What is Narcolepsy?
Narcolepsy is a condition in which people have difficulties staying awake for long periods of time. Many times, people with narcolepsy will find it difficult to stay awake during the daytime, and they might even fall asleep at very odd times, such as when eating dinner. Drowsiness and falling asleep happens even when the person with narcolepsy had a full night’s sleep the night before.
Some people with narcolepsy will also have a sudden loss of muscle tone when they have a strong emotion. This loss of muscle tone is called cataplexy, and it happens to people with type I narcolepsy. In contrast, people with narcolepsy without cataplexy are known to have type II narcolepsy.
There isn’t a cure for narcolepsy, and there’s no known reason for why some people get narcolepsy. What experts do know is that people with type I narcolepsy have low levels of hypocretin, which is a chemical in the brain that helps regulate REM sleep and wakefulness. No one knows for sure what causes the low levels of hypocretin, but experts believe that it’s probably something to do with an autoimmune reaction.
Most people with narcolepsy begin to experience symptoms between the ages of 10 and 30. Additionally, there’s an increased risk of people passing narcolepsy onto their children. In fact, it’s about 20 to 40 times higher in children with parents who have narcolepsy, but the rate of passing it on is still at only about 1%.
Symptoms of Narcolepsy
One of the most common symptoms of narcolepsy is difficulties staying awake even after getting enough high-quality sleep the night before. Some people will even doze off while doing other types of activities. When people doze off in the middle of a conversation or while working on something, they might fall asleep for a few minutes, or they might sleep for up to a half an hour at a time. When they wake up, they feel refreshed, but they’ll soon begin to feel drowsy again.
People with type I narcolepsy will experience sudden loss of muscle tone when they have strong emotions, including giddiness, fear, and other everyday emotions that people feel on a regular basis. Sometimes the only symptom will be slurred speech, but other times, the person might experience complete weakness of most muscles.
Some people will experience a couple of episodes of cataplexy a year, but other people will experience many episodes a day. In general, most episodes last at most several minutes, but not all people who have narcolepsy will experience cataplexy at all.
Narcolepsy can cause sleep paralysis at times other than during REM sleep, such as when falling asleep or waking up. It usually only lasts a couple of seconds to a couple of minutes.
People with narcolepsy are also more likely to transition to REM sleep much more quickly than people without narcolepsy, and they can have dream states at any time of the day because of this rapid transition to REM sleep, the type of sleep when dreams occur.
Finally, some people with narcolepsy can experience hallucinations as they’re falling asleep. They might have the sense that someone is in the room with them, but because they’re not actually asleep yet, they experience the hallucinations as reality, which is often frightening.
Treatment for Narcolepsy
Because there’s no cure for narcolepsy, the goal is to manage the symptoms. One of the primary tools for helping people stay awake throughout the day is stimulants to the central nervous system. Two of the most common types of drugs for this are modafinil and armodafinil. One of the reasons that these two drugs are preferred methods is because they’re not as addictive as other types of stimulants, and the side effects are usually much more mild and include things like headaches, nausea, and anxiety.
Sunosi and pitolisant are also often used for narcolepsy, and they can be especially useful for people with cataplexy. Methylphenidates like Concerta and Ritalin are also sometimes prescribed, but they’re not the first choice because the potential side effects are stronger and there’s more of a risk of addiction.
Doctors sometimes prescribe selective serotonin reuptake inhibitors. Some of these include fluoxetine and venlafaxine. These drugs are useful to people with narcolepsy, but many patients complain of side effects like weight gain, digestive problems, and insomnia. Sodium oxybate is often useful for people with cataplexy because it helps regulate sleep so that the patient gets more sleep at night.
There are also many lifestyle changes for people with narcolepsy, such as sticking to a regular sleeping schedule. Taking scheduled naps can also help people with narcolepsy stay focused and awake when they need to be. Additionally, avoiding alcohol and nicotine can help because these substances are known to worsen symptoms. Finally, getting regular exercise can also help with symptoms.
