Narcolepsy is a rare chronic neurological disorder that affects the brain’s ability to regulate the sleep cycle. The sufferer has little or no control over falling asleep which is immensely inconvenient as slumber can occur in the most embarrassing or dangerous situations. For instance: during a meeting, while talking to someone, or when driving.
The symptoms of narcolepsy often start to manifest at the age of 10 to 20 years old. Beginning with extreme sleepiness during daytime which is the most common sign of the disease. This followed by other symptoms: cataplexy, sleep paralysis, and hallucinations.
Cataplexy is the sudden loss of muscle control which occurs with little or no warning. In mild episodes, it affects only few of the voluntary muscles. For instance: jaw dropping, drooping of eyelids, or head falling to the side. In severe cases, it causes total loss of voluntary muscle control. This is manifested by the whole body suddenly falling to the ground and unable to move.
In general, cataplexy episodes last for just a few seconds and finish in less than 2 minutes. However, there are also people who experience repeated cataplexy attacks that persist for up to 30 minutes. The patient is fully conscious of what is happening during the attacks. The symptom is triggered by extreme emotions, either positive or negative. For instance: being very happy, excited, stressed, or upset.
Another symptom of narcolepsy is sleep paralysis. This occurs at the beginning or at the end of sleep. Patients commonly describe the condition as if a creature is sitting on their chest and holding them down. Making them feel afraid and unable to move.
People suffering from narcolepsy may also experience hypnagogic hallucinations, in the form of both visual and auditory. This hallucination takes place during the onset of sleep or upon waking up in the morning. For some patients, hallucinations also occur during cataplexy attacks.
There is still no known cause of narcolepsy at this time. However, the sleep disorder is associated with low supply of hypocretin in the brain. Hypocretin, also known as orexin, is produced by a small cluster of neurons in the hypothalamus which regulates arousal and wakefulness. In people with narcolepsy, about 90% to 95% of the hypocretin-producing neurons die off which results to hypocretin deficiency. The researchers are still trying to find out what kills these neurons to understand how narcolepsy occurs.
Since scientists are still trying to find out the exact cause of narcolepsy, there is no direct cure for the sleep disorder yet. The treatment for people with narcolepsy is focused on fighting the symptoms.
One remedy that is proven to be effective for excessive sleepiness is having multiple short daytime naps. Studies shows that scheduled and limited duration naps during daytime helps patients increase alertness, improve mood, and perform better at work. It is recommended to limit daytime naps at 10 to 20 minutes as prolong sleeping during the day may leave the patient feeling more weak and drowsy. Moreover, it can cause difficulty sleeping at night.
Practicing good sleep habits at night also plays a vital role in improving alertness and enhancing performance during the day. Ironically, most narcoleptic patients have trouble sleeping through the night; in the same way they have problem maintaining wakefulness through the day. Having a restful night can help reduce drowsiness during daytime. A warm bath, aromatherapy with lavender essential oil, relaxing massage, white noise, and dim lights are helpful to have a better and longer sleep at night.
For cataplexy, anti-depressant drugs are prescribed by doctors to avoid the onset of episodes. Selective serotonin uptake re-inhibitors (SSRIs) such as fluoxetine or venlafaxine, tricyclic such as clomipramine, and sodium oxybate like Xyrem are some of the most common medications for cataplexy. These medicines may have disruptive side effects like abnormal heart rate, nervousness, and changes in mood. They can also be addictive. Hence, it is critical to consult a doctor before taking any medications for cataplexy.
There is no specific treatment for sleep paralysis. Nevertheless, stress management, getting enough rest, and maintaining good bedtime habits can help reduce the occurrence of sleep paralysis. For hypnogogic hallucinations, antidepressant medications may be prescribed by a doctor to prevent it. Avoiding alcohol and drugs, meditation, and improving quality of sleep are also helpful to reduce hallucinations.
Narcolepsy can be hard to manage but you can do something about it. If you feel you are experiencing narcolepsy, I strongly suggest seeing a doctor to get treatment for your symptoms. You may also find joining support groups helpful as you’ll get to share your experience to people who understand your condition better.