What is Narcolepsy?

Narcolepsy is a health conditions wherein a person feels sleepy throughout the day. Sleep disorders can result from any of three basic reasons. These are:

Insufficient or poor sleep: An ideal example of this is the people suffering from sleep apnea. This problem can be sorted out if the patient’s sleep-related breathing issues are taken care of.
Weakened Brain System: This is also one of the reasons that can keep any person awake. A perfect example of this is Narcolepsy. In this situation, an individual feels very sleepy throughout the day even after having a good sleep at night.
A mixed condition: The condition of Narcolepsy usually develops in a person in his or her earlier childhood or teen years and eventually, with growing age and weight, it takes the form of sleep apnea, adding to the existing problems of the condition.

It is important to note that if a person is suffering from both the critical conditions and the treatment is applied on only one such as sleep apnea and not on the other, it can lead to disastrous results.

Treating sleep apnea may improve the health conditions of the patient but cannot eradicate the problem from its root. Cardiac and stroke related dangers can be alleviated but the untreated narcolepsy will make them fall asleep anyway, paving way for other complications. There can be more than one reason and symptom to any kind of sleep disorder. Hence, it’s essential to offer proper and wholesome treatment to the patient.

As mentioned earlier, Narcolepsy causes brain-related sleepiness in a person. In addition, it is also associated with REM sleep disorders. REM or Rapid Eye Movement sleep disorder in a person occurs immediately after he or she falls asleep. This disorder can be caused by hypnopompic hallucinations and hypnagogic. The hypnopompic hallucinations and hypnagogic is the occurrence of the fragments of dreams before or after the sleep. Another cause of REM sleep can be sleep paralysis or a situation where a person finds himself or herself unable to call out or even move his or her body while sleeping or waking up. Cataplexy as well as dreaming during short sleep can also cause REM sleep disorders. Cataplexy is a medical condition under which the patient feels weakness in his muscles due to any kind of emotional impact, such as laughter. Patients suffering from cataplexy typically always also have Narcolepsy, but patients having Narcolepsy might not always experience cataplexy.

Who can suffer From Narcolepsy?

Both males and females can suffer from Narcolepsy. The main symptom of this disease is sleepiness, which usually takes place in latter part of the childhood, teen years or beginning of 20s. Narcolepsy can also develop in the individuals who are 30 years of age, but, this is very rare.

Symptoms of Narcolepsy

The symptoms of narcolepsy are falling asleep at a frequent rate, hyperactive behavioural pattern, and even other conditions such as Cataplexy.

Causes of Narcolepsy:

This disease is caused if the chemical “neurotransmitters” is found to be missing in the brain cells. Neurotransmitters controls and supervises the communication link between different brain cells and nerve.

Some members in a family can be genetically prone to developing Narcolepsy. However, this is not considered to be a purely genetic ailment in people. Narcolepsy may sometime result from excessive stress, but, as with the instances of genetic causes, this is not strictly a psychological disorder.

How to diagnose Narcolepsy

In order to diagnose Narcolepsy, some careful steps need to be taken. The patient’s history should be carefully observed. His or her sleeping habits should be closely monitored, and a multiple sleep latency test should be conducted. Other than this, the cataplexy disorder should also be taken into consideration.

Is a Narcolepsy blood test helpful?

Narcolepsy cannot be conclusively diagnosed by blood test. However, there are some medical practitioners that believe that blood test can help diagnose this medical condition in a patient. They think that individuals suffering from Narcolepsy have specific HLA types. HLA types are genetically ascertained signs on white blood cells that help in finding out tissue compatibility-for instance, to check an individual’s willingness to donate a kidney to the one whose system may not accept the kidney that has been transplanted. HLA types are determined by a blood test. However, these tests cannot be used for diagnosing narcolepsy because of two reasons: 1) the test will be in negative for the patients who are suffering from narcolepsy as well as cataplexy, and 2) about 25% of the people have same HLA types that are related to Narcolepsy.

How to cure Narcolepsy?

Narcolepsy can be treated if proper medication as well as a bit of common sense is applied. A Narcoleptic patient cannot be treated solely on the basis of medication. The treatment should be designed according to each individual case in concern. In this process, it is important to remove all the aggravating elements that can cause the symptoms to grow more serious, and cause the suggested medications to become less useful.

To elucidate it further, the practitioner cannot recommend a diabetic to do anything whatever he or she feels like because insulin shots are being given. Prescribing medication also means that the patient should be given a proper diet chart and counselled as and when required. This is applicable in case of all types of ailments including Narcolepsy.

Also, the medical practitioner who is treating the individual with Narcolepsy symptoms should possess experience and expertise in handling these types of cases. Physicians should inform the patient about the things or conditions that can pose further risks to his or her health. Not only this, it’s the duty of the practitioner to educate his patient about the ways to handle this disorder with a positive attitude.

Some of the medications that can be prescribed to a Narcoleptic patient are sodium oxybate (Xyrem) and antidepressants. Sodium oxybate (Xyrem) taken at night. All these are stimulating agents. Since these medications may contain some side-effects, physician should prescribe them with utmost care to any individual based on his or her medical records, symptoms, and more.

ADHD, Narcolepsy

Narcolepsy Treatment and Drugs

by Annie Barraza May 6, 2023

Narcolepsy is a sleep illness that affects the lives of over three million people in the world today. This illness knows no color or class. It is found in both the rich and the poor. Some of the aspects of narcolepsy can be dangerous to the patients suffering from it and the people around them. Treatment of narcolepsy is a must for anyone who is plagued by this illness.

Narcolepsy treatments come in many forms. Most people, who have narcolepsy sleep disorder, must undergo a comprehensive treatment plan in order to have a chance at a normal life. Ultimately, this means a very rigid schedule is necessary to keep sleep attacks at a minimum and medications are usually needed to control the symptoms of narcolepsy.

Symptoms of Narcolepsy

The symptoms of narcolepsy can range in severity and they can cause a person much stress on a day to day basis. These can be as simple as someone forgetting to take the shopping list to the store with them after they very carefully wrote it. This person may not be a forgetful person, but narcolepsy has a way of causing such small dramas. The following is a list of narcolepsy symptoms and what can stem from them:

Excessive Daytime Sleepiness (E.D.S.) – This is when a person has trouble staying awake during the times when they need to be awake. They may fall asleep during a meeting at work, or in worse cases, while driving a vehicle.
Cataplexy- This is when a person suddenly a without warning loses muscle control. This can result in falls, which can leave a person seriously injured.
Sleep paralysis- This is when a person is aware of their surroundings, but can’t move or speak. This usually happens right when the person is going to sleep, or just as they begin to wake up.
Hallucinations- This is when a person sees or hears things that are not there. This is very common in people suffering with sleep paralysis.

Dangerous Aspects of Narcolepsy

Without proper treatment narcolepsy can get out of control and become dangerous to the person suffering with it, as well as the people around them. This can make every day, normal activity a real hassle to those involved, especially if the person with narcolepsy does not involve the people he or she knows by telling them about this condition. A person suffering from narcolepsy may be considered rude or lazy by those not knowing the whole story. This in turn can lead to embarrassment. Here is a list of the life altering aspects associated with narcolepsy symptoms:

Cooking can be a real hazard if the person falls asleep even for just a few seconds. This danger includes the stove catching fire and sharp knives causing injury.
Driving vehicles and/or operating machinery are already an activity that requires extreme attention in order for it to be safe. Someone with narcolepsy poses an increased risk for fatal injuries, especially if untreated.
Schooling can be drastically affected if a person with narcolepsy falls asleep during a lecture. Important information can be lost in just a few seconds.
If a person falls asleep on the job, the most likely disciplinary action is termination. A person with narcolepsy risks this situation on a daily basis. If the condition is made known, the employer may be lenient when dealing with situations like this.

Non Medication Narcolepsy Treatments

Treatment for narcolepsy starts at home with the person making a conscious decision to change his or her lifestyle. These changes, in necessity, range from somewhat important to very necessary, depending on the severity of the illness in the person. These changes include, but are not limited to:

Better sleeping habits
Avoid night time work
Scheduled naps during the day time
Involve friends, family, and co-workers
Improved diet
Avoid drugs, alcohol, nicotine, and over the counter medications that promote drowsiness
Keep a sleep journal handy at all times
Wear a medical bracelet to alert others of the condition
Seek counseling

These lifestyle changes combined with narcolepsy treatment drugs can provide anyone suffering with narcolepsy with a more normal life. These changes all must start with the person saying “I can change for the betterment of my life”.

Medical Treatments for Narcolepsy

Most of the time, narcolepsy is misdiagnosed due to the lack of medical history in a person. This could result in the prescribed medications being the wrong ones. Trial and error is usually the only thing that can be done in the beginning of narcolepsy drug treatment. Here is a list of types of drugs commonly used in the treatments of narcolepsy.

Stimulants- These are very common types of drugs used to promote wakefulness. Stimulants should be taken carefully, due to the side effects. Patients suffering from any psychiatric ailments should avoid stimulants.
Antidepressants- These are used to treat cataplexy and hallucinations due to sleep paralysis.
Sodium Oxybate- This is used to promote very peaceful sleep. This type of drug has to be taken carefully in several doses for it to work properly. It reduces E.D.S. and works to prevent cataplexy attacks.

Usually patients with narcolepsy need more than one of these types of drugs for the effects to be successful in their treatment. Narcolepsy drugs, as with any drugs, need time to build themselves up in the person for the treatment to be of benefit to him or her.

Narcolepsy Drug Treatment-Specific Drugs

Some common stimulants used to stimulate the central nervous system are:

Provigil
Ritalin
Concerta

Some common antidepressants used to treat cataplexy and hallucinations are:

Prozac
Zoloft
Sarafem
Effexor

Some older tricyclic antidepressants include:

Vivactil
Tofranil

These two drugs aren’t as common due to the side effect they produce, although they are considered by doctors to be very effective in controlling cataplexy.

The most common version of sodium oxybate is:

Xyrem

Xyrem has to be taken with absolute, extreme care. This drug has been called the “date rape drug” due to the intense deep sleep it can induce. This drug is also not like the other narcolepsy drugs, because it is a liquid instead of a pill. The doses have to be taken in multiples over a period of hours for Xyrem to work properly. Too much at one time can cause coma or even death.

Check with your local clinic for more information on how to manage insomnia, sleep apnea, narcolepsy and other hypersomnias. There may be a guide available with narcolepsy health information or a list of available treatments and drugs.

ADHD, Narcolepsy

Challenges and Practices in Narcolepsy Diagnosis

by Annie Barraza May 6, 2023

Even though disease, Narcolepsy can be identified positively through physical observation, physicians are still misdiagnosing patients. Misdiagnosis happens especially when dealing with those that have psychological problems. Clinical evidence suggest that tests on a patient’s cerebrospinal fluids (CSF) can nearly confirm Narcolepsy, as 90% of Narcoleptics tested in studies have shown to have no hypocretin-1 in their CSF.

Often doctors will rely on symptom reporting by patients, questionnaires, testing sleep latencies in patients, and monitoring a patient as he/she sleeps and may not test the patient’s CSF before starting therapy. Doctors can however be firm in their diagnosis by observing the presence of nearly all Narcolepsy symptoms together in a patient. The confirmation of cataplexy, for example confirms a patient has Narcolepsy, as it is unique to Narcolepsy.

Diagnosis and treatment of Narcolepsy is somewhat standardized but methods and drugs vary from patient to patient most of the time. Upon diagnosis doctors usually choose to prescribe two frontline medications (modafinil, sodium oxybate). Both of these drugs are habit forming and sodium oxybate can be very dangerous. For this reason the process of diagnosis may take some time because the doctor wants to be sure of his diagnosis before prescribing it.

Most patients do not receive their Narcolepsy diagnosis until ten to fifteen years after the first symptoms start appearing. For a doctor to make a correct narcolepsy diagnosis they must take into consideration the patient’s family and medical history. This includes the medications the patient is taking and any even what the person eats regularly. Diagnosing narcolepsy becomes easy when the patient exhibits all major narcolepsy symptoms listed below:

Excessive daytime sleepiness (EDS) and an urge to take frequent naps during the day. These daytime naps must happen every day for six months at least in order for it to be considered as solid basis for narcolepsy diagnosis. Diagnosing narcolepsy is common in young adults and adolescents; bringing the problem to their attention when they suddenly fall asleep at school or at work. Sometimes, patients also experience insomnia but the majority of time a narcoleptic will have no issue falling asleep and entering almost directly into REM sleep.
Cataplexy or sudden muscle weakness and loss of muscle control and tone, causing the patient to stop motor activity.
Visual or auditory hypnagogic hallucinations that occur right before falling asleep.
The inability to move upon awakening, or sleep paralysis.

However, narcolepsy diagnosis that’s based solely on symptoms can be problematic for several reasons. One reason is that some patients that receive a Narcolepsy diagnosis often seek medical advice for just one symptom (frequently hypnagogic hallucinations or sleep paralysis) which could be caused by other similar disorders; epilepsy in particular. Another reason for the difficulty in the diagnosis of narcolepsy is that the symptoms do not always become apparent to anyone for several years. This is true for the patient himself and even to a skilled observer. In certain cases, a patient is required to consult specialists in the field, or get treated and monitored at a sleep disorder clinic for a more effective treatment for Narcolepsy and to confirm that a patient does indeed have Narcolepsy.

Questionnaires for Diagnosing Narcolepsy

The Epworth Sleepiness Scale is one of the questionnaires for sleeping habits that a doctor can administer to get a more reliable narcolepsy diagnosis. The ESS makes use of simple questions in measuring excessive sleepiness; differentiating it from the normal sleepiness we usually feel in the daytime. See figure 02-01a for the test.

Figure 02-01a: The Epworth Sleepiness Scale

*Note this test varies slightly with different results analysis.

Situations	Chance of Dozing0-none1-slight chance2-moderate chance3-high chance
Sitting and reading	Indicate score (0-3)
Sitting inactively in public places	Indicate score (0-3)
As a car passenger for one whole hour without any breaks	Indicate score (0-3)
Watching television	Indicate score (0-3)
Sitting and talking to someone	Indicate score (0-3)
Sitting quietly after lunch (without alcohol)	Indicate score (0-3)
In a car stuck for a few minutes in traffic	Indicate score (0-3)
Lying down for an afternoon rest when circumstances allow	Indicate score (0-3)
Show Results	1 – 6: Getting enough sleep7 – 8: Tends to be sleepy but is average9 – 15: Very sleepy and must seek medical advice. Over 16: Dangerously sleepy

Multiple Sleep Latency Tests

MSLT or multiple sleep latency tests can also help in making an accurate Narcolepsy diagnosis. The MSLT makes use of a device that can measure the time a patient takes to fall completely asleep during the day while lying inside a quiet room. Patients are asked to take 4-5 scheduled naps that are 2 hours apart. People with healthy sleeping habits usually fall asleep in 10-20 minutes. However, patients with a diagnosis of Narcolepsy show a significantly shorter time duration; approximately less than eight minutes, when moving from wakefulness to sleep. At least two of these naps are REM sleeps; the sleep state associated with dreaming. Still, the test has its limitations. There is no clear definition which abnormal results are proven to be basis for diagnosing narcolepsy. The Epworth Sleepiness Scale might be more precise in identifying narcolepsy from regular daytime sleepiness.

Polysomnography

Polysomnography is a study of an overnight sleep that can prove valuable in determining the major cause of sleepiness. A patient, without changing any of his daily habits, goes to the sleep centre two hours before bedtime. Various devices are used to monitor the patient while he sleeps:

The ECG or electrocardiogram monitors the patient’s heart
The EEG or electroencephalogram monitors the brain’s electrical activity
The Electrooculogram monitors the eye movements
The Electromyogram monitors muscle movements

With these instruments, doctors can record a patient’s condition, and monitor activity as their patients pass, or fail passing, through the stages of sleep. Neuroimaging methods can also be used in studying or confirming physiological sleep theories and discovering new relevant information about neurobiological aspects of the human sleep, memory and dreams. A few studies in neuroimaging focus on subjects suffering from narcolepsy and other sleep disorders.

Narcolepsy Diagnosis and Narcolepsy Treatments are carefully adapting with new findings. Newer drugs are replacing older ones and doctors are diagnosing patients with better confidence. With proper diagnosis Narcolepsy symptoms can be treated quickly and nearly all signs and symptoms of the neurological disorder can be substantially reduced.

ADHD, Narcolepsy

Narcolepsy Diet and Food Habits Effect on Narcolepsy

by Annie Barraza May 6, 2023

What is Narcolepsy?

Narcolepsy is a disease that causes serious sleeping disorders to rise to the surface. At any time (especially during the day) narcolepsy victims experience sleep attack. Irrespective of time and place the sleep attack creates an embarrassing situation. Most Narcolepsy patients are depressed and hesitate to join in at any social or family events. This sleeping disorder can be threat for their professional life too. However, with more improved medical treatments and other therapies it is quite easy to heal diseases like cancer and others. Just a few changes in lifestyle and other practices can dramatically help to restore normalcy in a patient’s life.

Find out if you really suffer from Narcolepsy

A Narcoleptic patient has to go through two different levels of testing. This is the basic diagnosis of Narcolepsis. At the first level you go through a kind of Sonography. Polysogram is the first level. During this test more than two dozen electrodes are attached to different part of the body like nose, hand, abdomen and others. They transfer data to polysonogrph that records all the information. This helps the experienced professionals to diagnose the disease properly.

In the second level, the test will be on MLST or multiple sleep latency. This particular tool is used to record the time gap of daytime naps.

If you experience the effects of a sleeping disorder frequently, don’t ignore those symptoms. Often people consider them as general symptoms and later face severe difficulties in personal and professional life. When you have the option to prevent it, then why not start as soon as possible.

Take care of your food habits

For Narcoleptics, it is not good to drink alcohol. It is kind of depressant that weakens the nervous system and creates feelings of drowsiness. Therefore, for better sleep when it is an appropriate time to do so, it is best to avoid alcohol or any nicotine.

There are several side effects of sleepless nights. If you are not able to sleep properly at night, you won’t be able to work properly or concentrate on anything; this can result in other serious symptoms. Good sleep can enhance the working capacity of your brain. Thus don’t suppress it with alcohol or other intoxicants and try to sleep peacefully at night.

Not only does alcohol or caffeine affect sleep, but there are also specific dietary habits that can have a long-term effect on your sleep. Your food habits require changes if you experience sleeping disorder symptoms on a frequent basis. High protein or high-energy foods are good for those who suffer from the condition. It is also best to avoid junks or spicy food. This type of food affects the metabolism and the digestive system of your body and can result in Narcolepsy attacks. Try to eat a heavy meal at least five hours before you go to sleep. Don’t exercise after a heavy meal. If you can walk for fifteen or twenty minutes after your meals, it would definitely help you to sleep well at night. Drink water after an hour or two of eating food. You can also consult a nutritionist to get suggestions on a better, more helpful diet.

Many Narcoleptic people wake up at night to have something and they can’t sleep again until they eat. This is why majority of Narcoleptics end up gaining weight. When they wake up between sleep cycles, they are totally oblivious what had happened before. Still, a clue from the kitchen can help them to remember the whole scenario. It is not that they are hungry or they have the appetite to eat something. People facing this issue should try to stay away from food when they don’t need it. It won’t be very easy to avoid it at an advanced stage. Often you will fail to control the situation. Still if you try it now, you are bound to succeed once a positive habit has been formed.

Change your sleeping habit

As it is has been said earlier, sleeping disorders are the primary symptom of Narcolepsy. To prevent sleep attacks, a good, deep sleep at night is very important. After a certain time at night, forget all your office works or any other issues, no matter how important they are. If you want a productive morning, utilize the night. Try to sleep and awake at the same time every day. Sleep in dark and quiet room. For better sleep, try something that relaxes you. Drinking lukewarm milk or bathing in a warn tub before going to bed are some things worth mentioning. Narcolepsy patients can’t sleep for a long time at a stretch. In order to sleep properly, take a break of twenty minute. If it still doesn’t work, then read some books or magazines until you feel sleepy.

A daytime nap is good relief for Narcoleptics. Plan your daytime schedule so that you can get at least 15 to 20 minutes to take a nap. To avoid sleeping frequently during office hours, daytime napping is the best alternative, and some work environments may even have areas that would be convenient and discreet for taking a quick catnap while on break.

Regular exercise is good for Narcoleptics

Don’t forget to exercise regularly. It is well known that many Narcoleptics have been helped by yoga and other exercise forms. If you find it difficult to exercise, a brisk walk in the morning can be of great help. Exercise or walking increases the body strength and improves the metabolism of your body. Thus you can remain active during the day and enjoy a sound sleep at night.

Narcolepsy is not an incurable disease. If you can change your lifestyle, you can soon come out of it and you can also go for medication and natural therapies to get added relief. There are several holistic practices available that can help too. No matter what method you follow, practice it properly. Listen to what your doctor or mentor or nutritionist advises you, and don’t try to do it all on your own.

ADHD, Narcolepsy

Narcolepsy Research – Reaching for a Cure

by Annie Barraza May 6, 2023

Narcolepsy is a very serious, chronic sleep disorder that affects one in every two thousand people in the United States alone. Worldwide, the estimates of people living with the symptoms of narcolepsy reach over three million. Research on narcolepsy is among the top in all medical research fields, due to the seriousness of this condition. A better understanding of narcolepsy will ultimately lead to better understanding of other sleep disorders, which is why so much attention has been drawn towards narcolepsy research.

To research narcolepsy accurately, scientist not only do laboratory sleep studies, but they also depend on the information provided by the patients themselves. By keeping journals or recording episodes that occur, a patient can help researchers discover side effects of medications, episode time frames and so on. Unfortunately, this side of the research is needed, but since correct diagnosis is hard to determine, making it a truly priceless side of the research when it is attained.

Narcolepsy Basics

Narcolepsy is a chronic sleep disorder that has two different international classifications: narcolepsy without cataplexy and narcolepsy with cataplexy.

Narcolepsy has four major symptoms: Excessive Daytime Sleepiness (EDS), Sleep Paralysis, Hallucinations and cataplexy. Although there are several secondary symptoms, these are the classic symptoms seen in most patients.

EDS is pretty straight forward. Patients with narcolepsy experience a desire to sleep that is so strong it becomes an irresistible need.

Sleep Paralysis is occasionally experienced by a large number of people without narcolepsy. Narcolepsy patients that have sleep paralysis as a symptom tend to experience it more often. Sleep paralysis happens in the twilight between the sleep and wake cycles. The mind is not yet asleep but the body undergoes the paralysis that usually comes with REM sleep. Often, the subject will also experience hallucinations.

Hallucinations are common for the narcoleptic. Hallucination research and narcolepsy research show that narcolepsy patients have a similar amount of hallucinations as patients suffering from schizophrenia but narcoleptic hallucinations tend to be more visual whereas schizophrenics have more auditory hallucinations.

Cataplexy is experienced by seventy percent of narcoleptics. Cataplexy is peculiar to narcolepsy and it is extremely rare to have cataplexy without narcolepsy.

Cataplexy is the sudden loss of control over muscle function. The affected muscles become lax and lose tone. Cataplexy usually affects the face or neck, but can appear in any muscle group. In an extreme instance, the entire body can collapse. The oddest and most frightening thing about a cataplexy attack is that the patient remains alert and awake the whole time. Cataplexy is triggered by strong emotions.

Data collected during research and narcolepsy patient information led scientists to give narcolepsy with cataplexy its own diagnosis.

Research on Narcolepsy

In the early 1970’s, Dr. William Dement founded the Stanford University Sleep Clinic, which was the first clinic in history to specialize in sleep disorder studies. This research center was the first to discover that narcolepsy-cataplexy was linked to a deficiency in hypocretin. This research has been proven in both animal subjects and in human subjects. The Stanford Center for Narcolepsy was created in the 1980’s as an extension of the Department of Psychiatry and Behavioral Sciences. Today, this facility treats hundreds of narcolepsy patients per year, with many patients freely participating in other sleep studies as well. There have been hundreds of articles written on narcolepsy that give credit to the name of this facility for its extensive research of narcolepsy.

Hypocretin Research and Narcolepsy-Cataplexy

The cause of narcolepsy-cataplexy, in ninety percent of cases, is accredited to a lack of hypocretin-1 and hypocretin-2. The cause of narcolepsy without cataplexy remains a mystery. These molecules that are created in the hypothalamus (hypo) have a resemblance to the gut hormone called secretin (cretin), thus named hypocretin. Of the many billions of cells in the brain, only ten to twenty thousand produce hypocretin. The hypothalamus is also responsible for a host of basic functions of the body. It controls hunger, sexual impulses, blood pressure and sleeping. Hypocretin-1 (not hypocretin-2) can be measured in the cerebrospinal fluid, but not by blood or tissue samples. To collect this cerebrospinal fluid, a spinal tap is necessary. Most patients (about 90%) with narcolepsy-cataplexy have a zero percent level of hypocretin-1.

When trying to control the symptoms of narcolepsy, many things need to be considered. First, the proper diagnosis of the condition is critical. Does this case have cataplexy? Hallucinations? By asking these types of questions, a doctor can more accurately diagnose narcolepsy. Along with extensive questioning, there are tests and studies that can help in the diagnoses.

A nocturnal Polysomnogram is a test performed with electrodes placed on the patients scalp and measures the electrical activity in the brain and in the heart. This test takes place over night at a medical research facility designated by a physician.

A Multiple Sleep Latency Test (M.S.L.T.) is another test used to determine how long it takes a person to fall asleep during t day. The patient is asked to take five naps, each around two hours apart. Patients suffering with narcolepsy usually fall asleep very quickly and enter into R.E.M. sleep almost immediately.

Management of Narcolepsy

Narcolepsy and Research about its behavior has given doctors a few ideas into the treatment and prevention of its symptoms. If a patient has mild enough symptoms, then a simple change in lifestyle may be all that is required. More often, drug treatment in the form of stimulants and antidepressants becomes necessary.

Many times, the fact that there is no cure for this disease causes a feeling of helplessness, but with research awareness in narcolepsy, there is hope. With comprehensive management, a patient with narcolepsy can live a relatively normal life.

Narcolepsy Treatments

Lifestyle Changes
- strict bedtimes
- strategic daytime naps
- avoid stimulants like coffee
- make the people in your life aware of your disease
Drug Treatment for EDS
- Stimulants
  - Amphetamines
  - Modafinil
  - Selegiline
Drugs for Cataplexy
- Tricyclic Antidepressants
  - Imipramine
  - Protriptyline
- Selective serotonin reuptake inhibitors
  - Prozac
  - Paxil
  - Zoloft
- Sodium oxybate
  - Xyrem

Narcolepsy

The History of Narcolepsy – Discovery and Science

by Annie Barraza May 6, 2023May 6, 2023

Narcolepsy has been plaguing the human existence for centuries, with no known explanation as to why the brain shuts down, and the body goes into a form of sleep paralysis. Narcoleptic history is a touch and go subject because in the ancient times documents were not kept as accurately as they are today, and the documents that were kept were either destroyed, or cannot be deciphered. The history of narcolepsy in human beings is taken down by a physician and kept in an extensive medical file for that patient.

With each new case of narcolepsy the history and everything that is known about the brain and how it works is added to and carefully studied. Scientists have done extensive research to understand what is triggered when a cataplectic attack happens. With every sleep study that is preformed brain wave activity is measure, how long an episode lasts, and what happened before the attack happened is also carefully recorded to make sure that everything is properly noted.

Narcolepsy and Animals

Narcolepsy not only is a human disorder, but it also affects dogs and horses. This disorder works the same way in animals as it does in human beings:

Fatigue
Depression
Moodiness
Lost time
Sleep paralysis

All of these happen when a person has a history of narcolepsy, and most of time it has been diagnosed by a physician or a vet. The history of narcolepsy in horses is a little less definitive, because narcolepsy in horses is rare and often mistaken for a sleep apnea. Muscle fatigue and weight loss are both signs of a sleeping disorder, but not always narcolepsy when it comes to a horse. The signs are more noticeable, like standing still in mid step, are a general bad mood. While looking for these symptoms, the owner or trainer of the horse should also consult a veterinarian.

The canine history of narcolepsy is caused by a disruption of hypocretin receptor 2 genes or Hcrtr2, what the Hcrtr2 gene does is activates the brains sleeping agent making the body want to sleep and rest when the brain does not need to do so. With significant research being done with canines scientists have determined that the trait first developed in Labrador retrievers and Dobermans, and the gene was bred into them much like that of a horse retaining that trait from their parentage.

With each study that was taken with the dogs a pattern began to emerge with the breeds that had been back breed or had the same parents and brothers and sisters, the pattern clearly pointed out that the canines that were back breed had a greater likely hood of contracting the narcoleptic gene trait and making the animal more susceptible to having narcolepsy. The traits and genes are passed down from parent to child and continue down through the line. As the line continues throughout the years the narcoleptic trait becomes stronger and the chances of having the gene activate is greatly increased.

Narcolepsy-Cataplexy

When sleepiness and cataplexy become a factor in life and daytime sleep is needed to function normally, it becomes harder to deal with normal society, and daily functions. When falling asleep or waking after an episode has hit, the lack of muscle functions is hard to get over. The body does not want to move or respond no matter how hard the person tries to move or respond to a simple command because of the sudden attack leaves the muscles in a weakened state.

The lack of muscle usage is one of the main problems for people with narcolepsy, some episodes can take place while driving and the lack of motor control is a main cause of motor accidents for people with narcolepsy.

Nighttime sleep is hard to get when a person has narcolepsy with cataplexy, because of the need to sleep during the day. The body will get the initial six to eight hours of sleep required to function but not at the normal time. When the body has a cataplectic attack it will shut down and sometimes even do automatic responses such as eating, speaking, driving, reading, writing, cooking, and cleaning. Some of the auto responses are not as dangerous as the others but, cooking; eating and driving can all have fatal ends. Eating sounds like it would not have a fatal end when having a cataplectic attack but the person could choke, on their food and not being able to respond correctly could kill them.

Narcolepsy and its history has changed over the years and course of study, with therapy, and regular medical examinations narcolepsy and all of the effects can be controlled with medication, life style changes and sleep studies, a patients narcolepsy can be controlled and even prevented.

With regular treatment the signs of narcolepsy such as hallucinations, daytime sleepiness, fatigue, depression, and lack of interest in things can be changed. With the advances that have been made in the neurological field the studies that have been made on the brain and mapping each quadrant, greatly increases the understanding of not only how the brain works but as to why the brain sometimes has a deficiency. Another study shows that the narcoleptic trait has origins of being an auto immune disease or closely related to it.

With the studies that are being made and advances in science the narcolepsy history is being easier defined and laid out for people to understand. The fact that right before people fall asleep or hypnogogic is a crucial time for people with narcolepsy, because of how the muscle tone either tenses up or completely relaxes all depends how sever a cataplectic attack is going to be.

Throughout history narcolepsy has been a factor in lives and now in our modern world there is a potential cure for narcolepsy. The treatments that have been developed, and the ones that are still being developed for this disorder have come a long way and have been a really big help for making the lives of people with narcolepsy easier to cope with.

ADHD, Narcolepsy

Narcolepsy in Horses is Genetic

by Annie Barraza May 6, 2023

Narcolepsy in Horses is Genetic

The idea that horses can have narcolepsy is kind of an inconceivable concept, because narcolepsy is mainly associated with human beings and not with animals. The effect of narcolepsy in horses is much the same as it is in human beings the sleepiness, disorientation, hallucinations, and mood changes, are all evident in horses with narcolepsy.

Horses and Narcolepsy

In horses the most observable trait is that of narcolepsy with cataplexy, the other traits are harder to recognize. The symptoms of narcolepsy are hard to diagnose in a human patient that can tell the physician exactly what is going on and give and extensive medical history, but for animals that is even harder. This disorder is still being examined and studied, but as time goes by the cause still seems to elude physicians as to why narcolepsy has such an effect on the brain. With every new occurrence of narcolepsy showing up in animals physicians are more prone to believe that the brain is similar in more ways than originally thought.

Signs to Look For in Horses for Narcolepsy

depression
lack of interest in food
fatigue
moodiness
weak muscles

With these signs and symptoms being noticed in horses, even from a young age, this can make a breeder believe that the horse is from bad stock and sometime the owner puts the animal down because of such negative qualities. Without there being a proper way to diagnose an animal let alone a horse with narcolepsy, many mistakes are made and eventually the animal suffers massively from this disorder. Veterinarians are working on ways to properly diagnose animals that have the narcoleptic symptoms, almost in the same fashion that physicians are working so earnestly to find a way to properly diagnose and treat this disorder.

Some veterinarians are trying experimental medications high-performance liquid chromatography or HPLC has been used in experiments to determine if the drug will have a negative or positive effect on the horses and if so what dosage and how often should HPLC be used on the horses. Depending on the severity of the narcoleptic symptoms and the weight of the horse that the injection is being given to the HPLC drug can be very effective.

Narcolepsy and horses make a very interesting study the main thing to look for when it comes to the horse species and narcolepsy is constant fatigue, daytime sleepiness, and the unwillingness to do any form of physical activity. With these initial traits being noticed a trainer or owner has a better chance at identifying what is happening to the horse, if not then the horse can cause muscle problems, malnutrition, and could even cause broken bones from falling, or if hallucinating harm other animals and people around them because the animal could be easily spooked. With narcoleptic horses, it can become harder to train them and work with them because of the general lack of interest, and constant fatigue. Horses suffering from narcolepsy have a harder time going about their daily routines and life, without there being a risk to those around them as well as to their selves because of the lack of muscle control when falling asleep or waking up.

Bloodlines

Narcolepsy in horses is rare and often is bred into the horse by the parents that already have the existing narcoleptic gene in their system. Most horses have a form of sleep deprivation caused from over exercise, low food intake, and even missing fellow companions. This sleep disorder is a form of ED or extreme drowsiness, and can be observed when a horse seems to partially collapse and instead of going all the way to the ground and staying there to recuperate from the episode the horse will immediately regain their footing, and the cycle of partially collapsing and regaining their footing will begin all over again. With this occurring muscles can be pulled and harm can also be done to the ligaments in the fore legs and hind quarters.

These injuries can lead to even worse problems in the long run; they can even make a horse come up lame and no longer able to be ridden. Narcolepsy on horses can be just as hard if not even worse due to the fact that when horses sleep they sleep while standing; if they were to lie down for an extended period of time the weight and pressure being exuded could crush internal organs and break bones.

Horses suffering from narcolepsy, like human beings have lapses in time where they fall asleep and their bodies tense up causing a form of sleep paralysis, so if a horse has a cataplectic attack and suffers from a sleep paralysis, and falls then the damage can be irreparable and sometimes even fatal.

The narcolepsy in horses can even cause harm to the owner or person that is riding the horse because if a sudden attack should happen while riding say down a steep mountain side, the rider would be thrown from the saddle and become injured. So before riding a horse that has all of the symptoms of narcolepsy have it checked out by a veterinarian, to make sure that the horse is properly diagnosed and all safety measurements are taken before training or riding the horse.

While inspecting the horse make sure that it is receiving enough nighttime sleep and is not disturbed, especially if that particular horse is a mare that is about to foal, or give birth. Rest is needed for such a difficult and delicate situation as giving birth for a mare as well as the young colt that is being born. The narcoleptic trait will not be immediately noticeable in new born colts because they require a lot of rest, so even if a young colt is sleeping during the day that does not mean that they have narcolepsy.

The earliest age to begin looking for the narcolepsy trait in a horse is around a year and a half, by then the horse should be healthy enough to withstand going through the day without needing to stop and take a rest. If the symptoms of narcolepsy are there go to your local veterinarian and ask what narcolepsy in horses is? With the help of a vet then the animal will receive the attention and help that is needed to make sure that the animal remains healthy.

ADHD

What is Narcolepsy?

by Annie Barraza May 6, 2023

Narcolepsy is a chronic neurological disorder that can begin at any age and continues throughout life. It is a sleep disorder, involving irregular patterns in Rapid Eye Movement (REM) sleep, and significant disruptions of the normal sleep/wake cycle.

Onset typically occurs in pre-teens/teens or the early twenties, but can also happen later in life. Narcolepsy is believed to affect approximately 1 in 2,000 people in the United States. It affects both sexes equally and occurs throughout the world, but is underrecognized and underdiagnosed. Once established, narcolepsy is generally stable and can most often be effectively treated. Lifespan is not affected.

Narcolepsy with cataplexy is caused by the destruction of hypocretin-producing cells in the hypothalamus region of the brain. Hypocretin (also known as orexin) is a neurotransmitter involved in the regulation of the sleep/wake cycle as well as other bodily functions (e.g. blood pressure and metabolism). Narcolepsy with cataplexy is an auto-immune disorder. More research is needed to determine the exact triggers behind narcolepsy without cataplexy.

Diagnosis of narcolepsy is usually confirmed in a sleep lab through a series of tests, which typically includes an overnight polysomnogram (PSG or sleep study) to rule out other causes of EDS and detect any unusual REM patterns. The Multiple Sleep Latency Test (MLST), or daytime nap test, follows, which measures the rapidity of sleep onset and how quickly REM sleep follows. The MLST is the most widely accepted diagnostic test for narcolepsy. A blood test is sometimes used to determine if there is a genetic predisposition towards the disorder. Finally, some research facilities measure the level of hypocretin in the cerebrospinal fluid (CSF). This is rare and only used in certain situations.

The Diagnostic and Statistical Manual (DSM V) divides narcolepsy into Narcolepsy Type 1, or narcolepsy with cataplexy, and Narcolepsy Type 2, or narcolepsy without cataplexy.

Symptoms include:

Excessive Daytime Sleepiness (EDS) is described as a persistent sense of mental cloudiness (brain fog), lack of energy, or extreme exhaustion. It includes daytime sleep attacks that may occur with or without warning and may be uncontrollable, and persistent drowsiness, which can continue for prolonged periods of time. Microsleeps, or fleeting, involuntary moments of sleep that may intrude into the waking state, are also experienced as part of EDS for many people. Naps can help people with narcolepsy (PWNs) feel refreshed for a short period of time before EDS symptoms return.

Cataplexy, the second major symptom of narcolepsy, is nearly unique to the disease. It is a sudden loss of muscle tone, usually triggered by emotions such as laughter, surprise, fear, or anger. Cataplexy occurs while the person is awake and causes feelings of weakness and a loss of voluntary muscle control. Cataplexy may occur more often during times of stress or fatigue. Attacks can involve only a slight feeling of weakness in one part of the body (i.e. sagging facial muscles, nodding head, buckling knees, garbled speech, etc.) or an immediate and total full body collapse. Although someone suffering a severe cataplexy attack may appear unconscious, they are actually awake and alert. Attacks can last from a few seconds up to several minutes. Cataplexy is related to the loss of muscle tone usually associated with dreaming or REM sleep; as protection against acting out one’s dreams, muscles become immobile or paralyzed. In cataplexy, this protection is triggered inappropriately during wakefulness.

Disrupted or fragmented nighttime sleep is sleep disrupted by periods of wakefulness, vivid dreams, sleep talking, and movement. PWNs typically have no difficulty initially falling asleep.

Hypnagogic (during sleep onset) and hypnopompic (during waking) hallucinations are vivid, realistic, and often frightening dreams that occur on the edge of sleep and wakefulness.

Sleep paralysis is the temporary inability to move, occurring in the transition between sleep and wakefulness.

If you think you have narcolepsy, take the Epworth Sleepiness Scale which can help assess daytime sleepiness.

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What is Narcolepsy?

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Multiple Sleep Latency Tests

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What is Narcolepsy?

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Regular exercise is good for Narcoleptics

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