Narcolepsy is a long-term neurological disorder that affects your quality of sleep. It can interrupt with wakefulness and control of sleep causing daytime drowsiness. People with narcolepsy disorder may find it difficult to stay awake for long periods during day time. Severe cases of narcolepsy can interfere with your normal routine. Narcolepsy is not related to depression, fainting or lack of sleep but it is a sleep disorder that causes sudden spells of sleep, irrespective of circumstances.
Some people may fall asleep suddenly during any time of the day and they would not have control over it. They go to sleep even during work-time while doing any activity or urgent task. Narcolepsy cannot be cured and often it is chronic. Medications and lifestyle modifications can help you overcome daytime sleepiness.
Causes :
Narcolepsy is believed to be caused by genetic factors. Certain genes are responsible for managing the release of chemicals in the brain that induces sleep. Low level of hypocretin (neuro chemical) in the brain can cause narcolepsy disorder. Certain abnormalities in the brain can affect the normal sleeping pattern. Under normal conditions, people fall asleep with NREM pattern during which there will not be rapid eye movement.
This is followed by deep sleep and finally it ends with REM (rapid eye movement) phase. It is during this phase, one would get dreams and makes muscle movement. However, people with narcolepsy would directly go into REM sleep without having NREM stage. This process occurs at any time of the day or night.
Symptoms :
People with narcolepsy would fall asleep at any time, irrespective of the time and circumstances. It can cause excessive daytime sleepiness which can interfere with routine activities. Daytime sleepiness (excessive) is the first symptom of narcolepsy which may be misunderstood for other illnesses. They may experience lack of concentration, confusion, lapse of memory and fatigue. In some people, it can cause cataplexy, a condition of loss of muscle control. Sudden lapse might occur in muscle tone causing slurred speech, imbalance while walking and sometimes body collapse. Strong emotions may trigger cataplexy condition causing abrupt loss of muscle control.
They might have delusions (seeing objects that are non-existing) and it differs widely from one person to the other. Narcolepsy can cause sleep paralysis for short time making them unable to speak or move suddenly. This condition occurs during the stage of falling asleep or while waking up from sleep. But this may last only for few seconds to minutes and soon they will recover fully. Narcolepsy may occur at any age, but it often begins between 10-25 years. People with narcolepsy disorder may have related sleep problems like sleep apnea, insomnia and restless leg syndrome.
Diagnosis :
Your doctor would observe for sudden loss of control on muscle tone and excess of daytime sleepiness. He may request for special tests for assessing your sleep history for which you may have to stay at sleep center overnight. Team of trained professionals would observe your sleeping pattern. Polysomnogram test would be done for studying the electrical activity of the brain when you are asleep. If necessary, sleep latency test and hypocretin test would be done to measure hypocretin.
Treatment :
Narcolepsy cannot be cured and in most of the cases it is chronic (long term) disorder. Medications are given to manage the intensity of symptoms. For people who have problems in staying awake during daytime, stimulants like Provigil or Nuvigil are given. It acts directly on the central nervous system helping them to reduce the episodes of daytime sleepiness.
Amphetamines like concerta or Ritalin are effective in treating the symptoms of narcolepsy. But it can cause adverse effects. SSRI inhibitors like fluoxetine or venlafaxine are prescribed to suppress the sudden REM (rapid eye movement) sleep. Antidepressants like imipramine or protiptyline are given to control the effects of cataplexy, but it may cause side effects. Some doctors prescribe xyrem for managing daytime sleepiness and to improve quality sleep during night. You need to consult your doctor if you observe any changes since it can interfere with other medications also.
Home Remedies :
You need to stick on to your schedule on all the days by going to sleep at the same time and waking up at fixed time. You can explain your condition to your office and take short naps during the course of the day. This would considerably reduce your daytime sleepiness. Avoid using alcohol since it may worsen your symptoms and intensify drowsiness.
Do regular exercise which can help you to stay awake during daytime. If you are planning to drive long, it is better to have your friend by your side since in spite of taking medications you may feel sleepy. Stop driving if you are feeling sleepy or drowsy by taking a break for half-an-hour. By discussing your problem with your friends and family you can carry out your daily routine.