Narcolepsy: Symptoms, Causes, Prevention, and Treatment

What is Narcolepsy?

Narcolepsy is a sleep disorder that causes people to be very sleepy during the day. People with narcolepsy find it difficult to stay awake for long periods of time. They suddenly fall asleep. This can cause serious problems in their daily routine.

Narcolepsy is a lifelong condition for which there is no cure. However, medications and lifestyle changes can help manage symptoms. Support from others family, friends, employers, and teachers can help people cope with the disorder.

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Symptoms: 

The symptoms of narcolepsy may worsen during the first few years of the disorder. Then they continue throughout life. They are: 

1. Excessive daytime sleepiness: People with narcolepsy fall asleep without warning. It can happen anywhere and anytime. It can happen when you are bored or during a task. For example, you may be working or talking with friends and suddenly fall asleep. It can be especially dangerous if you fall asleep while driving. You may fall asleep for just a few minutes or up to half an hour. You will often feel refreshed after waking up, but sleepy again.

2. Sudden loss of muscle tone: This condition is called cataplexy. It can cause slurred speech or complete weakness of most muscles. Symptoms may last up to several minutes.

3. Sleep paralysis: During sleep paralysis, you can’t move or talk when you fall asleep or when you wake up. It is usually short lasting a few seconds or minutes. Not everyone with sleep paralysis has narcolepsy.

4. Hallucination. Sometimes people see things that aren’t there during sleep paralysis. Hallucinations can also occur in bed without sleep paralysis. They are called hypnagogic hallucinations if they occur while you are falling asleep.

5. People with narcolepsy may have other sleep disorders like insomnia.

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Causes: 

The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of hypocretin, also called orexin. Hypocretin is a brain chemical that helps control wakefulness and when you enter REM sleep.

1. Hypocretin levels are low in people who suffer from cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain is unknown. But experts believe it is due to an autoimmune reaction. An autoimmune reaction is when the body’s immune system destroys its own cells.

2. It is also likely that genetics play a role in narcolepsy. But the risk of a parent passing the disorder on to a child is very low only about 1% to 2%.

3. Narcolepsy may be linked to exposure to the swine flu (H1N1) virus. It may also be associated with a certain form of the H1N1 vaccine. 

Risk factors: 

There are only a few known risk factors for narcolepsy, including:

1. Age:  Narcolepsy usually begins between the ages of 10 and 30.
2. Family history: The risk of narcolepsy is 20 to 40 times higher if you have a close family member who has it.

Facts: 

1. Cataplexy is triggered by intense emotions. Often the emotions that cause cataplexy are positive. Symptoms may cause laughter or excitement. But sometimes fear, surprise or anger can cause a loss of muscle tone. 

2.  Intense feelings such as anger or joy can trigger cataplexy. This can cause people with narcolepsy to withdraw from emotional interactions.

Treatment: 

There is no cure for narcolepsy but medication and lifestyle changes can help you manage the symptoms.

Medications for narcolepsy include:

1. Stimulants: Medications that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Your healthcare provider may recommend modafinil or Provigil or Nuvigil. These drugs are not as addictive as older stimulants. They also don’t create the highs and lows associated with older stimulants. Side effects are uncommon but may include headache, nausea, or anxiety.

Some people need treatment with methylphenidate or amphetamines. These drugs are effective, but they can be habit-forming. They can cause side effects such as nervousness and rapid heart rate.

Tricyclic antidepressants:  These older antidepressants can treat cataplexy. However, they can cause side effects such as dry mouth and dizziness. These drugs include protriptyline, imipramine, and clomipramine.

Xywav is a newer formulation with less sodium. These drugs work well in relieving cataplexy. They help improve night sleep, which is often poor in narcolepsy. They can also help control daytime sleepiness. It is taken in two doses, one at bedtime and one up to four hours later.

These medications can have side effects such as nausea, bedwetting, and sleepwalking. Taking them with other sleeping pills, narcotics, or alcohol can lead to breathing problems, coma, and death.

Some over-the-counter medicines can make you drowsy. These include allergy and cold medicines. If you have narcolepsy, your doctor may advise you not to take these medications.

Home remedies: 

1. Stick to the schedule. Go to bed and get up at the same time every day, including on weekends.
2. Schedule short naps at regular intervals throughout the day. A 20-minute nap during the day can be refreshing. They can also reduce sleepiness for 1 to 3 hours. Some people may need longer sleep.
3. Avoid nicotine and alcohol. Taking these substances can make your symptoms worse.
4. Exercise regularly.

Prevention: 

1. Explain your situation to your close ones as that will help in an emergency situation and avoid accidents. 
2. Take therapy and avoid self-blame to cope with the intense pressure. 
3. Eat healthily and avoid going to sleep alone. Prefer living with family or friends to dealing with it alone. 

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