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Narcolepsy

What is Narcolepsy?

Narcolepsy is an uncommon sleep disorder whose main symptom is powerful daytime sleepiness. During the day, a person with narcolepsy may be overwhelmed with sleepiness, fall asleep for 10-20 minutes, wake up refreshed but within 1 or 2 hours begin to feel sleepy again. The sleepiness usually occurs in situations when the person is quiet, inactive or bored (for example, listening to a boring lecture, play or movie). At first the person can usually fight the sleepiness, but over time the sleepiness can be overwhelming and at least a brief nap is needed.

What are the symptoms of narcolepsy?

One of the main symptoms of narcolepsy is extreme sleepiness during the day. A person with narcolepsy may also have symptoms when falling asleep or waking up in which they are unable to move their bodies. This is called sleep paralysis and may continue for seconds or minutes. They may also have vivid dreams. One of the most intense symptoms of narcolepsy is called cataplexy. During an attack of cataplexy, the person is awake and alert, but may develop sudden muscle weakness and actually fall down if standing. Cataplexy often occurs at times of strong emotion. Another symptom of narcolepsy is hallucinations (dreaming while falling asleep or waking up). If they occur as you fall asleep, they're called hypnogogic hallucinations; if they occur as you wake up, they're called hypnopompic hallucinations. These symptoms can be very upsetting and frightening before they are properly diagnosed.

What causes narcolepsy?

The exact cause of narcolepsy is unknown. We know that in some people genetics may be involved. We know that people with narcolepsy have a problem with the natural rhythm of sleep and waking, and that this rhythm is controlled by brain chemistry. As a result, we know that a chemical imbalance in the brain is at least part of the problem. At this time, the exact problem in brain chemistry has not been worked out.

What happens to people who have narcolepsy?

Narcolepsy is a lifelong illness that can be kept in control for most people. If not treated or kept in control, it can cause danger since episodes may occur while driving, operating machines, or other risky activities. With medications and enough sleep, including naps or rest periods, many people with narcolepsy can stay awake and alert all day. Narcolepsy can also create problems with family and friends and trouble at work. As a result, it may be hard to keep a job and enjoy lasting relationships. For some people with narcolepsy there is an extra burden of dealing with people who falsely believe their symptoms are caused by laziness or lack of will power.

What is the treatment for narcolepsy?

The treatment for narcolepsy usually involves taking medications to reduce sleepiness during the day and in those who have cataplexy, other medications to prevent cataplexy. The medications to prevent sleep during the day are a group of medicines called stimulants that includes Ritalin, Adderall, Dexedrine, Provigil and others. Cataplexy is usually treated with antidepressant medications that repress REM (dreaming) sleep such as Tofranil, Norpramin, Prozac, Paxil and Zoloft.

What can I do to help control my narcolepsy?

  • Make sure you get enough sleep at night. Eight hours is right for most people.
  • Have a regular time for getting to sleep and waking up and stick with it seven days a week.
  • It may be very helpful to have rest periods or brief naps during the times of day when sleepiness usually occurs.
  • Since strong emotion may provoke symptoms, learn skills for dealing with strong emotions.
  • Avoid a heavy meal before any important event since a heavy meal may provoke a sleep attack.
  • Get some exercise most days, in the morning or afternoon.
  • Avoid caffeine, nicotine and alcohol in the late afternoon or evening.
  • Many people benefit from support groups that focus on coping skills and finding community resources.
  • If you think you may have narcolepsy, go to an accredited sleep disorder center so you can be properly diagnosed and get good treatment recommendations.

What can I do to prevent the symptoms from coming back once they're in control?

If daytime sleepiness or cataplexy become more of a problem again, check with your healthcare provider. Make sure you get enough sleep at night and that you stick to a regular schedule for getting to sleep and waking up. It may also help to take brief naps or rest periods during the day.

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