Narcolepsy

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Narcolepsy
Definition
Narcolepsy, which affects approximately 140,000 Americans, is a neurologic disorder characterized by frequent, involuntary, episodes of sleeping during the day. Sleep attacks may occur while driving, talking or working.
Causes
The cause of narcolepsy is unknown, but it is thought to have a genetic component.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
• Family members with narcolepsy
Symptoms
Symptoms of narcolepsy usually start during the teenage years. Onset may range from 5 to 50 years old. Symptoms may worsen with aging, but may improve in women after menopause.
Symptoms include:
• Excessive daytime sleepiness
• Daytime involuntary sleep attacks
• Unrefreshing sleep
• Sudden loss of muscle tone without loss of consciousness (cataplexy)
• Temporary paralysis while awakening
• Frightening mental images that appear as one falls asleep
• Memory problems
• Symptoms may be triggered by:
o A monotonous environment
o A warm environment
o Eating a large meal
o Strong emotions
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. If narcolepsy is suspected, you may be referred to a specialist in sleep disorders.
Tests may include:
Sleep Latency Test – measures the onset of rapid eye movement sleep, which occurs earlier than normal in narcolepsy
General Sleep Lab Study – helps rule out other causes of daytime sleepiness. The following things are monitored while you sleep:
• Brain waves
• Eye movements
• Muscle activity
• Respiration
• Heart beat
• Blood oxygen levels
• Total nighttime sleep
• Amount of nighttime REM sleep
• Time of onset of REM sleep
• Degree of daytime sleepiness
Treatment
Treatment may include:
• Stimulant medications that increase levels of daytime alertness include:
o Methylphenidate
o Pemoline (requires regular blood testing for liver function)
o Dextoamphetamine
o Methamphetamine
o Modafinil
• Antidepressants – to help treat many symptoms of narcolepsy, include:
o Cataplexy
o Hallucinations
o Sleep paralysis
• Other treatment options include:
o Planned short naps throughout the day
o Counseling to cope with issues of self esteem
o Wearing a medical alert bracelet or pendant
Prevention
There are no guidelines for preventing narcolepsy itself. However, you can try to prevent symptoms.
• Avoid activities that carry a risk of injury from a sudden sleep attack, such as:
o Driving
o Climbing ladders
o Using dangerous machinery
• Exercise on a regular basis.
• Get adequate sleep at night.