepsy Diagnosed?
The primary symptom of narcolepsy, which is excessive daytime sleepiness is common in other conditions. Its only unique symptom cataplexy is not present in all patients with narcolepsy and it often takes a long time to develop. These are the reasons why narcolepsy is often misdiagnosed.
Diagnosing narcolepsy is often done through the
- Epworth Sleepiness Scale, which is a general sleep questionnaire
- Nocturnal Polysomnogram, an overnight test of the electrical activity of the heart and brain
- Multiple Sleep Latency Test (MSLT)
- Spinal Fluid Analysis to determine if there is lack in hypocretin
How Is Narcolepsy Treated?
Even though there is no cure for narcolepsy, medications and lifestyle changes can help you cope with the condition.
Medications include stimulants, selective serotonin or norepinephrine reuptake inhibitors (SSRIs, SNRIs), tricyclic antidepressants, and sodium oxybate (Xyrem).
It's also recommended that you stick to a certain schedule, take naps during the day, avoid nicotine and alcohol, and get regular exercise.