Summary

Narcolepsy is a persistent sleep-wake disorder marked by a disturbance of the sleep-wake cycle and REM sleep intrusion.

The traditional tetrad of narcolepsy involves extreme daytime drowsiness, cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations, which are only found in 10% to 15% of patients.

Cataplexy is the only clinical symptom that is unique to narcolepsy. The disease commonly appears in the second decade of life. A shorter sleep latency and at least two sleep-onset REM episodes are frequently seen in a multiple sleep latency test.

Therapy for cataplexy includes lifestyle changes, stimulants for daytime drowsiness, and medication treatment.

Definition

Narcolepsy is a persistent sleep-wake cycle condition characterised by rapid eye movement sleep incursion into the awake state.

It is characterised by a tetrad of extreme daytime drowsiness, cataplexy (generalised muscular weakness leading to partial or total collapse), and hypnagogic/hypnopompic hallucinations (visual hallucinations) in its classic form, which occurs in only 10% to 15% of patients.

What is Narcolepsy?

Narcolepsy is a kind of sleep deprivation. It is a central nervous system disorder that lasts a lifetime.

Definition Narcolepsy | Narcolepsy of Symptoms | Types and Treatment
Narcolepsy

Even after having enough overnight sleep, narcolepsy produces excessive and overwhelming daytime drowsiness. If you have narcolepsy, you’re more prone to feel drowsy or fall asleep at inconvenient times. These sleep episodes can occur without warning or with a lot of forewarning.

You may experience many assaults in a single day. The tiredness might linger for quite some time. It’s possible that your nighttime sleep may be disrupted, and you’ll find yourself waking up frequently.

Narcolepsy is a persistent brain illness characterised by a lack of control over one’s sleep-wake cycles. Narcolepsy patients have periods of excessive daytime tiredness as well as unexpected, uncontrollable episodes of sleep that can happen at any time.

Although this illness can manifest at any age, it most commonly manifests during puberty. In the United States and Western Europe, narcolepsy affects roughly one in every 2,000 persons.

However, the illness is likely underdiagnosed, especially in those who have just minor symptoms.

Who is Afflicted with Narcolepsy?

Both men and women are affected by narcolepsy. Symptoms often begin in infancy, adolescence, or young adulthood (ages 7 to 25), but they can occur at any age. Narcolepsy affects somewhere between 135,000 and 200,000 persons in the United States.

However, because this ailment is frequently misdiagnosed, the figure might be much higher. People with narcolepsy are frequently misdiagnosed with other ailments, such as mental disorders or emotional issues, so getting the appropriate diagnosis might take years.

Factors that Increase your Risk

Narcolepsy has just a few identified risk factors, including:

  1. Age: Narcolepsy usually strikes adults between the ages of 10 and 30.
  2. Your Family’s History: If you have a family member with narcolepsy, your chance of developing it is 20 to 40 times higher.

2 Common Types

Narcolepsy Type 1

Cataplexy and extreme daytime drowsiness are both symptoms of this kind of narcolepsy. Cataplexy occurs when a person has a series of powerful emotional outbursts, such as laughing, wrath, surprise, or shock. Cataplexy is a condition in which a person’s physical capabilities suddenly deteriorate.

Definition Narcolepsy | Narcolepsy of Symptoms | Types and Treatment
Narcolepsy

The patient may lose muscular tone and control of the muscles in their face, arms, legs, or torso during a cataplexy episode while awake. In more severe cases, cataplexy can result in slurred speech, collapsing knees, and even full paralysis.

Narcolepsy Type 2

When you experience excessive daytime drowsiness without cataplexy, you have this kind of narcolepsy. You may slumber for a couple of hours and feel revitalised when you wake up. However, you become exhausted again after a short period of time.

When someone has extreme drowsiness but no cataplexy, they are said to have this kind of narcolepsy. These folks may slumber for a couple of hours and feel revitalised when they wake up, but they soon become too exhausted.

Nausea, sleep attacks, dream-like hallucinations, paralysis when falling asleep or waking up, and interrupted nocturnal sleep are all symptoms of narcolepsy          type 2.

Symptoms of Narcolepsy

Symptoms of narcolepsy can emerge suddenly or gradually over time. Cataplexy, sleep paralysis, and hypnagogic hallucinations are the four most prevalent symptoms. The only symptom in some situations is increased daytime drowsiness.

Definition Narcolepsy | Narcolepsy of Symptoms | Types and Treatment
Narcolepsy

Excessive drowsiness during the day (EDS)

Narcolepsy is characterised by a chronic sensation of drowsiness and a tendency to doze off at irregular intervals throughout the day, frequently at inconvenient times.

They may also have the following experiences:

  • Mental haze
  • Inability to concentrate
  • Loss of energy
  • Gaps in memory
  • Exhaustion
  • A gloomy disposition
EDS is the most common sign of narcolepsy. Narcolepsy patients frequently describe being easily exhausted or tired all of the time. They fall asleep not just in situations where most people would stay awake (after meals or during a boring lecture),

But also in situations where most people would stay awake. Narcolepsy patients may also have “sleep attacks” at inconvenient and occasionally dangerous periods (while in the middle of a conversation or driving a car).

Significant Drowsiness during the day

Excessive – Daytime – Sleepiness (EDS) is a symptom of narcolepsy in which you have an overwhelming desire to sleep during the day. It’s tough to operate normally during the day when you have Excessive Daytime sleepiness.

Cataplexy

Depending on the muscles involved, this might result in everything from slurred speech to complete bodily collapse. It’s usually brought on by strong emotions like surprise, laughing, or fury.

Cataplexy might be the earliest sign of narcolepsy, however it generally appears years after the onset of EDS.

Cataplexy is a condition in which muscular control is lost suddenly and for a short period of time. Cataplexy can be moderate (for example, a transient sense of weakness in the knees) or severe (leading in a fall).

A person experiencing such an incident is fully awake and aware of what is going on. Stress or a strong emotion such as laughing, wrath, or surprise can cause cataplexy. Attacks might be triggered by just recalling or expecting an emotionally or anxiously provoking circumstance in some people.

Sleep Paralysis (Insomnia)

When you’re falling asleep, sleeping, or waking up, you can’t move or talk. Only a few seconds or minutes pass between episodes.

Definition Narcolepsy | Narcolepsy of Symptoms | Types and Treatment
Narcolepsy

The paralysis exhibited during REM sleep is similar to sleep paralysis. However, it has no impact on eye movements or breathing abilities.

When you’re going asleep or waking up, you can lose the ability to move and feel immobilised. This normally only lasts a few seconds to a few minutes.

This can be terrifying, but it isn’t linked to a lack of oxygen. In certain cases, sleep paralysis is accompanied by hallucinations, which can be very distressing.

Sleep Disturbances during Night

Sleep fragmentation is typical in narcoleptics, who may wake up several times throughout the night. Narcoleptics are also more likely to have other troublesome sleep issues, such as excessive bodily movements and sleep apnea.

Automatic Responses

This symptom is defined as falling asleep for several seconds yet continuing to conduct everyday actions such as eating, talking, driving, or writing without being aware of or remembering doing so.

Sleep Deprivation

About 50% of narcoleptics have difficulty sleeping through the night. You may find it difficult to get back to sleep if you wake up frequently.

Hallucinations Caused by Sleep

When going asleep (hypnagogic hallucinations) or waking up, vivid visions might occur (hypnopompic hallucinations). This might be accompanied with sleep paralysis, which can be quite upsetting or terrifying.

Diagnosing Narcolepsy

Narcolepsy is a sleep condition that affects a small percentage of the population. Narcolepsy is characterised by extreme daytime drowsiness, frequent episodes of sleep attacks, and involuntary falling asleep at inconvenient times, typically multiple times each day.

Narcolepsy can strike at any age, however it most usually strikes around adolescence or middle age. Narcolepsy is a disorder that most people have for the rest of their lives.

Although all patients with narcolepsy experience excessive tiredness throughout the day, the way this manifests itself varies. Some persons with narcolepsy,

For example, may fall asleep for 10 to 20 minutes multiple times a day, whether or not they want to. Others with this disease have more control over their naps, choosing when and where to sleep, such as during lunch breaks.

Because people’s symptoms differ so widely, a laboratory technique called the Multiple Sleep Latency Test can be performed to quantify daytime drowsiness over the course of four to five 20-minute naps. This test may also reveal whether REM (rapid eye movement or dreaming) sleep is disrupted very early.

Prevention

Narcolepsy cannot be prevented. The number of assaults may be reduced with treatment. If you are prone to narcolepsy attacks, stay away from conditions that aggravate the condition.

Definition Narcolepsy | Narcolepsy of Symptoms | Types and Treatment
Narcolepsy

Treatment

Although there is no cure for narcolepsy and no way to avoid it, the symptoms can be managed with behavioural and pharmacological therapy. Stimulant medications or the chemical modafinil may be used to treat excessive daytime drowsiness. Antidepressants can help with cataplexy and other REM-sleep disorders.

Medications will, at most, minimise symptoms but not completely eliminate them. In addition, many of the currently available drugs have negative side effects.

Regulating sleep cycles, taking planned daytime naps, and avoiding “overstimulating” circumstances can all assist to keep symptoms from interfering with daily tasks.

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