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What is narcolepsy?

Narcolepsy was first described in 1880. it is characterized by an abnormal need to sleep, often in inappropriate situations. Nocturnal sleep is often disturbed.

What are the symptoms of narcolepsy?

The main symptoms are excessive daytime sleepiness, attacks of muscle weakness called cataplexy, sleep paralysis (transient inability to move as you fall asleep or wake up), and visual hallucinations.

How common is narcolepsy?

classic narcolepsy is rare but it has many variations that are more common. some 20–50 people in 100,000 have the condition. between 1 and 4 in 10 people with narcolepsy have a family member who is also affected. rarely, narcolepsy can be passed on through the genes. it can be a major social disability. Almost all patients with narcolepsy have a special genetic marker in the blood which can be tested for. Narcolepsy is now known to be due to a deficiency of the substance hypocretin (orexin) in the brain and spinal cord. Very rarely, the symptoms of narcolepsy may appear following a brain injury or in association with diseases of the central nervous system.

At what age does narcolepsy start?

Narcolepsy usually appears between the ages of 15 and 30; sometimes it can start before the age of 10, or may not be recognized until after 50 years of age or even older. it is a lifelong condition.

How is narcolepsy diagnosed?

Narcolepsy can be confirmed by doing an overnight sleep study followed by a special test called the multiple sleep latency test (MslT). This test involves having 4–5 separate naps over the course of the day, assessing the time it takes for a person to get to sleep, and also whether dreaming sleep occurs. A special blood test is used to look at the genetic make up of the person to support a diagnosis of narcolepsy. A diagnosis of narcolepsy is made on the basis of the symptoms that the patient reports and the results of more objective testing as mentioned above.

The sympToms of narcolepsy

Excessive daytime sleepiness.

People with narcolepsy can have anywhere from 2 to 30 episodes of uncontrollably falling asleep during the day. These attacks can occur at any time, even if a person is working. Each sleep attack can be as short as a few seconds and up to 20 minutes in duration. Following a sleep attack, they feel refreshed.

Cataplexy. Cataplexy is muscular weakness caused by strong emotions such as laughter. Cataplexy attacks commonly occur in situations involving perfectly normal emotions, such as humor (hearing or telling a joke),

competitiveness (bidding in a game of bridge), excitement (viewing, or especially participating in, a sports event), and stress or self-assertion.

Sleep paralysis. This is a short period of inability to move during sleep, and it can last from a few seconds to half an hour. It is due to loss of postural muscle tone.

Hypnagogic hallucinations.

A hypnagogic hallucination is best described as visual hallucinations or dreamlike images (“awake dreaming”) that can occur at the start of sleep.

Is narcolepsy a severe condition?

if mild, the symptoms of narcolepsy may cause no more than minor inconveniences. if severe, however, symptoms can cause significant disruptions in one’s social and professional life, and may become profoundly disabling. parents, teachers, spouses, and employers may often mistake sleepiness for lack of interest, or as a sign of hostility, rejection, or laziness.

How is narcolepsy treated?

The sleepiness associated with narcolepsy can generally be greatly improved by the regular use of stimulant medication, such as modafinil (see p181). At present, these stimulant medications are the only drugs available. For cataplexy, antidepressant medication (such as clomipramine and imipramine) can be very helpful. The drug sodium oxybate can also be useful in instances of severe cataplexy.

Can narcoleptics drive a vehicle?

if symptoms are well under control, narcoleptics can continue driving under normal conditions, and if they are being seen by a doctor at least once a year to discuss their symptoms and their medication. it is the responsibility of the person with narcolepsy to notify their insurance company and the appropriate licensing authority of their condition.

What are theother disorders of excessive daytime sleepiness?

A few other disorders can make you sleep a lot during the day, like idiopathic hypersomnolence (idiopathic means “without a cause,” hypersomnolence means “excessive sleepiness”). Most are rare and the diagnosis can only be made by a sleep specialist or physician. some people who sleep in excess are naturally “long sleepers” but this diagnosis is made only if all other disorders are excluded.