Narcolepsy

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 Narcolepsy is a sleep disorder characterized by abnormal nightly sleep cycles and excessive daytime sleepiness. It can have an underlying genetic cause but may skip generations.

People with narcolepsy typically wake up frequently during the night and fall asleep or lose muscle control suddenly during activities like driving, eating, walking or talking. Narcolepsy can:

• make people more susceptible to having accidents while driving or operating machinery
• interfere with psychological, social, and cognitive function and development
• inhibit one’s ability to enjoy social activities and perform well at school and at work.

People with narcolepsy typically report that they:

• Often experience overwhelming feelings of sleepiness during daytime hours, no matter how long they have slept the previous night
• Sometimes experience sleep paralysis and are unable to move as they fall asleep or when they first awake
• Often have vivid dreams or involuntary leg movements that wake them up during the night
• Sometimes experience a sudden loss of muscle control or collapse when laughing or feeling angry, stressed or excited. This is known as cataplexy.

In a normal sleep cycle, rapid eye movement (REM) sleep starts about 60 to 90 minutes after falling asleep. Dreams occur during REM sleep, and the brain keeps muscles limp during this sleep stage, which prevents people from acting out their dreams. People with narcolepsy frequently enter REM sleep within 15 minutes of falling asleep. Also, the muscle weakness or dream activity of REM sleep can occur during wakefulness or be absent during sleep.

Narcolepsy diagnosis and treatment starts with a physical exam to determine if there are any other neurological conditions that are causing or contributing to this sleep disorder. You may also be asked to keep a sleep journal noting the times of sleep and symptoms over a one- to two-week period. 

Two tests are needed for a diagnosis. The first is an overnight sleep study (Polysomnogram) to ensure that there are no other causes of daytime sleepiness such as sleep apnea or periodic limb movements. The overnight test is followed the next day by a Multiple Sleep Latency Test (MSLT). After the testing the doctor will review the results with you and formulate a treatment plan. 

Although there is no cure for narcolepsy, some of the symptoms can be treated with medicines such as Modafinil, Armodafinil, Methylphenidate or other stimulants. The following lifestyle changes can also help people cope with narcolepsy:

• Take short regularly scheduled naps.
• Keep a regular sleep schedule. A regular bedtime and wake-up time usually helps people sleep better.
• Avoid large, heavy meals right before bedtime.
• Relax before bed. A warm bath before bedtime can help you feel sleepy.