What is narcolepsy?
Narcolepsy is a horrendously misunderstood neurological (most likely autoimmune) disease characterized by excessive daytime sleepiness despite adequate rest, and may present with cataplexy (sudden loss of muscle tone).
What are the symptoms of narcolepsy?
As stated before, narcolepsy is characterized by Excessive Daytime Sleepiness (EDS), hypnogogic/hypnopompic hallucinations, and may (or may not) present with cataplexy.
It is characterized and diagnosed by four main criteria:
a) excessive daytime sleepiness (EDS) And no, folks, we’re not talking about the kind that you get when you sit too long at your desk and can remedy with a cup of coffee. We’re talking about the kind of sleepiness that happens after you’ve been asleep for twenty hours and you wake up feeling like you’ve just gone to battle or run a marathon. As if you’ve been awake for 5 days already. The kind that hurts and makes you feel like you’re losing your mind. The kind you can’t help. You can’t help it so much you sleep when you’re not only sitting or laying there, but also when you’re watching TV, driving, trying to have a conversation with someone, or trying to have sex. You just can’t help it. It happens.
b) hypnagogic hallucinations Sounds scary, right? Right. Hypnagogic hallucinations are the kind of dreams that occur as you are falling asleep (hypnagogic) or waking up (hypnapopmic). They occur during the same times during sleep that lucid dreaming does. They are “dreams” that you’re awake for and can occur for any of your senses. Sometimes they’re nice, sometimes their not. For a lot of people, they can be alien intruders, things or people coming into the room that aren’t really there, loud noises and crashes, or bright lights, intense emotions and feelings, or sexual encounters and feelings that aren’t actually happening. An important feature is they seem to be really happening (in a technical sense, they are really happening – in your head); and this can be really disturbing for some people.
c) sleep paralysis Sleep paralysis is a bitch. Especially if it occurs along with a hypnagogic hallucination. You know, you’re awake but you can’t move anything? These are more common for “normals” to experience – maybe about once a year. But, try having this happen every time you sleep.
Sleep paralysis is one of the most terrifying aspects of narcolepsy, and if your brain is strange enough, will make you feel like you’re losing your mind. Try telling your mom you were abducted by aliens last night and they came from another dimension through the mirror. Then tell her with a serious look on your face. See?
As a side note, sleep paralysis is believed to be linked to SUNDS (Sudden Unexpected Nocturnal Death Syndrome), and there’s a lot of superstition around it in the Philippines. Many people believe it’s linked to high carbohydrate consumption in the evening. Which is just another reason why you shouldn’t eat bread. <snark>
d) cataplexy. When you think of narcolepsy, this is probably what you are thinking of. Usually, it’s not people just falling over asleep like most people believe. Rather it is a spontaneous loss of muscle tone — you can think of it like the opposite of a seizure. Instead of uncontrollably moving (seizure), you are uncontrollably not moving (cataplexy). The current medical opinion is that as a narcoleptic either you have cataplexy, or you do not have cataplexy; although there is probably some spectrum in between (I for example, do not have overt cataplexy, but I intensely avoid overly emotional situations or I get muscle weakness, but I don’t have total loss of muscle tone). Anyway, when you laugh hysterically at dogs falling over when they get excited for food? That’s it.
How is narcolepsy diagnosed?
Narcolepsy is usually diagnosed by an overnight sleep study called a polysomnogram, as well as a day-time sleep study called a multiple sleep latency test (MSLT). The MSLT is a measure of how quickly a person falls into rapid-eye movement (REM) sleep. Individuals with narcolepsy have a very reduced time-to-REM period, often beginning REM within several minutes of falling asleep.
What are the standard treatments for narcolepsy?
Currently, there is no cure for narcolepsy by conventional medicine. Treatment for narcolepsy involves symptom management, and include stimulant prescription drugs for the daytime, such as Ritalin or Provigil, as well as drugs to help improve nighttime sleep quality and cataplexy attacks such as Xyrem.
What causes narcolepsy?
While the exact cause of narcolepsy is unknown, it is widely assumed to be an autoimmune disease. Narcolepsy has the highest HLA (genetic) association than any other autoimmune disease, with more than 90% of individuals with narcolepsy having a gene called HLA-DQB1*0602. Narcolepsy may present at any age, but most people are officially diagnosed in their early-to-mid twenties.