NARCOLEPSY

 Basic information

description

Narcolepsy is a sleep disorder that affects the control of sleep and wakefulness. Type and severity of symptoms can vary in people who have the disorder. It usually begins in the teen years or young adulthood. Young children and the elderly can also be affected. Often, it goes undiagnosed for years.

FREQUENT SIGNS & SYMPTOMS

• Excessive daytime sleepiness (hypersomnia).
• Uncontrollable sleep attacks that may occur up to 10 times a day. They may last from 30 seconds up to 30 minutes or more. An attack leaves the person feeling refreshed, but another may occur again quickly. Attacks can occur while driving, talking, working, in warm environments, after large meals, or at social events.
• Hallucinations (seeing things that aren't there) when first going to sleep or waking up. This is called hypnagogic or hypnopompic.
• A short period of paralysis (sudden loss of muscle strength) when falling asleep or just before awakening.
• A few seconds of paralysis not related to sleep when feeling sudden emotion, such as anger, fear, or joy. This is called cataplexy.
• Nighttime sleep is disturbed by leg jerks, tossing and turning, nightmares, and frequent awakenings.

causes

The exact cause is unknown. It is a neurologic (nervous system) disorder. Low levels of a brain chemical called hypocretin (that normally helps staying awake) play a role. It may also be linked to autoimmune disorders. In these disorders, the immune system by mistake attacks the body. There is also a genetic link.

risk increases with

• A family history of narcolepsy.
• Genetic factors.
• Brain injury (e.g., stroke or tumor), infections, contact with toxins (e.g., pesticides), or autoimmune disorders.

PREVENTIVE MEASURES

No known preventive measures.

expected outcomes

The disorder appears to be lifelong. There is no cure. Drugs and lifestyle changes can help control the symptoms. Most people with the disorder can lead a near-normal lifestyle.

possible complications

• Accidental injury during a sudden sleep attack.
• The disorder may affect all aspects of one's life. This includes work, social life, personal relationships, and emotional health.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask about your symptoms and activities. You may be asked to keep a 2-week diary about your sleep patterns. An overnight study in a sleep clinic followed by a daytime multiple sleep latency test (MSLT) may be done.
• Treatment usually involves lifestyle changes along with drugs to help control the drowsiness. It may take several weeks or months to achieve the best results.
• Schedule a regular time for going to bed and getting up. Stick to the schedule. Get at least 8 hours of sleep.
• Take regular naps 2 to 3 times during the day. One 15-minute nap after lunch and another at around 5:30 pm may help symptoms.
• Avoid shift work, night work, or rotating schedules.
• Avoid over-stimulating activities, if possible.
• Wear a medical alert type bracelet or pendant to indicate you suffer from this disorder.
• To learn more: Narcolepsy Network, PO Box 294, Pleasantville, NY 10570; (888) 292-6522; website: www.narcolepsynetwork.org.

medications

• Stimulants that increase levels of daytime alertness may be prescribed.
• Modafinil for wake-promoting may be prescribed.
• Antidepressants or sodium oxybate (Xyrem) for cataplexy or other symptoms may be prescribed.
• New drugs for this disorder are being studied.

activity

• Don't engage in any activity that carries the risk of injury from a sudden sleep attack. These include activities such as driving long distances, climbing ladders, or working around dangerous machinery.
• Exercise regularly, but not within 3 hours of bedtime.

diet

No special diet. Avoid alcohol and caffeine.

 notify our office if

• You or a family member has symptoms of narcolepsy.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: