Narcolepsy Sleep Attacks

Introduction

Narcolepsy is a sleep problem that is frequently misdiagnosed. It is characterized by severe and persistent daytime sleepiness, which can hinder performance at work, school, and social settings and increase the likelihood of serious injuries and accidents.

Narcolepsy affects hundreds of thousands of Americans, including children and adults, despite the fact that it is uncommon in comparison to many other sleep disorders. Understanding the different types of narcolepsy and its causes, symptoms, diagnosis, and treatment can enable patients and their friends and family to really adapt to it more.

What Is Narcolepsy?

Narcolepsy is a problem that upsets sleep-wake processes. The brain's inability to regulate wakefulness and sleep is the cause of excessive daytime sleepiness (EDS), which is the primary symptom of narcolepsy.

The final stage of normal sleep, which typically lasts for an hour or more after falling asleep, is rapid eye movement (REM) sleep. In narcolepsy, REM rest is unpredictable and frequently starts within the space of minutes subsequent to nodding off, which is significantly sooner than usual.

Narcolepsy patients experience rapid REM sleep because their brains undergo changes that disrupt the way sleep works. Additionally, these disturbances result in daytime sleepiness and other narcolepsy symptoms.

What Are the Types of Narcolepsy?

There are two types of narcolepsy, according to the International Classification of Sleep Disorders, Third Edition (ICSD-3): type 1 (NT1) and type 2 (NT2) narcolepsy.

Narcolepsy Type 1 (NT1):

The sudden loss of muscle tone, a symptom known as cataplexy, is linked to NT1. Previously, NT1 was referred to as "narcolepsy with cataplexy."

Not all patients who are determined to have NT1 experience episodes of cataplexy. When a person has low levels of hypocretin-1, a chemical in the body that helps control wakefulness, NT1 can also be diagnosed.

A significant number of people with low levels of hypocretin-1 eventually develop cataplexy, even if it was not present at the time of diagnosis.

Narcolepsy Type 2 (NT2):

Previously, NT2 was referred to as "narcolepsy without cataplexy." Although they do not have cataplexy or low hypocretin-1 levels, people with NT2 exhibit many of the same symptoms as people with NT1.

A person with NT2 can have their diagnosis reclassified as NT1 if they later develop cataplexy or low hypocretin-1 levels. It is estimated that approximately 10 % of cases result in a new diagnosis.

What Are the Symptoms of Narcolepsy?

The effects of narcolepsy symptoms can be significant both during the day and at night. The most widely recognized side effects include:

• Excessive Daytime Sleepiness (EDS): All people with narcolepsy experience EDS, the most common symptom. EDS is characterized by an irrational desire to sleep that typically manifests in monotonous situations. Attention lapses are frequently caused by severe drowsiness. “Sleep attacks,” which involve falling asleep without warning, can be caused by narcolepsy. After short rests, individuals with narcolepsy, for the most part, feel briefly invigorated.

• Automatic Behaviors: Trying to stay awake can set off automatic behaviors that happen without a person realizing it. For instance, a student in the class might continue to write while merely scribbling lines or other gibberish on the page.

• Disturbed Sleep at Night: Sleep discontinuity is normal in individuals with narcolepsy who might stir on various occasions during the evening. Narcoleptics also have a higher prevalence of other bothersome sleep issues, like sleep apnea and excessive physical movement.

• Sleep Paralysis: Sleep paralysis, or the sensation of being unable to move while falling asleep or waking up, is more common in people with narcolepsy.

• Sleep-related Hallucinations: Hypnopompic hallucinations (vivid imagination while waking up) and hypnagogic hallucinations (vivid imagination when falling asleep) both involve vivid imagery during sleep. This might go along with sleep paralysis, which can be especially upsetting or startling.

• Cataplexy: A sudden loss of muscle control is cataplexy. It only affects those with NT1, not NT2. A cataplexy episode frequently occurs in response to positive feelings like joy or laughter. Cataplexy typically lasts between a few seconds and a few minutes and typically affects both sides of the body. Certain individuals with NT1 just have episodes of cataplexy a couple of times each year, while others can have at least twelve episodes each day.

Even though narcolepsy affects everyone, less than a quarter exhibit all of these symptoms. Furthermore, the signs and symptoms might not appear simultaneously. Cataplexy, for instance, can begin years after an individual first develops EDS.

Are the Symptoms of Narcolepsy Different in Children?

Adult and child narcolepsy symptoms share a lot of similarities, but there are also significant differences. EDS is more likely to manifest itself in children as restlessness or irritability, which could be mistaken for a behavioral issue. Children with narcolepsy may sleep longer at night.

In children, cataplexy can be more subtle, but it can happen in up to 80 % of cases. It may be perceived as a facial tic because it typically affects the face rather than the body. Children's cataplexy may not be caused by an emotional reaction. Children's cataplexy symptoms develop into their more common form over time.

What Causes Narcolepsy?

A lack of the brain chemical hypocretin, also known as orexin, which regulates wakefulness, is frequently the cause of narcolepsy. Hypocretin deficiency is thought to be brought on by the immune system attacking the cells that make it or the receptors that make it work in the wrong way. Be that as it may, this does not make sense in all instances of narcolepsy, and the specific reason for the issue is frequently hazy.

Things that have been recommended as potential triggers of narcolepsy include:

• Hormonal changes may occur during menopause or puberty.

• Major psychological stresses.

• An infection like the swine flu or the vaccine used to prevent it.

How Is Narcolepsy Diagnosed?

A medical professional will conduct a physical examination and inquire about the symptoms. A blood test may be performed on the affected individual to rule out other conditions that may have similar symptoms. These include:

• Insomnia and a few other sleep disorders.

• Seizures.

• Restless leg syndrome.

• Sleep apnea.

• A few other medical, psychiatric, or nervous system disorders.

A few other tests might also be performed, which may include the following:

• ECG (electrocardiogram) to measure the electrical activity of the heart.

• EEG (electroencephalogram) to measure the electrical activity of the brain.

• Polysomnogram to study the sleep pattern.

• Multiple sleep latency test (MSLT). A person's ability to fall asleep during a daytime nap will be measured using this test. Narcolepsy sufferers fall asleep much more quickly than those without the condition.

• Genetic testing to detect the narcolepsy gene.

• Lumbar puncture (spinal tap) to determine low levels of hypocretin.

How Is Narcolepsy Treated?

Narcolepsy cannot be cured. Notwithstanding, treatment can assist with controlling the symptoms.

Lifestyle Changes:

Changing certain things can help one sleep better at night and reduce daytime sleepiness:

• Having the same time every day for waking up and going to bed.

• Ensuring that the bedroom is dark and comfortable. Ensuring that the pillows and bed are comfortable.

• Avoiding alcohol, caffeine, and spicy or heavy meals several hours before going to bed.

• Avoid smoking.

• Practicing relaxing techniques, such as reading a book or taking a warm bath before bed.

Medications:

• Stimulant medications can assist with remaining conscious during the day.

• Cataplexy, sleep paralysis, and hallucinations can be reduced with the help of antidepressant medications.

• To control cataplexy, sodium oxybate works effectively. It can also help to stay awake during the day.

Conclusion

Narcolepsy is a mind-related condition that causes disturbances in the body's normal rest/wake processes. While this condition is not generally risky, it can take a chance in specific circumstances. Additionally, it is a condition that has the potential to seriously alter daily routines and activities. It is possible that many people with this condition will struggle with everyday activities like driving and working.

Luckily, this condition is treatable, and a great many people with narcolepsy see a few upgrades from treatment in any event. Behavior changes related to sleep can also be beneficial. Although it is not always possible to avoid the signs and symptoms of narcolepsy, many people are able to manage the condition and adapt to most or all of its effects.