Narcolepsy

Narcolepsy is a chronic sleep disorder with the main characteristics being sudden 'attacks' of sleep and drowsiness in the daytime. Individuals suffering from narcolepsy often have a reduced number of neurons which control appetite for sleep and sleep patterns in the brain. Narcolepsy affects men and women equally and symptoms usually appear between the ages of 15 to 30. It's estimated that around one in 2000 people have the disorder.

What is Narcolepsy?

As mentioned above a main symptom of narcolepsy is excessive sleepiness in the daytime, even following a good night's sleep. Also a person with narcolepsy often becomes drowsy or falls asleep at inappropriate times and places. These sleep 'attacks' often occur without warning and can't be resisted. Along with these there are four other common symptoms associated with narcolepsy (although not all symptoms will appear in each case);

Cataplexy - This features loss of muscle function ranging from mild weakness (such as going limp in the knees) to full body collapse. Episodes of cataplexy can be triggered by sudden emotional reactions like anger, laughter or fear and can last from a couple of seconds to a few minutes. The person will remain conscious throughout the episode and in some cases cataplexy can resemble an epileptic fit.
Sleep Paralysis - Sufferers may experience periods of whole-body paralysis when waking or falling asleep. Throughout the episode the person is conscious but can't speak or move. This can be a terrifying experience but episodes usually last under 20 minutes.
Hallucinations - Again, at the moment of waking or sleeping the individual may experience vivid images, sounds and sometimes sensations of touch which are often disturbing.
Automatic Behaviour - Where sufferers continue routine activities on 'auto-pilot' while in a seemingly trance-like state.

What causes narcolepsy?

The causes of narcolepsy are currently unknown but research is ongoing and a number of theories exist. Scientists have discovered several conditions which can increase the risk of developing the disorder. A lack of a neurotransmitter called orexin in the brain, which is responsible for controlling sleep patterns has been noted in many narcoleptics. Also there are genetic factors involved with researching showing links between narcoleptic individuals and variations in certain genes. Narcolepsy can also be triggered by certain diseases like measles or by hormone changes during adolescence.

How is it diagnosed?

When all the symptoms of narcolepsy are present a diagnosis is fairly simple. But if sleep attacks aren't frequent and other symptoms are mild or absent then this makes diagnosis much more difficult. As the main symptoms are exhaustion and sleeping narcolepsy is often mistakenly thought to be the product of staying up late or laziness. There are several conditions which can causes similar symptoms to narcolepsy like anaemia or hypothyroidism and people are sometimes misdiagnosed as having these.

What are the treatments?

At present there is no 'cure' for narcolepsy. However symptoms can be managed and minimised enough to let the individual lead a normal life. Treatment for the excessive daytime sleepiness is usually done with stimulants such as amphetamines to keep the person alert throughout the day. For cataplexy antidepressants are often prescribed and have been shown to help with other symptoms like sleep paralysis and hallucinations. If the sufferer is experiencing insomnia then sleep-inducing agents may be prescribed. Stress reduction and regular exercise are also commonly suggested to minimise attacks during the day.