Narcolepsy Is an Often Misunderstood Condition
Narcolepsy is a rare neurological disorder in which the brain cannot regulate its sleep and wake cycles. It's often mistaken for other disorders, laziness or lack of sleep. It's frequently misdiagnosed even by medical professionals. In fact, about 75 percent of people with this condition don't know it because of the failure to correctly diagnose it. There are two types, narcolepsy 1 and narcolepsy 2. The first type involves cataplexy, a condition in which the body suddenly loses muscle tone as a result of a powerful emotion, such as laughing or crying. This can result in extreme muscle weakness and even total body collapse. Both types involve episodes of extreme daytime sleepiness, paralysis during sleep, difficulties sleeping at night and hallucinations. Only narcolepsy type one involves cataplexy. The condition affects about one in every 2000 people, with symptoms typically starting somewhere between the ages of 10 and 30.
Causes of Narcolepsy
The condition is caused by a deficiency of a specific brain chemical. The exact origin of this deficiency is unknown, but it may be related to genetic factors, environmental factors or both. About one-quarter of the United States population carries a gene known to be associated with narcolepsy. However, since only about 500 of these persons will actually develop the disease, genetic factors cannot be the only cause. Narcolepsy may also have an autoimmune cause. An autoimmune disease is one in which the body's cells attack its own tissues. Type 1 diabetes is an example of this. The body's cells attack the part of the pancreas that makes hormones and destroys it. Without that hormone in the bloodstream, type 1 diabetes results. The same concept may apply to narcolepsy. The body may attack either the cells that make hypocretin or the cell receptor sites on which it works. Although they are not technically a cause, other possible triggers include certain viral agents and significant hormonal changes.
Signs and Symptoms of Narcolepsy
Narcolepsy involves sudden attacks of sleep that occur without warning. The person may literally fall asleep in the middle of a sentence. Other symptoms include an inordinate amount of dreaming and two types of dream-like hallucinations associated with sleep. Hypnagogic hallucinations occur at the onset of sleep; hypnopompic ones happen just before waking. Someone with narcolepsy will wake up throughout the night and will experience episodes of overwhelming daytime drowsiness. Sleep paralysis, a condition which renders a person temporarily unable to move just after falling asleep or just before waking, is also common. However, sleep paralysis can happen to anyone and is not in itself an indication of narcolepsy. For those with narcolepsy 1, cataplexy is another symptom. Not everyone with the condition will necessarily have every symptom, and symptoms may vary over time.
People with narcolepsy may be misunderstood because of these symptoms. They may be seen as lazy or irresponsible. Other possible signs of narcolepsy include headaches, depression, memory problems and situational amnesia, that is, being unable to recall doing a certain activity.
Treating Narcolepsy
Narcolepsy has no cure. It's not physically damaging to the body, but it can cause significant social dysfunction. It can be dangerous for someone who is driving a car or operating machinery. Treatment can only help to manage symptoms and has varying degrees of success. To manage this condition, it's important to modify sleep habits and keep to a strict bedtime routine. Short naps during the day may help to reduce sleep attacks without interfering as much with nighttime sleep. To better identify the sleep problem, the patient may be observed overnight in a sleep disorder diagnosis center. During this observation, a sleep expert will analyze sleep patterns and measure REM sleep. REM is an abbreviation for rapid eye movement, a phase of sleep associated with dreaming. Medications may help with daytime sleep attacks.
