Definition of Narcolepsy
Narcolepsy is a chronic neurological sleep disorder that consists of sudden unexpected and uncontrolled episodes of daytime sleepiness. The onset of the disorder is typically in adolescents. Another peak onset is in the 30’s. Narcolepsy is dangerous because the episodes of sleepiness may come on quickly, increasing the risk of accidents and injury. Fortunately, the symptoms of narcolepsy may be managed with lifestyle changes and prescription medication.
Causes of Narcolepsy
Narcolepsy is due to a lack of a brain chemical called Hypocretin. Hypocretin is the orchestrator of sleep and wake and without this conductor, sleep and wake recur cyclically throughout day and night. Many persons with Narcolepsy have poor sleep. There is a genetic component.
Symptoms of Narcolepsy
The key symptom is Excessive Daytime Sleepiness (EDS) in spite of sufficient amount of sleep at night. The onset is typically in adolescence. Symptoms of narcolepsy occur gradually and begin to appear in adolescence and young adulthood.
Other symptoms include loss of muscle control with emotion. This is called Cataplexy and is triggered by strong emotions. Laughter is the most frequent trigger but any intense emotion can result in Cataplexy. During cataplexy you may lose muscle control of your entire body and slither to the ground. However, Cataplexy can be very subtle such as head nodding or your legs feeling like jelly. Young children may simply stare. You may also experience hallucinations when falling asleep known as Hypnagogic (sleep onset) Hallucinations or when waking from sleep known as Hypnopompic (wake onset) Hallucinations. A very frightening symptom is Sleep Paralysis (SP) that occurs typically at the transition of sleep to wake but can also happen when falling asleep. Sleep Paralysis is when you experience an inability to move (muscles are paralyzed) but you are awake. You are conscious during the event and move your eyes but not speak. SP is a frightening experience but is short lived (minutes). SP does not result in any injury or consequences.
Diagnosis of Narcolepsy
The diagnosis of Narcolepsy will be made by Dr. Gingras based on your history. She will eliminate any other conditions that could cause your daytime somnolence. She will also order a night-time sleep study to learn more about how your body functions while you sleep and to eliminate any other sleep disorders that could cause your daytime sleepiness. This will be followed by a daytime series of naps called a Multiple Sleep Latency Test (MSLT). The MSLT is essential to confirm a diagnosis of narcolepsy. The test evaluates how long it takes you to fall asleep for daytime naps and whether Rapid Eye Movement (REM) sleep occurs during the naps. The MSLT is a measure of daytime sleepiness.
Treatment of Narcolepsy
Narcolepsy is a lifelong condition. Although, at this time, there is no cure for narcolepsy the condition can be managed with lifestyle changes and prescription medication. It can be helpful to schedule naps during the day and avoid eating heavy meals. Treating other sleep related disorders appears to improve narcolepsy symptoms.
Prevention of Narcolepsy
Currently, there is no prevention for Narcolepsy but there is treatment. Dr. Gingras will review all these options once the diagnosis is established.
Am I at Risk for Narcolepsy?
If there is a family history of Narcolepsy and you have daytime sleepiness, you should seek evaluation.
Complications of Narcolepsy
Dr. Gingras will review your work and sleep history and discussed possible complications and make recommendations as how to avoid potential problems.
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