Narcolepsy
Introduction
A neurological sleep disorder called narcolepsy is characterized by abrupt, unplanned episodes of excessive daytime sleepiness. A person may experience multiple episodes at any time or location during the day, and they usually last around fifteen minutes. Uncontrolled narcolepsy is risky because it can produce sudden periods of drowsiness, which raises the possibility of mishaps and injuries.
After roughly 60 to 90 minutes, persons in a typical sleep cycle transition into rapid eye movement (REM) sleep. People dream the most when they are in the REM sleep cycle. In order to keep the person from acting out their dreams, the brain keeps their muscles slack during this phase of sleep.
The control of the sleep and wake cycles is disturbed in narcoleptics (a condition known as fragmented sleep). Because of this, it is simpler to conflate wakefulness and sleep, and elements of both can coexist. Narcoleptics usually reach REM sleep far faster, usually within 15 minutes of falling asleep. While they are awake, individuals may also feel weak muscles or have REM sleep-related dreams.
Daily activities might be significantly impacted by narcolepsy. Undiagnosed or untreated narcolepsy can disrupt social interactions, emotional health, and cognitive function, which can impact social life, employment, and education. Fortunately, lifestyle modifications and prescription medicine can help manage narcolepsy symptoms.
Narcolepsy Epidemiology
One out of every 2,000 people suffers from narcolepsy. However, because so many different illnesses induce daytime sleepiness, specialists estimate that only approximately half of those who have it are diagnosed. It is believed that men and women are affected by the illness at the same rate. However, other studies have indicated that men and those assigned male at birth are more prone to experience it.
Narcolepsy types
Narcolepsy can be divided into two main categories:
- There are two methods to diagnose type 1 narcolepsy, formerly known as narcolepsy with cataplexy. One method is to look for low amounts of the natural hormone hypocretin, sometimes referred to as orexin, which keeps you awake and regulates REM sleep. A person with cataplexy may also exhibit excessive daytime sleepiness during a special nap test.
- Previously referred to as narcolepsy without cataplexy, type 2 narcolepsy is characterized by excessive daytime sleepiness without cataplexy. Additionally, their hypocretin levels are often normal, and their symptoms are less severe.
Causes
It is unknown what causes narcolepsy. Experts’ believe that it is caused by a combination of factors that interfere with your REM sleep and produce issues in your brain. People with type 1 narcolepsy have a gene variant, DQB1*0602, in about 90% of cases. It’s unclear how this relates to narcolepsy, though. Some specialists believe that a problem with the brain’s production of hypocretin may be the cause of narcolepsy. According to one idea, it occurs when a genetically susceptible person’s immune system is triggered by an outside stimulus. Their immune systems then target the neurons that produce hypocretin. This is only one possibility, though. Additionally, issues have been discovered in the brain regions that regulate REM sleep.
Symptoms
Narcolepsy symptoms start to show up in youth and early adulthood and develop gradually. Excessive daytime sleepiness is typically the first symptom to manifest. Over the course of months or years, other symptoms could appear. Uncontrollable daytime napping eventually results from excessive daytime tiredness. The average duration of a sleep episode is fifteen minutes. You might have multiple experiences of this type every day.
Although you can wake up feeling really refreshed, you might have another episode soon after. You might nod off unexpectedly while working, attending class, or operating a motor vehicle. The most common times for unexpected daytime sleep episodes are after meals and during times when there is little to no physical activity or mental stimulation. Narcolepsy that is not under control raises the possibility of accidents and injuries.
Some narcoleptics have transient paralysis, generalized weakness, or a decrease in muscular tone during sleep-wake cycles. Some individuals have hallucinations, which are seeing or hearing of things that are not actually there, particularly just before bed or just after waking up. Narcolepsy that is out of control might affect your relationships, activities, work, and education.
Diagnosis
If you suffer excessive daytime sleepiness or think you may have narcolepsy, you should speak with your doctor. To rule out other disorders with comparable symptoms, your doctor will thoroughly evaluate your medical history and may perform assessments. To find out if you have genes linked to narcolepsy, blood testing may be performed. Other specialists, such as a psychiatrist, neurologist, or sleep medicine physician, might be recommended to you.
You can find out more about how your body works while you sleep by participating in a clinical sleep study. Another useful tool for verifying the diagnosis of narcolepsy is the Multiple Sleep Latency Test (MSLT). The test assesses whether Rapid Eye Movement (REM) sleep takes place during naps during the day and how long it takes a person to fall asleep. An indicator of daytime drowsiness is the MSLT.
Treatment
Narcolepsy is a chronic illness. Narcolepsy cannot be cured, although it can be controlled with prescription drugs and lifestyle modifications. Avoiding big meals and scheduling naps during the day can be beneficial. Narcolepsy symptoms seem to be alleviated by treating other sleep-related conditions.
Prevention
There is no known cause for narcolepsy, and there is no surefire method to stop it from starting. To lower the risk of accidents, people with narcolepsy should carefully follow their doctor’s advice and take preventative measures. Scheduling naps for after meals or at other points during the day can be beneficial.
Am I at Risk?
The risk factors for narcolepsy are poorly understood because its cause is unknown. Men and women are equally affected by narcolepsy, as is well known. Usually, excessive daytime sleepiness is the initial sign. You should discuss any worries you have with your physician. If other family members are impacted, the doctor might inquire.
Complications
Consult your physician about personal safety measures. Unexpected sleep periods make it risky to drive or operate machines. Consult your physician or the state department of motor vehicles, as certain states have limitations on narcoleptics’ ability to drive.
Advancements
Patients with narcolepsy have been shown to be overweight, often despite eating less than others without the illness. Although the exact causes are unknown, it’s possible that a shift in their eating habits and a diminished capacity for calorie burning are to blame.
