Narcolepsy is a chronic neurological condition affecting the area of the brain that regulates sleeping and waking.
Throughout the day, people with narcolepsy will feel strong urges to go to sleep and may fall asleep for a few seconds or minutes, or sometimes up to an hour or longer, without realising what they are doing.
This article is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
What are the symptoms?
As well as feeling very sleeping and suddenly falling asleep during the day, there are several other symptoms of narcolepsy:
Cataplexy – an abrupt loss of muscle control in the body. This can be triggered by eating a heavy meal, stress, or the experience of sudden emotion, such as laughter, and can happen several times a day, lasting for just a few seconds or several minutes. Cataplexy always occurs during periods of wakefulness and can be very slight, affecting just the eyelids and face, or can be severe affecting the whole body.
Hallucinations – at the moment of falling asleep or waking, or after a cataplectic attack, the individual can experience vivid images or sounds, and sometimes even touch sensations.
Paralysis – brief periods of whole-body paralysis at the moment of waking or sleeping. The person is conscious but cannot speak, move, or breathe deeply. Although it can be a terrifying experience, it rarely lasts longer than twenty minutes.
- Trance-like behaviour, lasting for just a few moments or longer periods
- Waking in the night with a racing heart, hot flushes, a craving for sweets, or a feeling of being overly alert
- Disturbed nighttime sleep
- Low self-esteem, depression, relationship problems (caused by the symptoms of narcolepsy and how individuals are treated by wider society)
- Periodic Limb Movement Disorder (PLMD) which causes the leg muscles to involuntarily contract every twenty to forty seconds throughout sleep.
Who is affected?
Exact numbers showing how much of the population is affected by narcolepsy is not known, as the condition is under-reported, however it is estimated that approximately one in every two thousand people has the disorder. Most commonly starting between the ages of fifteen and thirty, narcolepsy affects men and women equally.
What are the causes?
Until fairly recently, the causes of narcolepsy were completely unknown. Much research is now being undertaken to try to get a better understanding of the origins of this condition. Possible causes include:
- The lack of a neurotransmitter in the brain called orexin (or hypocretin)
- An auto-immune disorder, meaning that the body attacks itself
- Inherited factors – if someone in your family already has narcolepsy you are up to ten times more likely to develop the condition yourself
- Recent research undertaken in Japan identified a DNA mutation between two genes known to play a part in sleep control mechanisms
- Can be triggered by infectious diseases such as measles or mumps, accidents, or adolescent hormonal changes
How is it diagnosed?
Narcolepsy is a difficult condition to diagnose as the main symptom is exhaustion and sleeping. And since the onset of the condition is most commonly in puberty, symptoms of narcolepsy are often mistakenly attributed to laziness or staying up too late at night. People are also misdiagnosed as having other conditions that can cause tiredness and sleeping, such as anaemia, heart conditions, low blood sugar, hypothyroidism, epilepsy, or even multiple sclerosis. Teenagers are often accused of illegal drug-taking.
A proper narcolepsy diagnosis will probably take some time to confirm, involving monitoring sleep patters, nighttime behaviour, and perhaps an EEG to show brain wave patterns.
What is the treatment?
Unfortunately, there is no cure for narcolepsy at present. Symptoms can be controlled and minimised to enable the individual to lead a normal life but once the condition is diagnosed it will probably never get better.
Sleep therapy – Undertaking a sleep therapy course, developing a timetable for napping throughout the day and sticking to strict bedtimes, can help reduce excessive daytime fatigue. It is also a good idea to improve the quality of nighttime sleep as much as possible, for example avoiding caffeine and alcohol just before bed.
Drugs – Antidepressant drugs have been effective in helping to prevent cataplexy in people who have narcolepsy (tricyclics and selective serotonin reuptake inhibitors). Stimulant drugs such as amphetamines can also help keep a person alert during the day.
Otherwise, attacks during the day can be minimised by:
- Reducing stress
- Taking regular exercise
- Keeping rooms well ventilated