What is Narcolepsy?
Narcolepsy is a chronic neurological disorder that causes excessive sleepiness without warning and at inappropriate times. When a person has Narcolepsy, the brain is unable to regulate the sleep-wake cycles normally. Numerous factors contribute to sleep disturbances and neurological dysfunction. As a result, both daytime and night-time sleep attacks occur.
During the day, people with narcolepsy can experience sleep attacks repeatedly. This causes them to fall asleep suddenly and without warning, while at night, their sleep is disturbed and they wake up frequently.
There are two main types of sleep: rapid eye movement (REM) sleep and non rapid eye movement (NREM) sleep. For people without sleep disorders, during REM, the body becomes immobile and conscious thinking ‘paralysis’ occurs.
Your eyes move quickly in different directions even though your eyelids are closed and intense dreaming occurs. When people fall asleep, they usually have NREM sleep first, followed by REM sleep. People suffering from narcolepsy fall into REM before NREM sleep and they may be either asleep or awake.
People who suffer from narcolepsy are a safety hazard to themselves and to others. It is hard to imagine what life must be for a narcoleptic, difficult, dangerous, embarrassing and definitely frustrating.
A narcoleptic will doze off in the train and miss his or her stop, fall asleep in the bathtub with potentially dangerous consequences, or have to be shaken awake by the dentist so that a dental procedure may occur. They fall asleep while driving, doing their jobs, socializing with friends and family, or even eating. People with Narcolepsy are often on the verge of unconsciousness.
Narcolepsy can occur in men, women, children and the elderly. Signs and symptoms of narcolepsy usually develop during adolescence, but can also appear in children as young as ten years old, as well as in adults. Sometimes narcolepsy can go undiagnosed for several years, and be mistakenly diagnosed as laziness, lack of sleep, depression or a seizure disorder.
Children suffering from narcolepsy are often thought to have some type of learning disorder or seizure disorder such as epilepsy. Their ability to study, focus and remember becomes severely affected. This leads to depression, a decreased immune response, stress, poor work performance and interpersonal problems with teachers and their peers. Some children have even been misdiagnosed with hyperactivity. When they are tired, they tend to do their work or activities in a hurry rather than slow down. If your child displays symptoms of narcolepsy, it is best that they receive medical care immediately.
Although narcolepsy is a lifelong condition, symptoms will improve with ongoing treatment so that people are able to lead more productive lives.
A diagnosis of narcolepsy is based on the patient’s symptoms, physical exam and family history of narcolepsy. The doctor may refer the patient to a sleep specialist for observation and evaluation of sleeping patterns. Some sleep tests require that the patient stays over at a sleep centre.
Diagnostic methods used to determine narcolepsy include:
Epworth Sleepiness Scale: This sleep questionnaire consists of questions that have to be ranked on a numbered scale by the patient. An example would be: "Do certain situations make you feel sleepy?"
Nocturnal polysomnogram: This test measures the electrical activity of the brain (electroencephalogram) and heart (electrocardiogram), the movements of muscles (electromyogram) and eyes (electroculogram) as well as respirations (oral thermistor or nasal pressure transducer) during sleep.
Multiple sleep latency test (MSLT): This test measures how long it takes to fall asleep during the day. The patient is asked to take short naps every two hours and sleep specialists observe sleeping patterns.
Hypocretin Test: This test measures the levels of hypocretin in the fluid that surrounds the spinal cord. A low level of hypocretin can indicate that you have narcolepsy, although this is not always the case.
Narcolepsy is characterized by the following symptoms:
- Excessive daytime sleepiness: People with narcolepsy experience sudden, overwhelming urges to sleep during the day. This uncontrollable need to sleep occurs anywhere and at anytime.
- Cataplexy: This is the sudden, temporary loss of muscle tone often triggered by intense emotions such as laughter, excitement, fear or anger. Muscles become completely weak which causes physical changes such as slurred speech, knees buckling or your head drooping uncontrollably. Approximately 70% of people with narcolepsy experience cataplexy.
- Hallucinations: Hallucinations are referred to as hypnagogic hallucinations and are described as vivid dreamlike experiences occurring while falling asleep or upon awakening. This hallucination occurs when a person falls instantly into REM sleep (rapid eye movement is the period of sleep when most dreaming occurs). When the person starts dreaming, it is most likely he or she is semi-awake, and the dream is experienced as being very real. These dreams may therefore be exceptionally vivid or terrifying.
- Sleep paralysis: Paralysis occurs upon falling asleep or awakening. A person with narcolepsy is unable to move or speak for a few minutes, while falling asleep or upon waking up. This sleep paralysis that usually occurs during REM sleep may prevent the body from experiencing the ability to dream. Sleep paralysis is generally experienced in young adulthood.
- Automatic Behavior: During sleep episodes, a person suffering from narcolepsy will perform functions and activities such as talking, walking or putting things away without being aware that he or she is actually doing them.
What Causes Narcolepsy?
The cause of narcolepsy is not exactly known, but research suggests that it could be as a result of the lack of the chemical called hypocretin in the brain, especially when cataplexy is also present.
Hypocretin stimulates the brain cells and promotes a state of wakefulness. There are factors that may contribute to the lack of hypocretin in the brain and they include infection, autoimmune reaction, stress or hormonal changes.
Help for Narcolepsy
Narcolepsy is a chronic and lifelong condition, but symptoms can be managed and controlled. One should keep in mind that each person is different, and their response to treatment will depend on the severity of their symptoms. Certain medications, lifestyle changes and alternative therapies have proven effective in reducing the frequency of narcoleptic episodes.
Often symptoms are severe, and narcolepsy becomes so frustrating, that people immediately turn to conventional medication to relieve symptoms. It is also important to control symptoms to prevent the potential dangers involved in sudden attacks of sleepiness.
Medications used primarily to treat narcolepsy include stimulants and antidepressants. Although these medications can help to control the symptoms to varying degrees, they do not address the underlying cause and may cause unwanted side effects.
Natural treatments can be used in conjunction with conventional medicine or as an alternative and may offer people a safer and all-natural option to promote optimal health and longevity. Natural remedies focus on improving symptoms and can also help to support one’s physical, mental and emotional health.
A combination of herbal and homeopathic treatments with beneficial ingredients such as Hypericum perforatum, Schizandra chinesis, Calcium lactate, Magnesium lactate and Vitamin B6 can provide relief for narcoleptics. By incorporating natural remedies into your treatment plan, you will able to maintain regular sleeping patterns and improve your quality of life. It is important not to stop your prescription medication without consulting your doctor or seeking the supervision of a complimentary health practitioner or homeopath.
A holistic approach
By opting for a more holistic approach, natural and alternative treatments can complement conventional medicine. Complementary therapies and other treatment modalities to consider including in the treatment program are:
- Counseling and psychotherapy
- Spiritual therapy
It is also important to remember that eating healthily and exercising on a regular basis helps to improve the quality of a person’s sleep and relieves the stresses of daily life.
People who are suffering from narcolepsy can incorporate lifestyle
changes which will help them manage this condition.
- Establish a structured sleeping routine by maintaining a sleeping and rising time as well as having daytime naps.
- Have access to family, marriage and occupational counseling.
- Avoid caffeine, alcohol and nicotine especially during the afternoon and at night.
- Join a support group.
- Be responsible – don’t drive or handle hazardous equipment if you feel sleepy
- Spend time outdoors after waking up as this regulates the body’s biological clock.
- Ensure that your sleeping environment is peaceful and comfortable, and is used primarily for sleeping.
- Keep a sleep journal to jot down your sleeping patterns and habits.
- Carry a tape recorder with you to record important conversations that you may forget when you feel sleepy.
- Practice visualization and relaxation techniques to assist in sleeping better.
- Reduce stress and maintain an even mood to prevent bringing on a narcolepsy attack
Treatment of the future?
Because the number of people with narcolepsy is relatively low and the ‘market’ is therefore small, medical research into more permanent cures is not high on the list of priorities for the pharmaceutical companies. However, possible areas of research include stem cell therapy as well as a synthetic form of hypocretin.