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CategoriesNarcolepsy

Does Cataplexy without Narcolepsy happen?

by Annie Barraza

Although narcolepsy without cataplexy happens often, Cataplexy almost never occurs without narcolepsy, except in the rare case that is the result of a major brain trauma.

Some drug therapy and lifestyle changes can take care of mild symptoms of narcolepsy and without cataplexy, it can be managed easily enough to maintain a normal life.

What is Cataplexy?

Cataplexy is exclusively a symptom of narcolepsy that is experienced by seventy percent of the 3 million people who suffer from narcolepsy worldwide.

Narcolepsy with cataplexy has its own biomarker.  That is, there is a specific, measurable trait that is exhibited by most narcolepsy patients with the symptom of cataplexy.  The peptide hypocretin-1, which is derived from the hypothalamus in patients with healthy sleep patterns and a narcoleptic without cataplexy, tends to be deficient in cataplectic. This unique feature has earned Narcolepsy with Cataplexy its own separate diagnosis from the narcolepsy without cataplexy.

Most Narcolepsy symptoms can be seen as a disassociated part of REM sleep.  Cataplexy is no different. One of the things that happen during REM sleep is that the body’s muscles lose tone and go limp. Cataplexy is the same phenomenon, during wakefulness.

Hypocretin-1 plays a major role in the sleep/wake cycles of the brain.  A deficiency manifests itself in the symptom of cataplexy.  There is no correlation between hypocretin-1 deficiencies without cataplexy in narcolepsy, making it an unreliable test for narcolepsy without cataplexy.

Cataplexy is the uncontrollable loss of muscle tone.  It can be a minor annoyance or a major event.  Either way, it can be embarrassing to the person suffering from it. Cataplexy episodes are triggered by strong emotional response. Anger and robust laughter are at the top of the list.

A cataplectic episode can range from unnoticeable to a serious event.

  • Mild Cataplexy

When cataplexy is mild, it can go unnoticed.  Perhaps the patient experiences a little clumsiness or trips.  It can manifest in a single tiny muscle group, usually in the face.  A droopy eyelid or momentary slackening of the jaw can be from cataplexy. Cataplexy can last as little as a few seconds, hardly giving it enough time to register as ever having happened at all.

  • Severe Cataplexy

Cataplexy can last for over an hour.  It can affect the arms or legs.  It commonly affects the neck, resulting in the head suddenly falling forward.  In some cases, the entire body is affected. The result is a total collapse. The subject is awake and alert, but unable to move or communicate. It can be frightening to experience, especially when it is new.

Diagnosing Cataplexy

Diagnosing narcolepsy without cataplexy and narcolepsy with cataplexy is done much the same way.  There are no simple blood tests that reveal the disorder.  Even testing for a hypocretin-1 deficiency is a difficult and painful process.  It requires a spinal tap to test the spinal fluids. Because of the risk involved, this kind of test is not likely to become a mainstream diagnostic tool.

Without cataplexy, narcoleptic diagnosis involves a detailed history and the use of sleep studies.

Sleep studies include the nocturnal Polysomnogram and the multiple sleep latency test (MSLT).  The MSLT is the currently accepted standard in testing and data collection for the diagnosis without cataplexy of narcolepsy.

The nocturnal Polysomnogram and the MSLT are usually done together, consecutively. This way, a physician can get a complete portrait of sleep habits and REM cycles of his or her patient.

The tests are performed in a sleep clinic. The subject has a continuous electroencephalogram (EEG) while they are settled into a room in which to sleep.  The EEG and visual monitoring will be used to record everything the patient experiences during a restful state.

For the nocturnal Polysomnogram, they will spend the night.  For the MSLT, the next day they will have 5 scheduled naps that are 2 hours apart and will last for 20 minutes.

With the presence of moderate to severe cataplexy, diagnosis is simple, since cataplexy is a narcolepsy specific symptom, if it is present, a diagnosis of narcolepsy with cataplexy is certain to follow.  If the episodes are milder, a detailed history and probably the use of journaling the symptomatic episodes may be required as there is no other way to uncover the existence of cataplexy.

Cataplexy Treatments

Without cataplexy narcoleptic symptoms can often be managed with careful lifestyle changes such as dietary guidelines, strict adherence of bedtimes and scheduled daytime naps.  Often, drug therapies that include the use of stimulants and antidepressants are required.

Narcolepsy patients with cataplexy almost always need to be treated with drugs.

Behavioral and Pharmacological Treatments

Behavioral

for narcolepsy

Pharmacological:

For EDS

Pharmacological:

For cataplexy

avoid sleep deprivation

Methylphenidate

Xyrem

sodium oxybate

strategic naps

Amphetamine

Protriptyline

avoid caffeine

Modafinil

Imipramine

involve the people you associate with regularly

Selegiline

(also anti-cataplectic)

Selective serotonin reuptake inhibitors

Sodium Oxybate

The most effective drug treatment for cataplexy and EDS is gammahydroxybutyric acid (GHB). It is the only drug approved by the FDA for the treatment of cataplexy.  It is sold in the USA as sodium oxybate and is produces as the drug Xyrem.

Xyrem works on the part of the brain that controls sleep cycles. At higher levels, as a very effective sedative.  Promoting deep restful sleep at lower levels it is a stimulant that keeps EDS at bay.

GHB is a highly regulated substance as it is associated with illegal abuse. IT has a high rate of dependence and serious withdrawal symptoms. It induces a euphoric effect that is similar to the street drug ecstasy and it has been used to facilitate date rape. It has the ability to stimulate the human growth hormone and so it has also been abused by body builders.  Overdoses of GHB can result in respiratory depression, bradycardia, seizures and death.

The most common side effects of Xyrem are:

  • headache
  • nausea and vomiting
  • dizziness
  • nasopharyngitis
  • somnolence
  • urinary incontinence

Sodium Oxybate needs careful consideration with patients that have heart concerns as it raises sodium levels in the blood.

CategoriesADHD,  Narcolepsy

Types of Narcolepsy: What You Might Not Know About The Different Types of Narcolepsy in an Overview

by Annie Barraza

Narcolepsy is an intrusive sleeping disorder that is currently affecting around 200,000 American people. Narcolepsy is one of medical science’s most unique sleeping disorders. Not only is Narcolepsy itself an odd and interesting disorder, it comes as a package deal with various other unique medical problems like Cataplexy, hallucinations, Automatic Behavior, and even Sleep Paralysis. Patients who have been diagnosed with the disorder should learn about all types of Narcolepsy, and undiagnosed patients who may be suffering should study Narcolepsy and its different types.

The Different Types of Narcolepsy

Technically, there are not different types of Narcolepsy. Unlike other sleep disorders like Sleep Apnea, there is not a central and an obstructive classification. Narcolepsy is the same in all patients who suffer from its symptoms. The disorder is defined as the uncontrollable urge to sleep at inappropriate times during the day; this is absolutely true in all patients with Narcolepsy, so technically, there is one medically recognized type of the disorder.

More often than not, however, most Narcolepsy patients experience at least one or more complicated disorders in addition to their Narcolepsy. The majority of narcoleptics also suffer from one of the following four complications: Cataplexy, Hypnagogic Hallucinations, Automatic Behavior, and Sleep Paralysis.

Narcolepsy with Cataplexy

Only three million people in the entire world suffer from some type/degree of Narcolepsy. Out of those three million people, only two percent also suffer from Cataplexy. Cataplexy is thought to be unique to Narcolepsy patients, and is often one of the disorder’s primary identifiers; it is often associated with other Narcolepsy symptoms like Sleep Paralysis and hallucinations.

Cataplexy is defined as the sudden loss of muscle tone and strength coupled with severe daytime sleepiness. The sudden loss of muscle strength can be mild or severe. In mild Cataplexy episodes, there may only be a small portion of muscle on the body that becomes paralyzed. In opposition, severe episodes of Cataplexy can leave the entire body unable to move or speak for several minutes at a time. These sudden changes in muscle tone are often triggered by the patient’s witnessing of a strong emotional response.

Laughter, crying, and shouting are some of the most common triggers in people with this type of Narcolepsy.

Cataplexy is extremely dangerous, and is one the leading causes for accidents, especially automobile accidents. Because Narcolepsy patients are unable to determine when an episode of Cataplexy will occur, there Cataplexy victims often live in constant fear of witnessing a trigger and embarrassing themselves in public.

Narcolepsy with Hallucinations

Unlike the rare Cataplexy, this type of Narcolepsy is extremely common. Patients who suffer from Narcolepsy are at a high risk for experiencing Hypnagogic Hallucinations; in fact, hallucinations are one of the disorder’s most commonly recognizable symptoms. Where Cataplexy is only present in two percent of all Narcolepsy patients across the world, as many as fifty percent of all narcoleptics are thought to suffer from Hypnagogic Hallucinations.

There are two main types of hallucinations: Hypnagogic Hallucinations and Hypnopompic Hallucinations. Hypnagogic Hallucinations occur during the transitional period that takes place when the brain is shifting from a place of wakefulness to one of sleep. Hypnopompic Hallucinations, on the other hand, are the opposite; these hallucinations occur when the body is shifting from a place of sleep to one of wakefulness. Hypnagogic Hallucinations are seen in this type of Narcolepsy, and can be extremely vivid.

Patients who also suffer from Hypnagogic Hallucinations experience intense dream-like visions when they are falling asleep. Many Hypnagogic Hallucinations incorporate various images that actually present in the sleeper’s environment into vivid hallucinations. These hallucinations can involve the manipulation of the patient’s vision, hearing, sense of touch, sense of balance, and even their ability to move. Many Narcolepsy patients who suffer from the hallucinations describe them as bizarre, and even frightening. Because the hallucinations are so realistic, patients become afraid of them; many patients even fear the hallucinations as a sign of mental instability.

Narcolepsy with Automatic Behavior

One of the most interesting, and consequently dangerous, types of Narcolepsy includes symptoms of Automatic Behavior. Often confused with sleep walking, Automatic Behavior refers to the continuation of an activity that was taking place while before falling asleep after falling asleep. In many cases, Automatic Behavior occurs when patients with this type of Narcolepsy attempt to fight off sleepiness in an effort to complete an activity. For example, patients who suffer from this type of Narcolepsy may suddenly fall asleep while washing the dishes. Instead of dropping the plate they were holding when they suddenly fell asleep, patients with Automatic behavior continue washing the plate as if they remained awake.

Although Narcolepsy patients with Automatic Behavior continue performing the activity while unconscious, they have absolutely no memory of the even upon wakening; the event is out of conscious control. Unconscious periods of continued behavior can last anywhere from a few short seconds to as long as half an hour. Patients who experience this unique disorder often wake up in strange places disoriented and frightened. Automatic Behavior becomes a serious and dangerous problem when it occurs during dangerous activities like driving or cooking.

Automatic Behavior, also called automatism, is not unique to Narcolepsy types. It is a common symptom of many different psychiatric and neurological disorders. Schizophrenia and Fugue are common psychiatric disorders that are associated with Automatic behavior.

Narcolepsy with Sleep Paralysis

Although it is possible to see symptoms of Sleep Paralysis in patients plagued with disorders other than Narcolepsy, Sleep Paralysis is most commonly associated with this form of Narcolepsy. In addition to Cataplexy and hallucinations, Sleep Paralysis, which can also be called Isolated Sleep Paralysis, completes the trio of famous Narcolepsy identifiers (in addition to daytime sleepiness, of course).

Narcoleptics who suffer from Sleep Paralysis experience periods on paralysis, either when going to sleep or upon wakening. During an attack of Sleep Paralysis, the victim is completely unable to move voluntarily, and must wait for the attack to pass. Although Sleep Paralysis is passing, and not physically harmful, it can still be terrifying and stressful to try and deal with on top of Narcolepsy’s other problems and complications.

CategoriesNarcolepsy

Hypocretin Deficiency: Narcolepsy with Cataplexy

by Annie Barraza

Narcolepsy without cataplexy and narcolepsy with cataplexy are two different classifications in international diagnosis.

While there is little known about the cause of narcolepsy, over the past few decades scientists have made huge leaps in the understanding of cataplexy.

Evidence of a Deficiency in Hypocretin-1 in patients with cataplexy has given Narcolepsy with cataplexy its very own biomarker. During clinical testing of the cerebrospinal fluid (CSF), nearly all narcolepsy patients with cataplexy had a severe deficiency of the protein hypocretin-1which is normally located in the hypothalamus.  The reason for this deficiency is unknown, but there is speculation that it may be an autoimmune dysfunction. Cataplexy is also sometimes referred to as a hypocretin deficiency syndrome.

Narcolepsy without Cataplexy

The diagnosis of narcolepsy sleep disorder can be a difficult one to confirm.  There are no physical tests.  No genetic testing, no blood tests.

Doctors will take a complete history and use clinical testing like the multiple sleep latency test or MSLT, and perform a nocturnal Polysomnogram to determine the existence of narcolepsy or its symptoms.

During the nocturnal Polysomnogram, the patient is placed in a comfortable room and monitored all night to determine the cause of symptoms like insomnia and EDS. An electroencephalogram or EEG is used as well as video monitoring to record body functions and sleep patterns and activity.  Some pertinent data that is recorded would be breathing, including the existence of apnea. Pulse and blood pressure, Snoring, sleep talking and restlessness.  The onset and duration of REM sleep is carefully recorded.

The MSLT is done the day after the nocturnal Polysomnogram.  The patient will stay at the clinic the rest of the day and have 5 naps during their stay.  The naps are done in the same relaxing setting as the nocturnal Polysomnogram. An EEG is used again, as well as video surveillance to monitor and record the time it takes the subject to fall asleep, or if the onset of REM sleep is accomplished. These factors are standard to diagnose narcolepsy.

Narcolepsy alone can be difficult to live with.  Falling asleep at inappropriate times wreaks havoc on patients’ lives.  School, work and relationships become impossible to maintain and patients sometimes then succumb to depression and reduced sense of self-worth.

With carefully planned lifestyle changes such as tight bedtime routine, strict diet and scheduled daytime naps, patients with mild narcolepsy symptoms can sometimes beat the disease. However, when symptoms are more severe, the lifestyle changes are still utilized, but drug therapy is added to round out the treatment.

Drug treatment for narcolepsy includes stimulants such as Provigil or Nuvigil are used to combat Excessive Daytime Sleepiness or EDS. These drugs help the narcoleptic stay awake during the day. Many people with narcolepsy need stimulants to function at an acceptable level in their daily lives and to live successful and prosperous lives.

Narcolepsy Therapies

Behavioral

Pharmaceutical

for EDS

Pharmaceutical

for Cataplexy

>Carefully controlled night time sleepMethylphenidatesodium oxybate, GHB
Scheduled daytime napsAmphetamineProtriptyline
smaller, lighter, more frequent mealsModafinilImipramine
Involvement of friends, family and associatesSelegiline (also anti-cataplectic)Cloniipramine

Narcolepsy with Cataplexy

Patients who have the condition: narcolepsy with cataplexy, also suffer the same EDS symptoms as narcolepsy without cataplexy.  However, they have the added stress of the symptom of cataplexy.

Cataplexy is a bizarre and rare phenomenon that affects over two million patients with narcolepsy. When a patient experiences cataplexy, they lose muscle tone and function, suddenly and without warning.

These episodes can be so slight they go unnoticed.  Perhaps the patient will feel clumsy for a moment.  Or an eyelid may droop or the cheek may go slack. It may last for as little as a few seconds. Hardly enough time to register the change.

A cataplexy episode can also be more severe. In the event of a severe episode, a person can lose all muscle control in his or her body and a total collapse is experienced.

Cataplexy can cause psychological trauma, particularly after the first episode or when it strikes in children because the collapse is experienced while completely awake and alert.  The inability to move or respond to their environment is particularly terrifying for many patients.

What Causes Narcolepsy?

No one knows what causes narcolepsy without cataplexy. There is some speculation that it is genetic, but there is insufficient evidence as it rarely runs in families. Recently, some evidence has come to light that it may be an autoimmune function, like cataplexy. There must be much more research done to confirm this and even longer before a suitable diagnosis and treatment can be formulated on the autoimmune basis.

Sodium Oxybate- Xyrem

Xyrem is the brand name for the drug sodium oxybate.  The chemical is gammahydroxybutyric acid or GHB.  GHB is the most effective treatment of cataplexy. It has the disorder covered on both ends of the spectrum.  GHB is paradoxical in its behavior in the body. It is both an extremely effective sedative and a potent stimulant. In high doses, it interacts with the GAGA system; it has a sedative effect and inhibits the release of dopamine in the brain.  At a lower dose, it works as a stimulant.  It stimulates the brain to produce dopamine and glutamate.

GHB has been successfully used to treat several disorders, such as depression and insomnia for years in other countries.  In the US, however, it is only approved by the FDA for the treatment of Cataplexy. It does not affect the deficiency of hypocretin, but the symptoms of cataplexy are greatly improved.

GHB is associated with tremendous amounts of negativity. In high doses, it is a highly effective sedative.  It has been called the “date rape drug” for its most infamous criminal use. It is sometimes abused as a street drug, as in moderate amounts, it causes euphoria.  On the street, it’s referred to by several names, including as “liquid ecstasy.”  It has been abused by body builders as well. In small amounts it stimulates the production of the human growth hormone.  It is addictive and abrupt cessation can cause terrible withdrawal symptoms.

Antidepressants for Cataplexy

Even though the FDA has not approved them for this use, several antidepressants are being used to manage the symptoms of cataplexy.  There needs to be a lot more research done into the effectiveness of antidepressants for cataplexy.

Tricyclic antidepressants have shown a lot of promise in the treatment of narcolepsy and its symptoms.  Unfortunately, there are a whole host of frightening side effects that are common to tricyclic antidepressants.  Although they were a popular treatment in the past, they are not used very often anymore.

Although less proven, the selective serotonin reuptake inhibitors, or SSRIs, like Prozac, Paxil and Zoloft are commonly used to treat these symptoms.  Their effectiveness is the subject for debate among doctors and scientists until proven one way or another.

CategoriesNarcolepsy

Narcolepsy Medications and Treatment Options

by Annie Barraza

Getting the right narcolepsy medication can be a complicated, trial and error type of ordeal for patients that suffer from the symptoms of narcolepsy. Some medications for narcolepsy are not suitable for everyone, and for this reason it sometimes takes years for some people to receive the correct combination of medical treatments and drugs.

Who Needs Medication for Narcolepsy?

People suffering with the symptoms of narcolepsy can sometimes get through every day by simply making lifestyle changes. These changes include better sleep schedules, routine naps at set times throughout the day and a well-balanced diet. These are the lucky few who do not need medication. Narcolepsy has some complications that are worse than a mere inconvenience. Those experiencing cataplexy are in real danger of becoming seriously injured at any time during the day. Patients with narcolepsy and cataplexy must have the medication of narcolepsy symptoms.

Narcolepsy is a disorder characterized by sudden, yet brief, periods when sleep is uncontrollable. When seeking medications narcolepsy patients should be prepared to give a complete history to their physician. Patients must report a detailed history of personal medical and health information and keep a journal of sleep disturbances, insomnia, hallucinations and sleep attacks for their doctor when seeking treatment and medications of narcolepsy symptoms.

Symptoms of Narcolepsy

Narcolepsy has a wide range of symptoms that can drastically impact the lives of the people suffering from them. Many of the symptoms are shared among several other sleep disorders such as insomnia and sleep apnea. This fact alone makes it very hard to diagnose the disease.

The following is a list of some of these symptoms.

  • E.D.S. or excessive daytime sleepiness is the most common of all narcolepsy symptoms, in fact, in many ways; E.D.S. is narcolepsy when you think about it.
  • Cataplexy is when a person suddenly loses his or her muscle control. This is sometimes mistaken for epilepsy due to the falls it commonly produces. A narcolepsy patient who suffers with cataplexy is at a higher risk for personal injury, than people who don’t.
  • Sleep paralysis is a frightening ordeal that is linked to narcolepsy. Sleep paralysis occurs when a person is falling asleep or just when they’re beginning to wake up. The brain disconnects from the body leaving the person aware, but unable to speak or move. However, it should be stated that many people who occasionally experience sleep paralysis are not always diagnosed with narcolepsy.
  • Hallucinations are when a person hears and/or sees things that are not really there. This is a very common factor found in patients who are suffering from sleep paralysis, as well as a symptom of sleep deprivation.
  • Insomnia is a symptom of narcolepsy.  People with narcolepsy do not actually sleep more hours per day than people without narcolepsy. Their night time sleep is usually interrupted and irregular, causing the strong need to sleep during the day.

Types of Medication and Narcolepsy Treatments

  • Stimulants

Most medications that are used for the treatment of narcolepsy but are not for E.D.S. are stimulants. Stimulants help the patients get through the day feeling energized and help regulate their sleep cycles.  Among these is a wide array of Amphetamines including:

  • Dextroamphetamine (Dexedrine)
  • Methamphetamine (Desoxin)
  • Amphetamine Salts (Adderall)
  • Methyphendiate (Ritalin)
  • Armodafinil (Nuvigil)
  • Modafinil (Provigil)

There have been many successes and a few failures over the years in the quest to find successful treatments of narcolepsy. One medication, Pemoline (Cylert) was removed from the market due to the risk of liver failure and even death. People taking the listed medications to treat narcolepsy may find some that work and others that don’t. Many neurological disorders share symptoms and treatments with narcolepsy and are often treated with the same drugs.  Like these, trial and error is the key to finding the correct combination of medication for each patient. Some of these medications take several weeks to become truly effective. Sometimes the secret is in a very tight combination. Care should be taken as stimulants should not be taken by people with a history of psychiatric issues or heart complications.

  • Antidepressants

Antidepressants help with mood, but they are also useful in the treatment of R.E.M. or rapid eye movement disruptions, hallucinations, and cataplexy.

Some of the more common antidepressant medications include:

  • Venlafaxine (Effexor SR)
  • Atomoxetine (Strattera)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Protriptyline (Triptil and Vivactil)
  • Imipramine (Janamine and Trofanil)
  • Desipramine (Norpramine and Petrofran)
  • Clomipramine (Anafranil)

A newer drug that is used to treat these same narcoleptic symptoms is Sodium Oxybate (Xyrem). Sodium Oxybate is completely different than the other antidepressants listed, because it has to be taken in separated doses, it is a liquid and it promotes stages three and four of sleep. When taken as directed, Sodium Oxybate can actually eliminate the need for other antidepressants. There are several side effects associated with sodium oxybate.  These side effects include: headache, nausea, dizziness, vomiting, and urinary incontinence. A caution to consider are that it is sodium and therefore people with a history of heart disease should not take it.

Other Narcolepsy Treatments

As well as a large number of prescription medications, narcolepsy symptoms can also be treated with lifestyle changes. In most cases these lifestyle changes are an absolute necessity for the person to get the most out of the medication being taken. A “more bang for your buck” mentality should be used when using medications for the treatment of narcolepsy. The following is a list of the changes that people with narcolepsy should make to get the most from their treatment.

  • Proper diet
  • Avoid caffeine, alcohol, nicotine and over the counter cold medications
  • Schedule naps throughout the day, 10 to 15 minutes each, especially after meals
  • Improve night time sleeping habits, a regular hour for bedtime and arising helps
  • Avoid night time work
  • Keep a sleep journal handy at all times to record sleep disturbances and daytime sleep deep breathing exercises and stretching
  • Involve all people that you see on a daily basis

Contact your local clinic to request more information about these treatments as well as listing for support groups for narcolepsy and other hypersomnias.

CategoriesNarcolepsy

Narcolepsy Blood Test & Other Useful Facts

by Annie Barraza

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:

  1. 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.

  2. 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.

  3. 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.

CategoriesADHD,  Narcolepsy

Narcolepsy Treatment and Drugs

by Annie Barraza

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.

CategoriesADHD,  Narcolepsy

Challenges and Practices in Narcolepsy Diagnosis

by Annie Barraza

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:

  1. 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.

  2. Cataplexy or sudden muscle weakness and loss of muscle control and tone, causing the patient to stop motor activity.

  3. Visual or auditory hypnagogic hallucinations that occur right before falling asleep.

  4. 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 readingIndicate score (0-3)
Sitting inactively in public placesIndicate score (0-3)
As a car passenger for one whole hour without any breaksIndicate score (0-3)
Watching televisionIndicate score (0-3)
Sitting and talking to someoneIndicate score (0-3)
Sitting quietly after lunch (without alcohol)Indicate score (0-3)
In a car stuck for a few minutes in trafficIndicate score (0-3)
Lying down for an afternoon rest when circumstances allowIndicate score (0-3)
Show Results1 – 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:

  1. The ECG or electrocardiogram monitors the patient’s heart
  2. The EEG or electroencephalogram monitors the brain’s electrical activity
  3. The Electrooculogram monitors the eye movements
  4. 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.

CategoriesADHD,  Narcolepsy

Narcolepsy Diet and Food Habits Effect on Narcolepsy

by Annie Barraza

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.

CategoriesADHD,  Narcolepsy

Narcolepsy Research – Reaching for a Cure

by Annie Barraza

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
CategoriesNarcolepsy

The History of Narcolepsy – Discovery and Science

by Annie Barraza

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.

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