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Things you should know about Narcolepsy

Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. It affects your ability to wake and sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances and should visit the best hospital in Nagpur for treating narcolepsy. They have excessive, uncontrollable daytime sleepiness. They may also suddenly fall asleep at any time, during any type of activity.


In a typical sleep cycle, we enter the early stages of sleep, then the deeper stages, and finally (after about 90 minutes) rapid eye movement (REM) sleep. People with narcolepsy go into REM sleep almost immediately in the sleep cycle and sometimes while they’re awake.


Narcolepsy is a chronic condition for which there's no cure. However, medications and lifestyle changes can help you manage the symptoms. Support from others family, friends, employers, teachers can help you cope with narcolepsy.

Sometimes, narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy), which can be triggered by strong emotion. Narcolepsy that occurs with cataplexy is called type 1 narcolepsy. Narcolepsy that occurs without cataplexy is known as type 2 narcolepsy. You can consult a neurologist in Nagpur to know about the implications of loss of muscle tone during narcolepsy.


Narcolepsy Symptoms

In REM sleep, we can dream and have muscle paralysis, which explains some of the symptoms of narcolepsy. Those symptoms may include:


- Excessive daytime sleepiness (EDS): In general, EDS makes it harder to do everyday activities, even if you got enough sleep at night. The lack of energy can make it hard to concentrate. You have memory lapses and feel depressed or exhausted.

- Cataplexy: This can cause problems ranging from slurred speech to total body collapse, depending on the muscles involved. It’s often triggered by intense emotions such as surprise, laughter, or anger.

- Hallucinations: These delusions can happen at any time and are often vivid and frightening. They’re mostly visual, but any of the other senses can be involved. If they happen as you’re falling asleep, they’re called hypnagogic hallucinations. If they happen when you’re waking up, they’re called hypnopompic hallucinations.

- Sleep paralysis: You may be unable move or speak while falling asleep or waking up. These episodes usually last a few seconds to several minutes.

Disrupted sleep: You might have a hard time staying asleep at night because of things like vivid dreams, breathing problems, or body movements.

- Other Characteristics: People with narcolepsy may have other sleep disorders, such as obstructive sleep apnea, a condition in which breathing starts and stops throughout the night, restless legs syndrome and even insomnia.


Some people with narcolepsy experience automatic behavior during brief episodes of narcolepsy. For example, you may fall asleep while performing a task you normally perform, such as writing, typing or driving, and you continue to perform that task while asleep. When you awaken, you can't remember what you did, and you probably didn't do it well. You should visit a critical care hospital in Nagpur if you perform some task unconsciously and do not remember anything about it.


Narcolepsy Causes

Experts don’t know what causes narcolepsy. They think it involves multiple things that come together to cause problems in your brain and disturb your REM sleep. Scientists are getting closer to finding genes linked to the disorder. These genes control the production of chemicals in your brain that may signal sleep and awake cycles.

Some experts from the multispeciality hospital in Nagpur think narcolepsy may happen because your brain has a hard time making a chemical called hypocretin. They’ve also found problems in parts of the brain involved in controlling REM sleep.


Normal Sleep Pattern vs Narcolepsy

The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep. During this phase, your brain waves slow considerably. After an hour or so of NREM sleep, your brain activity changes, and REM sleep begins. Most dreaming occurs during REM sleep.

In narcolepsy, however, you may suddenly enter into REM sleep without first experiencing NREM sleep, both at night and during the day. Some of the characteristics of narcolepsy, such as cataplexy, sleep paralysis and hallucinations, are similar to changes that occur in REM sleep, but occur during wakefulness or drowsiness.


Risk Factors

There are only a few known risk factors for narcolepsy, including:


- Age: Narcolepsy typically begins in people between 10 and 30 years old.

- Family history: Your risk of narcolepsy is 20 to 40 times higher if you have a family member who has narcolepsy.


Narcolepsy Related Conditions and Behaviours

Some people with narcolepsy also have related problems, including:

- Periodic limb movement disorder (PLMD): Your leg muscles move without your control many times during the night.


- Sleep apnea: Your breathing often stops and starts while you sleep.

- Automatic behavior: You fall asleep during a regular activity like driving, walking, or talking. You continue the activity while asleep and wake up with no memory of what you did.


Complications

- Public misunderstanding of the condition: Narcolepsy may cause serious problems for you professionally and personally. Others might see you as lazy or lethargic. Your performance may suffer at school or work.

- Interference with intimate relationships: Intense feelings, such as anger or joy, can trigger signs of narcolepsy such as cataplexy, causing affected people to withdraw from emotional interactions.

- Physical harm: Sleep attacks may result in physical harm to people with narcolepsy. You're at increased risk of a car accident if you have an attack while driving. Your risk of cuts and burns is greater if you fall asleep while preparing food.

- Obesity: People with narcolepsy are more likely to be overweight. The weight gain may be related to a low metabolism.


Narcolepsy Diagnosis

Symptoms of narcolepsy can look like those of other health problems. Expert neurologists from Nagpur suggest the diagnosis might involve:


- Physical exam and medical history

- Sleep records: Your doctor might ask you to keep track of your symptoms and when you’re sleeping for a couple of weeks.

- Polysomnogram (PSG): This is done in a sleep disorder clinic or a sleep lab. It’s an overnight test that takes constant measurements while you’re asleep to record problems in your sleep cycle. A PSG can help reveal whether you go into REM sleep at unusual times in your sleep cycle. It can rule out other problems that might be causing your symptoms.

- Multiple sleep latency test (MSLT): This is also done at a special clinic or lab. The test takes place during the day to measure your tendency to fall asleep and find out whether certain elements of REM sleep happen at unusual times during the day. You’ll take four or five short naps, usually 2 hours apart.


Narcolepsy Treatment

There’s no cure for narcolepsy. But treatments that can help ease your symptoms include:


- Lifestyle changes to help you accomodate living with narcolepsy.

- Stimulants to treat sleepiness

- Antidepressants to treat problems with REM sleep

- Sodium oxybate (Xyrem) to treat cataplexy

- Pitolisant (Wakix) or Solriamfetol (Sunosi) to help you stay awake for longer periods

- Lifestyle and Home Remedies

- Lifestyle modifications are important in managing the symptoms of narcolepsy. You may benefit from these steps:

- Stick to a schedule. Go to sleep and wake up at the same time every day, including weekends.

- Take naps. Schedule short naps at regular intervals during the day. Naps of 20 minutes at strategic times during the day may be refreshing and reduce sleepiness for one to three hours. Some people may need longer naps.

- Avoid nicotine and alcohol. Using these substances, especially at night, can worsen your signs and symptoms.

- Get regular exercise. Moderate, regular exercise at least four to five hours before bedtime may help you feel more awake during the day and sleep better at night.

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