Description
Narcolepsy is a rare condition of irresistible drowsiness and inappropriate periods of REM (rapid eye movement) sleep coupled with cataplexy, or loss of muscle tone. It is usually a chronic, lifelong illness. However, narcolepsy may also follow a sudden, emotional, incident.
Total daily sleep time rarely increases, regardless of the frequency of episodes. This condition is found equally in both men and women and affects one out of one thousand people.
Symptoms and Signs:
Symptoms typically start at a young age and continue throughout life, i.e., there is usually a history of episodes. Symptoms are subtle at first and become more severe over time.
Excessive Daytime Sleepiness (EDS), cataplexy, sleep paralysis, and hypnagogic hallucinations are the four classic symptoms that define narcolepsy and are outlined below. Note that only 10 percent of people with narcolepsy experience all four of these symptoms, making the disorder difficult to accurately diagnose.
Excessive Daytime Sleepiness
Excessive Daytime Sleepiness, or sleep attack, is an irresistible urge to fall asleep. It occurs daily, regardless of the amount of sleep obtained at night, and especially during meetings, lectures, and other sleep-inducing situations. You are likely sleepy, tired, exhausted, and lack energy, though feel refreshed after an episode. EDS is also described as having "sleep attacks" since sleep can come on very suddenly and without warning -- even in mid-conversation. Several attacks can occur in a day. It is ironic that people with EDS usually receive poor quality, frequently interrupted, nighttime sleep.
Cataplexy
Cataplexy is the sudden loss of voluntary muscle tone and is usually triggered by strong emotions such as fear, anger, or laughter. You may have a slight feeling of weakness via a nodding head or weak knees, or you may completely collapse for several minutes.
Sleep Paralysis
Sleep paralysis is the inability to move or talk for approximately one minute. Usually occurs when waking up or falling asleep.
Hypnagogic Hallucinations
Hypnagogic hallucinations are intense, vivid, realistic dreams that occur when falling asleep or awakening. They are occasionally difficult to distinguish from reality and may be accompanied by frightening sounds or feelings.
Other Symptoms
A number of studies have found certain common gene sequences in narcoleptics. Narcolepsy also tends to run in families.
Other general symptoms include anxiety, automatic behaviour (performing a task with no memory recall of having done or completed the action), blurred or double vision, depression, disrupted nighttime sleep, headaches, high insulin levels, hypoglycemia, leg cramps, memory difficulties, and improper nervous system function.
Causes:
The direct cause of narcolepsy is not known but, as mentioned above, may be genetic in nature. Other theories point to brain infection or tumours, head trauma, or a biochemical anomaly of the central nervous system. It is not due to insomnia or sleep deprivation.
Narcolepsy is strongly associated with obesity and usually follows a sudden emotional incidence. Diabetics may also be prone to this condition.
What to Expect:
Irresistible drowsiness and falling asleep at inappropriate times are the defining symptoms of narcolepsy. When you fall asleep, you move directly into REM sleep, as opposed to the gradual transition through sleep stages that occur during typical sleep. As a result, you instantly lose muscle control and become paralyzed. This may be preceded by vividly hallucinated sights and sounds, which is a common symptom in young children. Loss of muscle tone may also occur and you are unable to move initially upon awakening.
In addition, there is usually an extreme, generalized, muscle weakness without loss of consciousness. This condition is known as cataplexy (as described under Symptoms and Signs, above) and often follows an emotional incidence such as laughing, surprise, fear, or anger. Weakness may be localized in the limbs and you may fall. This state will then lead to sleep in half of all people with this condition.
Sleep can occur at any time and the number of episodes can vary from few to many instances in a single day. Each episode can last for minutes or hours and you can be roused from sleep as easily as a person in a normal sleeping state. You may feel refreshed upon awakening but can potentially fall back asleep in several minutes. Nighttime sleep may be unsatisfying and can be interrupted by intense, frightening dreams.
Due to the nature of this condition, the various symptoms can put you in risk of personal injury and often interfere with work and social relationships, as narcolepsy may be embarrassing and is quite inconvenient. Activities such as driving, sports, precision work, and the operation of heavy machinery should also be limited and/or avoided.
Testing
Two tests are available to assist your naturopath or other health practitioner in properly diagnosing narcolepsy. These are outlined below.
Polysomnography/Sleep Study: This test requires you to spend the night in a special sleep lab. A number of body functions are monitored to detect arousal and fragmented (interrupted) sleep. These include airflow through the nose, blood oxygen level, blood pressure, brain waves, and eye motion. If you have narcolepsy, you will fall asleep very quickly, rapidly enter REM sleep, and awaken many times throughout the night.
Multiple sleep latency test: This test monitors how long it takes you to fall asleep and what type of sleep you have during normal wakeful hours. The test is given every two hours and measures daytime sleepiness. If you have narcolepsy, you will fall asleep very quickly and immediately enter REM sleep.
Remedies
Although there is no cure for narcolepsy, several tactics are available to help deal with this condition.
Conventional Approaches
Several drugs are often prescribed to stimulate the central nervous system, which improve alertness. These include Dexedrine, Ritalin, and Cylert. Antidepressants may also be prescribed to treat cataplexy, due to their effect on REM sleep.
Amino Acids
Low levels of tyrosine have been associated with narcolepsy. Eat almonds, avocados, bananas, dairy products, lima beans, pumpkin seeds, and sesame seeds. Depending on the country in which you live, L-tyrosine may also be available as an isolated supplement in capsule or tablet form. You may require a prescription. NOTE: Do not supplement with tyrosine if taking an MAO (Monoamine oxidase) inhibitor drug for depression. Also, avoid foods containing tyrosine (high protein foods) if supplementing, as interactions can dangerously affect blood pressure.
Lifestyle
Some researchers recommend scheduling several short, 20 - 40 minute napes throughout the day to fight excessive sleepiness.
Avoid stimulants such as alcohol, caffeine, nicotine, and sugar in the afternoon and evening.
Eat high protein foods such as fish, chicken, cheese, nuts, and soy products in the afternoon and high carbohydrate foods such as pasta, whole grains, legumes, and fresh fruits and vegetables in the evening. High protein foods promote alertness while high carbohydrate foods have a more calming, relaxing, effect that promotes sleepiness.
It is important to ensure you receive a good night sleep. This can be encouraged by going to bed at a regular time every night and getting seven to eight hours of sleep.
Therapies, Healing Aids, and More
It is suspected that some food allergies may cause narcolepsy. Allergy testing can be done to determine specific allergens. Strategies include a skin test, Radioallergosorbent (RAST) test and Enzyme-Linked Immunoadsorbent Assay (ELISA) test. Contact your local allergy testing centre for more information.
Exercise daily to promote circulation and tissue oxygenation. Go for walks and bike rides or join a fitness class.
Actions and Remedy Listings
| Allergy Testing | Avoid Stimulants | Eat High Carbohydrate Foods in Evening |
| Eat High Protein Foods in Afternoon | Exercise | Get 7 - 8 hours of sleep. |
| Go to bed at a regular time every night. | Take short, 20 - 40 minute naps throughout the day. | Tyrosine |
For More Information ...
Organizations
The National Center on Sleep Disorders
(a division of the National Heart, Lung and Blood Institute Information Center):
NHLBI Information Center
P.O. Box 30105
Bethesda, Maryland
20892-0105
Tel.: 301.592.8573
Fax: 301.592.8563
Web: www.nhlbi.nih.gov
Email: nhlbiic@dgsys.com
National Sleep Foundation
1522 K Street, NW, Suite 500
Washington, DC
20005
Tel.: 202.347.3471
Fax: 202.347.3472
Web: www.sleepfoundation.org
Email: nsf@sleepfoundation.org
Websites
Narcolepsy Network. Narcolepsy questions and answers:
www.websciences.org/narnet/faq.htm
National Sleep Foundation. Living with narcolepsy:
www.sleepfoundation.org/publications/livingnarcol.epsy.html
See also
Obesity, Sleeping Problems
