Narcolepsy
There is no known cause for this chronic sleep disorder. Characterized by excessive and overwhelming daytime sleepiness, even after getting a good night's sleep, narcolepsy can make someone fall asleep at inappropriate times and in uncommon places. Some can occur more than once in a single day.
Three other symptoms of narcolepsy are as follows:
- Cataplexy, which involves sudden episodes of loss of muscle function as severe as complete body collapse
- Sleep Paralysis, which is the inability to move when falling asleep or waking up, from a few seconds to several minutes
- Hypnagogic Hallucinations, which are vivid, dream-like experiences you may have when dozing or falling asleep
The three aforementioned conditions may also occur in people who do not have narcolepsy. One in four patients who have narcolepsy also have the other three conditions. Needless to say, these symptoms can cause serious disruptions in a person's life and can cause a person to think of severely limiting their activities of daily living.
How Common Is Narcolepsy?
Narcolepsy is as common as Parkinson's Disease, although it has less of a public profile due to the lack of awareness of the condition. It is estimated that as many as 200,000 Americans have it, but fewer than 50,000 have been diagnosed. Thus, 75% of the people with narcolepsy don't know for sure that they have it, or not. Often, people with narcolepsy are thought to have depression, epilepsy or suffering from the side effects of various medications.
Who Gets Narcolepsy?
Anyone can get narcolepsy, at any age. It may also run in families, since it is estimated that 8-12% of people with narcolepsy have a close relative who also has the disease. Yes, narcolepsy is classified as a disease.
How Is Narcolepsy Diagnosed?
We review your entire medical history, including your present regimen of medications. We also ask you questions that become part of your Sleep History. Two tests that we perform to diagnose narcolepsy include a polysomnogram and a multiple sleep latency test. The polysomnogram is a continuous recording of your brain waves while you sleep and analysis of nerve and muscle functions during sleep. The multiple sleep latency test involves allowing you to sleep every two hours during normal waking times. We observe how long it takes you to reach various levels of sleep, and how long it takes you to reach REM sleep (rapid-eye movement). Patients with narcolepsy usually fall asleep rapidly and get to REM sleep early.
How Is Narcolepsy Treated?
Treatment can take weeks, or months, before an optimal regimen can be established. In addition, complete control of cataplexy is extremely difficult and rarely possible. Treatment of narcolepsy involves medications as well as lifestyle changes. The medications used for excessive daytime sleepiness in narcolepsy are known as central nervous system stimulants. For cataplexy, and other REM-related sleep symptoms, doctors will prescribe antidepressant medications and other drugs that suppress REM sleep. Caffeine is not recommended, nor are over-the-counter drugs.
Scheduling short naps is also an important part of a treatment regimen. Naps of 10-15 minutes in length, 2-3 times per day, can help the patient stay awake and alert as long as possible.
Finally, communication is a key factor in helping patients work with their physician, their families and the other people in their lives to help the patient toward control over this sometimes debilitating disease. Support groups are also available to provide advice and information, and there are a number of online resources of information available.
The Trinitas Comprehensive Sleep Disorders Center stands ready to help you determine if you have Insomnia and, if you do, to provide you with whatever solutions work best in your particular case. We're experienced in Sleep Medicine and we look forward to helping each and every patient achieve the best possible result. Call us at 908-994-8694 or email us at Sleep@trinitas.org for more information or to arrange an appointment.