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more about Narcolepsy

  • A disorder characterized by excessive fatigue, sleepiness, and sudden attacks of sleep during waking hours. It is often associated with dreaming (REM sleep), sleep abnormalities, and sudden muscle weakness or paralysis (cataplexy) without losing consciousness -- usually in response to heightened emotion.
  • Narcolepsy is the second leading cause of excessive daytime sleepiness, occurring in 1 in every 2000-3000 Americans, affecting both sexes equally.

  • Excessive daytime sleepiness and abnormal REM sleep present in all
  • Symptoms vary with each individual.
  • Sudden REM sleep attacks may last minutes or hours. Naps of 5-10 minutes help afterwards.
  • Sleep paralysis (aware but unable to move) lasting seconds to minutes often occur upon waking or falling asleep.
  • Dreamlike hallucinations (hearing or seeing things that are not real) or feeling as if some one were in the room, can occur while dozing or falling asleep.
  • Possible increased leg movements during sleep.
  • There may be normal deep sleep but still not a restful sleep.
  • Sudden onset of muscle weakness (cataplexy) lasting a few seconds, to minutes, often affects both sides of the body and is provoked by strong emotions (feeling elated, stressed, angry; laughing).
  • During a cataleptic event, one may fall to his knees, have difficulty speaking (if jaw muscles are involved), be unable to move a leg or arm, or be completely paralyzed and unconscious -- with no memory of the event.
  • Depression, strains on relationships, and job pressure may occur as a result.
  • Falls, fractures, and accidents while driving may also occur.

  • Unknown
  • Genetics -- 60-fold increase is seen in families with a positive history.
  • In Caucasians, a gene marker known as HLA-DR2 is seen in almost 100% of patients.
  • Immune system -- the body's own defense system against cancers, toxic agents, and infections may be involved.
  • Brain chemicals such as dopamine and over-sensitivity to acetylcholine may play a role.

  • Rule out other sleep problems with a full history (symptoms, diseases, habits, family, and medications) and a physical exam.
  • Sleep studies done at overnight sleep labs are needed.
  • EEG measures the brain's electrical activities -- it is often done to rule out other causes of daytime sleepiness.
  • During sleep, cameras and equipment that record sleep-stages, brain waves, respiration, and heart rate are used.
  • These tests are useful when other symptoms of Narcolepsy are present:
    1. Nighttime polysomnography -- rules out other causes of daytime sleepiness.
    2. Multiple sleep latency test (MSLT) -- if the time needed to fall asleep is less than 5 minutes and a shortened time is needed to get to REM sleep, Narcolepsy is indicated.

  • Family history
  • Head trauma
  • Infections, or drugs, that affect the brain
  • Anesthesia

  • Sleepiness is treated with brain stimulants -- e.g., Ritalin, Dextrostat, and Sanorex.
  • Cataplexy is treated with Vivactil, imipramine, desipramine, and Prozac.
  • Avoid drugs and alcohol.
  • Take frequent scheduled naps.
  • No evidence for dietary treatments, but a diet low in animal fats, dairy, fried foods, sugars, and starches is recommended. Try eating fish, vegetables and fruits.
  • Exercise
  • Avoid climbing ladders, driving long distances, or engaging in aggressive sports if Narcolepsy is not controlled.

  • Do not panic because treatments often work, and research for a cure continues. Ask to be referred to a sleep specialist and notify the Department of Motor Vehicles (DMV). If you have any other questions you can call the American Narcolepsy Association at 1-800-327-6085.

  • Sleep Apnea syndrome -- normal breathing during sleep is interrupted by periods when breathing stops
  • Seizures
  • Syncope (faint or swoon)
  • Drugs -- sedatives, sleeping pills, or muscle relaxants
  • Nocturnal Myoclonus
  • Idiopathic hypersomnolence

more about Narcolepsy

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