The National Institute of Neurological Disorders
and Stroke calls narcolepsy "a disabling neurological disorder of sleep
regulation that affects the control of sleep and wakefulness." The
disorder causes sudden changes between wakefulness and REM sleep, or the
dreaming state. One out of every two thousand people suffers from the disorder.
Symptoms
The disorder usually presents between the ages of fifteen to thirty. The
first identifiable sign of the disorder is usually excessive daytime tiredness,
including sudden "nap attacks" that can occur in almost any
circumstance. These symptoms may occur regardless of the quality of nighttime
slumber. A variety of symptoms characterize narcolepsy:
Hypersomnia: Hypersomnia, or excessive daytime tiredness, is
usually the first indication of narcolepsy. Hypersomnia can cause sudden nap
attacks, which usually involve non-REM sleep. Narcolepsy's nap attacks differ
from other forms of hypersomnia, in that there is a sudden shift from waking
into REM sleep.
Automatic Behavior: Sufferers perform boring or routine tasks
without full awareness. Often they have no memory of performing the task. This
is especially dangerous when driving is involved.
Sleep Paralysis: Sleep paralysis occurs both upon falling asleep
and when awakening. A person suffering from sleep paralysis may not be able to
move or open his or her eyes for brief periods during these states.
Hypnagogic Hallucinations: One of the defining symptoms of
narcolepsy, hypnagogic hallucinations are vivid, often frightening images and
sounds experienced within the first hour of slumber. The presence of hypnagogic
hallucinations suggests REM activity is occurring.
Cataplexy: Cataplexy is sudden muscle weakness brought about by
strong emotions. Laughter, anger, fright, and grief can all cause cataplexy.
The condition can range from mild muscle weakness, slurred speech, and buckled
knees to a complete collapse.
In addition to these symptoms, narcolepsy can wreak havoc on personal
relationships, schoolwork, job performance, and personal finances. While no
cure exists, narcolepsy treatment can help people live with a minimum of
symptoms.
Diagnosis
If your doctor suspects narcolepsy, a full medical and physical history
will be taken. Your doctor may recommend overnight polysomnography test, and a
multiple sleep latency test, which measures how long you take to fall asleep
and wake up. Continue to Narcolepsy Treatments page.
Narcolepsy treatment requires the use of
medications coupled with behavioral changes. Practicing proper sleep hygiene can help to make people's rest patterns more consistent.
Scheduled napping during the day can help control hypersomnia and nap attacks.
Some authorities recommend several short naps a day; others suggest that one
long afternoon nap provides greater benefits. Twenty to forty minutes should be
set aside for each nap.
Medication Options
A number of medications are used in narcolepsy treatment. No single
medication controls all narcoleptic symptoms, so drug treatments must be
tailored to the individual. Common medications include:
Stimulants: Stimulants such as Ritalin®, Dexedrine® and
Cylert® are used to combat hypersomnia and nap attacks.
Stimulant side effects include headaches, irritability, mood changes,
nervousness, insomnia, and irregular heartbeat.
Modafinil: Modafinil (Provigil®) is a wake-promoting
drug that was approved for narcolepsy treatment by the Food and Drug
Administration in 1999. The drug helps prevent hypersomnia without stimulating
the rest of the body.
Antidepressants: Antidepressants may be prescribed to alleviate the
symptoms of hypnagogic hallucinations, cataplexy and sleep paralysis. The
multicyclics and SSRIs (selective serotonin reuptake inhibitors) are the most
commonly prescribed. Side effects can include drowsiness, low libido, and low
blood pressure.
Xyrem: The only FDA-approved treatment for cataplexy is Xyrem® (sodium
oxybate). It has a number of serious side effects, and adverse reactions have
caused deaths. As a result Xyrem is tightly controlled. Other side effects
include nausea, vomiting, bedwetting, and parasomnia activity.
Medication Interactions
Medications used to treat narcolepsy can interact with other medicine,
especially hypertension, heart and diabetes medication. Over the counter
allergy and cold medicine can cause drowsiness when taken in combination with
narcolepsy medications. Give your medical professional a complete list of all
medicines you take before starting a prescription for narcolepsy.
Social Support
School personnel, employers, co-workers and others in daily contact with
you should be informed so that they are able to recognize narcoleptic symptoms.
Support groups are available for you, both on and off-line. Joining these
groups can give you a sense of community and the chance to learn how other
people deal with the disorder.
The National Institute of Neurological Disorders
and Stroke calls narcolepsy "a disabling neurological disorder of sleep
regulation that affects the control of sleep and wakefulness." The
disorder causes sudden changes between wakefulness and REM sleep, or the
dreaming state. One out of every two thousand people suffers from the disorder.
Symptoms
The disorder usually presents between the ages of fifteen to thirty. The
first identifiable sign of the disorder is usually excessive daytime tiredness,
including sudden "nap attacks" that can occur in almost any
circumstance. These symptoms may occur regardless of the quality of nighttime
slumber. A variety of symptoms characterize narcolepsy:
Hypersomnia: Hypersomnia, or excessive daytime tiredness, is
usually the first indication of narcolepsy. Hypersomnia can cause sudden nap
attacks, which usually involve non-REM sleep. Narcolepsy's nap attacks differ
from other forms of hypersomnia, in that there is a sudden shift from waking
into REM sleep.
Automatic Behavior: Sufferers perform boring or routine tasks
without full awareness. Often they have no memory of performing the task. This
is especially dangerous when driving is involved.
Sleep Paralysis: Sleep paralysis occurs both upon falling asleep
and when awakening. A person suffering from sleep paralysis may not be able to
move or open his or her eyes for brief periods during these states.
Hypnagogic Hallucinations: One of the defining symptoms of
narcolepsy, hypnagogic hallucinations are vivid, often frightening images and
sounds experienced within the first hour of slumber. The presence of hypnagogic
hallucinations suggests REM activity is occurring.
Cataplexy: Cataplexy is sudden muscle weakness brought about by
strong emotions. Laughter, anger, fright, and grief can all cause cataplexy.
The condition can range from mild muscle weakness, slurred speech, and buckled
knees to a complete collapse.
In addition to these symptoms, narcolepsy can wreak havoc on personal
relationships, schoolwork, job performance, and personal finances. While no
cure exists, narcolepsy treatment can help people live with a minimum of
symptoms.
Diagnosis
If your doctor suspects narcolepsy, a full medical and physical history
will be taken. Your doctor may recommend overnight polysomnography test, and a
multiple sleep latency test, which measures how long you take to fall asleep
and wake up. Continue to Narcolepsy Treatments page.
Narcolepsy treatment requires the use of
medications coupled with behavioral changes. Practicing proper sleep hygiene can help to make people's rest patterns more consistent.
Scheduled napping during the day can help control hypersomnia and nap attacks.
Some authorities recommend several short naps a day; others suggest that one
long afternoon nap provides greater benefits. Twenty to forty minutes should be
set aside for each nap.
Medication Options
A number of medications are used in narcolepsy treatment. No single
medication controls all narcoleptic symptoms, so drug treatments must be
tailored to the individual. Common medications include:
Stimulants: Stimulants such as Ritalin®, Dexedrine® and
Cylert® are used to combat hypersomnia and nap attacks.
Stimulant side effects include headaches, irritability, mood changes,
nervousness, insomnia, and irregular heartbeat.
Modafinil: Modafinil (Provigil®) is a wake-promoting
drug that was approved for narcolepsy treatment by the Food and Drug
Administration in 1999. The drug helps prevent hypersomnia without stimulating
the rest of the body.
Antidepressants: Antidepressants may be prescribed to alleviate the
symptoms of hypnagogic hallucinations, cataplexy and sleep paralysis. The
multicyclics and SSRIs (selective serotonin reuptake inhibitors) are the most
commonly prescribed. Side effects can include drowsiness, low libido, and low
blood pressure.
Xyrem: The only FDA-approved treatment for cataplexy is Xyrem® (sodium
oxybate). It has a number of serious side effects, and adverse reactions have
caused deaths. As a result Xyrem is tightly controlled. Other side effects
include nausea, vomiting, bedwetting, and parasomnia activity.
Medication Interactions
Medications used to treat narcolepsy can interact with other medicine,
especially hypertension, heart and diabetes medication. Over the counter
allergy and cold medicine can cause drowsiness when taken in combination with
narcolepsy medications. Give your medical professional a complete list of all
medicines you take before starting a prescription for narcolepsy.
Social Support
School personnel, employers, co-workers and others in daily contact with
you should be informed so that they are able to recognize narcoleptic symptoms.
Support groups are available for you, both on and off-line. Joining these
groups can give you a sense of community and the chance to learn how other
people deal with the disorder.
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