Narcolepsy

  • Definition

    Narcolepsy is a disorder of the nervous system. It results in frequent involuntary, episodes of sleep during the day. Sleep attacks can occur while you drive, talk, or work.
  • Causes

    The cause is unknown. It is thought to have a genetic link. There is increasing evidence that it may be an autoimmune disorder. In this type of disorder, the body’s own immune system attacks a part of the brain.
  • Risk Factors

    Having family members with narcolepsy is a risk factor for the condition.
  • Symptoms

    Symptoms usually start during the teenage years. Onset may range from 5-50 years old. Symptoms may worsen with aging. They 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
    • Temporary paralysis while awakening or falling asleep
    • Frightening mental images that appear while awakening or as one falls asleep
    • Memory problems
    • Symptoms may be triggered by:
      • A monotonous environment
      • A warm environment
      • Eating a large meal
      • Strong emotions
    Brainstem—Area of Brain Related to Alertness
    GM00010 97870 brainstem.jpg
    Copyright © Nucleus Medical Media, Inc.
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. If narcolepsy is suspected, you may be referred to a specialist in sleep disorders.
    Tests may include:
    • Multiple sleep latency test (MSLT)—measures the onset of rapid eye movement (REM) sleep, which occurs earlier than normal in narcolepsy
    • General sleep lab study—often done the night before an MSLT; helps to rule out other causes of daytime sleepiness by monitoring:
      • 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
    • A questionnaire regarding your degree of daytime sleepiness
  • Treatment

    Treatment may include:
    • Stimulant medicines that increase levels of daytime alertness
    • Antidepressants to help treat symptoms of narcolepsy
    Other treatment options include:
    • Planned short naps throughout the day
    • Counseling to cope with issues of self esteem
    • Wearing medical alert jewelry
  • Prevention

    There are no guidelines to prevent narcolepsy. But, you can try to prevent symptoms by:
    • Exercising on a regular basis
    • Getting adequate sleep at night
  • RESOURCES

    Narcolepsy Network http://www.narcolepsynetwork.org

    National Sleep Foundation http://www.sleepfoundation.org

    CANADIAN RESOURCES

    Better Sleep Council of Canada http://www.bettersleep.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Bhat A, El Sohl AA. Management of narcolepsy. Expert Opin Pharmacotherapy. 2008;9(10):1721-1733.

    Dauvilliers Y, Arnulf I, et al. Narcolepsy with cataplexy. Lancet. 2007;369:499-511.

    Feldman NT. Narcolepsy. Southern Medical Journal. 2003;96:277-282.

    Narcolepsy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 6, 2013. Accessed June 3, 2013.

    Narcolepsy fact sheet. National Heart, Lung, and Blood Institute. National Institutes of Health website. Available at: http://www.ninds.nih.gov/disorders/narcolepsy/detail%5Fnarcolepsy.htm. Updated December 28, 2011. Accessed June 3, 2013.

    Narcolepsy: new understanding of irresistible sleep. Mayo Clinic Proceedings. 2001.

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