A medical condition in which the brain cannot control your ability to sleep or stay awake is called narcolepsy. Along with other symptoms, those who suffer from narcolepsy may fall asleep during the day. Although it is a serious health condition, narcolepsy responds well to treatment.
What is Narcolepsy?
A sudden urge to fall asleep during the daytime is a sleep disorder called narcolepsy. However, this disease is not common but it is widely known due to its symptoms. In most cases, narcolepsy is treatable but it continues to cause severe disruptions in your life such as the ability to work and social relationships.
Symptoms
Check below the four main symptoms of this sleep disorder:
- Sleep Paralysis – When a person wakes up sometimes fully but not every time and finds himself unable to move.
- Sleep-related Hallucinations – This symptom usually appears right before waking up or falling asleep.
- Sudden Muscle Weakness (Cataplexy) – It affects one side of the body or only light muscle weakness.
- Excessive Daytime Sleepiness – It is the most common symptom because it happens to anyone who experiences narcolepsy. Another name for this symptom is sleep attack.
Cataplexy
Narcolepsy is classified into two classes and only one of them experiences cataplexy. For example:
- Narcolepsy Type 1 – Roughly 20% of narcolepsy cases are type 1 and it involves cataplexy.
- Narcolepsy Type 2 – About 80% of narcolepsy cases are type 2 and do not involve cataplexy.
Those who experience cataplexy will notice sudden muscle weakness that is very similar to how the body blocks movements during REM sleep. However, in mild cases, this symptom may affect the face and neck only. In severe cases of cataplexy, an individual may collapse to the ground leading to injuries. These outcomes usually last several minutes.
Cataplexy is also considered an unusual symptom because it can occur due to certain emotions. For example laughing, making jokes, humor-related behavior as well as anger, and fear can trigger cataplexy. In addition, this symptom may take place in a mild form in children.
Sleep Paralysis
When a person experiences this symptom, the brain shuts down the body’s muscle control and keeps you from acting out the dreams. However, it should end when you wake up. In normal circumstances, while you sleep you can breathe and move your eyes but you can’t move the body and talk.
In addition, a common symptom that comes along with sleep paralysis is hallucinations. These hallucinations usually are vivid and extremely frightening. On the other hand, this symptom usually lasts a short time roughly several minutes.
Other Symptoms
Check below for some additional symptoms of narcolepsy:
- Sudden Outbursts Around Sleep Attacks – Those who experience narcolepsy may suddenly say something unrelated to what is happening around them. Moreover, people do not remember doing it.
- Amnesia or Forgetfulness – Commonly, people do not remember what they doing before falling asleep and it is common among people with narcolepsy.
- Automatic Movements – People may keep moving parts of their body (such as hands) even if fall asleep.
How Does Narcolepsy Affect My Body?
The following steps will help you to understand better this sleep disorder. Examples include:
- Stage 1 – This is a short stage that starts right after you fall asleep and it accounts for roughly 5% of entire sleep time.
- Stage 2 – It is a deeper sleep stage that consists of roughly 45-50% of all sleeping time.
- Stage 3 – The third stage accounts for about 25% of total sleeping time. Moreover, during this stage sleepwalking or sleeptalking occur.
- REM Sleep – In this stage a person usually dreams. Furthermore, in case a person is in REM sleep, you can notice eye movement beneath the eyelids.
In normal circumstances, if you do not have narcolepsy you will enter into the first stage and move through the second and third stages. Ultimately, your sleep cycle will go into REM sleep and you will start to dream. An individual may go through these steps about 5 times per night. In most cases, one normal cycle lasts approximately 90 minutes.
However, if you experience narcolepsy, you will go REM stage after falling asleep. Thereafter, all night you will sleep in short stretches only without going through the second and third stages. It does not matter how well you sleep at night, you can experience extreme sleepiness during the day, which lasts approximately 15-30 minutes. After that, you can return to what you did before. Unfortunately, extreme sleepiness may occur several times per day. That’s why it is considered a serious health condition that could negatively affect your quality of life.
Causes
In most cases, this condition is linked to the hypothalamus (an area in your brain that is responsible for your sleep and wake-up).
Narcolepsy Type 1
According to research, brain cells (neurons) use a chemical molecule (orexins) to communicate. These brain cells are located in the hypothalamus. Therefore, those neurons are responsible for keeping you awake. Hypocretin is another name of Orexin and it is a molecule created by neurons. These neurons are detectable in the cerebrospinal fluid (CSF), which is a thin layer of fluid that surrounds the brain and spinal cord. Additionally, people with narcolepsy have low orexin levels.
As per studies, in most cases, these neurons interrupt working due to an autoimmune disease. Therefore, the body’s defense attacks the neurons that use orexins. A specific genetic mutation experiences about 90-95% of people with narcolepsy type. Thus, this mutation negatively affects the immune system. However, roughly 25% of people have this genetic mutation but do not have narcolepsy.
In certain cases, narcolepsy can occur after a viral or bacterial infection (such as H1N1 influenza or strep throat). Researchers consider that these infections may cause some changes in the immune system.
Narcolepsy Type 2
It is not known the exact cause of why type 2 narcolepsy occurs. However, in the second type of condition, a decreased loss of neurons is observed.
Secondary Narcolepsy
Rarely, damage to the hypothalamus can cause narcolepsy. For example concussions, traumatic brain injuries, stroke, brain tumors, and others. This sleep disorder may also occur due to some inherited conditions. For example:
- Autosomal dominant narcolepsy, type 2 diabetes and obesity
- Autosomal dominant cerebellar ataxia, narcolepsy, and deafness (ADCADN)
In case you might think that narcolepsy is contagious, it is not. Therefore, you can get or spread this condition to others.
Diagnosis
Usually, the narcolepsy symptoms are very similar to other brain and sleep disorders. That’s why physicians should perform some tests to determine whether you have narcolepsy or not. Check below some tests:
- Sleep study (polysomnogram)
- Multiple sleep latency test (MSLT)
- Maintenance of wakefulness test
- Spinal tap (lumbar puncture)
Sleep Study (Polysomnogram)
This study involves many types of sensors that help to track how you sleep. The primary part of a full sleep study is known as a Polysomnogram (electroencephalogram or EEG sensors). This test helps to determine what stage of sleep you are in minute to minute.
Multiple Sleep Latency Test
This test commonly is used to identify if an individual has excessive daytime sleepiness.
Maintenance of Wakefulness Test
This test is done to determine if you can stay awake even if you are in a situation where is easy to fall asleep.
Spinal Tap (lumbar Puncture)
This test helps to check your orexin levels in the CSF, which is the main factor that provokes narcolepsy. It also can show whether a person develops cataplexy or not. Unfortunately, orexin levels do not change in people with narcolepsy type 2. Therefore, it becomes difficult to diagnose the second type of this condition.
Treatment
Narcolepsy is not a curable condition but it can be treated. The treatment includes medicines and lifestyle changes (such as quitting smoking, avoiding alcohol, regular exercise, and others). Check below some examples of medicines:
- Wakefulness Medicines – Modafinil and Armodafinil are prescribed by doctors because they stimulate the nervous system.
- Amphetamines and Amphetamine-like Stimulants – For example, Methylphenidate, Amphetamine, Dextroamphetamine, and others.
- Antidepressants – Drugs include Venlafaxine, Fluoxetine, Protriptyline, and others.
- Sodium Oxybate – This category of medicines helps to improve sleep and decrease cataplexy.
- Histamine-Affecting Medicines – Pitolistant is one medicine that usually physicians prescribe.
Ask your healthcare professional if you have any questions.
Frequently Asked Questions
What are possible narcolepsy complications?
Hypertension (high blood pressure) and irregular heart rhythms are two complications that may appear. These conditions commonly occur due to an interaction between narcolepsy medicines and others used to treat previous diseases. Discuss with your doctor before using any medication.
How common is narcolepsy?
About 20-50 people are affected by this sleep disorder in every 100,000 people in the entire world. In any case, it is difficult to estimate the exact number of people because diagnosing narcolepsy may take years.
Is it possible to prevent narcolepsy?
Approximately all cases of narcolepsy are sudden and unpredictable. Therefore, it is impossible to prevent or decrease the risk of this sleep disorder. For more details, discuss it with your healthcare professional.
