Narcolepsy is a chronic neurological sleep disorder that is characterized by the brain’s inability to control sleep-wake cycles. People with narcolepsy usually feel an overwhelming daytime drowsiness and experience sudden sleep attacks. These sudden sleep attacks may occur during any type of activity and at any time of the day. Many people with narcolepsy also experience uneven and interrupted sleep that can involve waking up frequently during the night.
More About Narcolepsy
In a normal sleep cycle, the body initially enters the early stages of sleep followed by deeper sleep stages. Then, after about 60 to 90 minutes, the body enters the REM (rapid eye movement) stage. During this stage (also known as the dream stage), the brain keeps muscles limp. This prevents the body from acting out the dreams.
People with narcolepsy frequently enter REM sleep rapidly, often 15 minutes after falling asleep. The muscle weakness or dream activity can happen during waking hours as well, which may explain one of the symptoms known as cataplexy (a sudden loss of muscle tone that leads to weakness and loss of muscle control). Cataplexy is often triggered by a strong emotion, usually, laughter or excitement, but also during fear, surprise or anger.
Other symptoms of narcolepsy may include vivid dream-like images or hallucinations (which may be attributed to wakeful dreaming), and total paralysis (sleep paralysis) just before falling asleep or just waking up.
Narcolepsy can cause serious disruptions to daily routines. People may unwillingly fall asleep even if they are in the middle of an activity like driving, eating, or talking. If left undiagnosed or untreated, narcolepsy can interfere with psychological, social, and cognitive function and development, and can inhibit academic, work, and social activities. Some people experience automatic behavior during these episodes, meaning they may fall asleep while driving and continue to function while asleep. When they wake, they can’t remember what they did.
Studies have shown that people with narcolepsy may experience other sleep disorders as well; This may include disorders such as sleep apnea (breathing starts and stops throughout the sleep cycles), restless legs syndrome, and insomnia. People with narcolepsy can also act out their dreams at night by flailing their arms about or kicking and screaming.
How is Narcolepsy Diagnosed
A physical exam and a detailed family history can be used to either rule out or identify other neurological conditions that may be causing the symptoms. However, none of the major symptoms are exclusive to narcolepsy. Specialized tests can be performed, and are usually required before a diagnosis can be established. Tests for narcolepsy may include: PSG (Polysomnogram) or sleep study – the PSG is a continuous multiple measurement recording of the brain and muscle activity, breathing, and eye movements. A PSG can help reveal abnormalities in the sleep cycle and whether REM sleep occurs at abnormal times in the sleep cycle, and if an individual’s symptoms result from another condition such as sleep apnea.
MSLT (Multiple sleep latency test) is a test performed during the daytime to assess sleepiness and a person’s tendency to fall asleep, and if they enter REM sleep. On the day of the test, the person is asked to take four or five short naps separated by two hours over the course of a day.
Although there is no cure for narcolepsy, many of the symptoms, such as excessive daytime sleepiness and cataplexy, can be controlled in most individuals by drug treatment. Recently, there has been a new medication approved for narcolepsy sufferers with cataplexy called Xyrem and it helps people get a better night’s sleep. People with narcolepsy can be helped but not cured.
It must be noted that a few lifestyle changes may also help reduce symptoms of narcolepsy. Regularly avoiding caffeine, nicotine, alcohol, and heavy meals; regulating sleep schedules, scheduling daytime naps (about 10-15 min in length), starting a normal exercise and meal schedule, have all been shown to help reduce symptoms of narcolepsy.
For more information about narcolepsy, or for a sleep study, please call Gingras Sleep Medicine at (704) 944-0562 today, or request an appointment online.