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Narcolepsy

Information About Narcolepsy

We Have to Know about the Narcolepsy

  • Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.

Could be dangerous, if the answer is YES for any one of the following questions

  • sleepy throughout the day?

Causes of Narcolepsy

  • Genetics and some sort of trigger may affect brain chemicals and contribute to the disorder.

Do’s of Narcolepsy

  • consult the doctor

Signs & Symptoms of Narcolepsy

The symptoms of narcolepsy most commonly begin between the ages of 10 and 25. They may worsen for the first few years and then continue for life. They include:

  • Excessive daytime sleepiness. People with narcolepsy fall asleep without warning, anywhere, anytime. For example, you may suddenly nod off while working or talking with friends. You may sleep for a few minutes or up to a half-hour before awakening and feeling refreshed, but eventually, you fall asleep again.
  • You also may experience decreased alertness throughout the day. Excessive daytime sleepiness usually is the first symptom to appear and is often the most troublesome, making it difficult for you to concentrate and fully function.
  • Sudden loss of muscle tone. This condition, called cataplexy (KAT-uh-plek-see), can cause a number of physical changes, from slurred speech to complete weakness of most muscles, and may last for a few seconds to a few minutes.
  • Cataplexy is uncontrollable and is triggered by intense emotions, usually positive ones such as laughter or excitement, but sometimes fear, surprise or anger. For example, your head may droop uncontrollably or your knees may suddenly buckle when you laugh.
  • Some people with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes daily. Not everyone with narcolepsy experiences cataplexy.
  • Sleep paralysis. People with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief — lasting a few seconds or minutes — but can be frightening. You may be aware of the condition and have no difficulty recalling it afterward, even if you had no control over what was happening to you.
  • This sleep paralysis mimics the type of temporary paralysis that normally occurs during rapid eye movement (REM) sleep, the period of sleep during which most dreaming occurs. This temporary immobility during REM sleep may prevent your body from acting out dream activity.
  • Not everyone with sleep paralysis has narcolepsy, however. Many people without narcolepsy experience some episodes of sleep paralysis, especially in young adulthood.
  • Hallucinations. These hallucinations are called hypnagogic hallucinations if they happen as you fall asleep and hypnopompic hallucinations if they occur upon waking. They may be particularly vivid and frightening because you may be semi-awake when you begin dreaming and you experience your dreams a reality.

Medical advice for Narcolepsy

  • See your doctor if you experience excessive daytime sleepiness that seriously disrupts your personal or professional life

Risk factors for Narcolepsy

  • The condition may run in families. A small percentage of people with narcolepsy have a close relative with the disease.

Treatment for Narcolepsy

Treatment

  • There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms.

Medications

Medications for narcolepsy include:

  • Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil (Provigil) or armodafinil (Nuvigil) first for narcolepsy because it isn’t as addictive as older stimulants and doesn’t produce the highs and lows often associated with older stimulants. Side effects of modafinil are uncommon, but they may include a headache, nausea or dry mouth.
  • Some people need treatment with methylphenidate (Aptensio XR, Concerta, Ritalin) or various amphetamines. These medications are very effective but may sometimes cause side effects such as nervousness and heart palpitations and can be addictive.
  • Selective serotonin reuptake inhibitors  (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Doctors often prescribe these medications, which suppress REM sleep, to help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis. They include fluoxetine (Prozac, Sarafem, Selfemra) and venlafaxine (Effexor XR). Side effects can include weight gain, sexual dysfunction, and digestive problems.
  • Tricyclic antidepressants. These older antidepressants, such as protriptyline (Vivactil), imipramine (Tofranil) and clomipramine (Anafranil), are effective for cataplexy, but many people complain of side effects, such as dry mouth and lightheadedness.
  • Sodium oxybate (Xyrem). This medication is highly effective for cataplexy. Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy. In high doses, it may also help control daytime sleepiness. It must be taken in two doses, one at bedtime and one up to four hours later.
  • Xyrem can have side effects, such as nausea, bed-wetting, and worsening of sleepwalking. Taking sodium oxybate together with other sleeping medications, narcotic pain relievers or alcohol can lead to difficulty breathing, coma, and death.

If you have other health problems, such as high blood pressure or diabetes, ask your doctor how the medications you take for your other conditions may interact with those taken for narcolepsy.

Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness. If you have narcolepsy, your doctor will likely recommend that you avoid taking these medications.

Emerging treatments being investigated for narcolepsy include hypocretin replacement, hypocretin gene therapy, and immunotherapy, but further research is needed before any may be available in clinical practice.

Self-care for Narcolepsy

  • Stick to a schedule.
  • Take naps.
  • Avoid nicotine and alcohol.
  • Get regular exercise.

Investigations for Narcolepsy

  • Sleep questionnaire
  • Polysomnogram Multiple sleep latency tests.
Causes of Narcolepsy
               Symptoms of Narcolepsy