The weekend of April 6 this year, when most Americans will “spring forward” and set their clocks one hour ahead for daylight-saving time, also marks the end of National Sleep Awareness Week (observed this year March 31 – April 6). And it may be a time when many Americans are losing something precious — an hour’s worth of sleep. When you don’t snooze, you lose — physically and mentally. Not getting a good night’s sleep can have a dramatic impact on your ability to perform even basic physical and mental tasks.
But imagine having a sleep disorder so serious that simply running into an old friend or holding your grandchild might result in an uncontrolled physical collapse, leaving you paralyzed. For persons with cataplexy, which is a symptom of narcolepsy, such episodes can oftentimes be a fact of everyday life.
Narcolepsy can have a very serious personal impact on those who suffer from it, affecting even routine tasks of everyday life. Stanford University’s Center for Narcolepsy reports that studies show patients who are treated for narcolepsy may be more prone to accidents than non-sufferers and are often impaired in the areas of work, leisure and personal relationships.
What Is Narcolepsy?
Narcolepsy is a chronic neurological sleep disorder that affects about one in every 2,000 Americans. It is characterized by sudden, uncontrollable attacks of deep sleep. Excessive daytime sleepiness, or the overwhelming and recurring need to sleep when you want to be awake, is one of the hallmark symptoms of the condition.
Cataplexy, another defining sign of narcolepsy, is often the most troubling symptom for many sufferers. Characterized by the sudden loss of muscular control without loss of consciousness, cataplexy affects between 60 and 90 percent of narcolepsy patients. Cataplexy attacks are usually triggered by strong emotional reactions, such as laughter, elation, anger, embarrassment and surprise.
The effects of cataplexy range from slurred speech to buckling of the knees and even total physical collapse. During severe attacks, a patient may collapse and be unable to move for several minutes, while still remaining conscious and alert of his or her surroundings. While some people with narcolepsy experience only one or two episodes of cataplexy a year, others have many such episodes each day.
“Cataplexy can have an extremely debilitating effect on persons who suffer from narcolepsy,” said John Bullion, CEO and chairman of Minneapolis-based Orphan Medical Inc., a company that has researched narcolepsy and cataplexy extensively.
“Imagine not being able to control where or when you might suddenly fall down and you’ll have some idea as to just how dramatically narcolepsy can impact the lives of those who are affected by the disorder.”
More Than a Nuisance
Individuals with narcolepsy can fall asleep without warning, at inappropriate times and places. You might, for example, suddenly doze off while working or talking with friends. Depending on the severity of the condition, narcolepsy sufferers may sleep for just a few minutes or up to a half-hour before awakening.
Other narcolepsy signs and symptoms can include:
- Hypnagogic hallucinations, which are extremely vivid, often scary dreams.
- Automatic behavior, in which familiar or routine tasks are performed without later memory of such events.
- Sleep paralysis, the brief inability to move or speak when falling asleep or waking up.
Such episodes are usually brief — lasting no more than 10 minutes — but they can be frightening.
Why Does This Happen?
While the exact causes of narcolepsy are unknown, many scientists believe that individuals with the disorder may have imbalances in certain brain chemicals that help regulate sleep. Normally, the process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep, a time in which your brain waves slow down considerably. After an hour or two of NREM sleep, brain activity picks up again and rapid eye movement (REM) sleep begins, a time of deep sleep when most dreaming occurs.
Narcolepsy sufferers, however, can suddenly and at abnormal times fall into deep REM sleep without first experiencing NREM sleep. Individuals with narcolepsy can experience certain aspects of REM sleep that should normally occur only during deep sleep — such as sudden lack of muscle control, sleep paralysis and vivid dreams.
Can It Be Cured?
Narcolepsy is a chronic condition, so symptoms usually don’t go away entirely. But doctors can suggest lifestyle changes and prescribe certain medications to help manage the symptoms of the condition:
Stimulants, which help people with narcolepsy stay awake during the day, have long been a primary treatment for narcolepsy. However, such medications may also be addictive and can cause side effects such as nervousness and heart palpitations.
Antidepressants can help suppress REM sleep, which may limit narcolepsy symptoms including cataplexy, hypnagogic hallucinations and sleep paralysis. Sodium oxybate, a prescription medication, is used to help improve nighttime sleep.
Studies have shown that the drug can dramatically reduce incidences of cataplexy in a large percentage of narcolepsy patients. It can also help reduce the occurrence of sleep paralysis and hypnagogic hallucinations.
Lifestyle modifications can also be important in managing the symptoms of narcolepsy. Patients are often encouraged to take steps such as setting a regular sleep pattern, scheduling naps of 10-15 minutes each day and exercising regularly. Avoiding substances that can impair the ability to sleep deeply, such as caffeine, nicotine and alcohol, may also aid in reducing symptoms.
Find Out More
If you experience excessive daytime sleepiness that you can’t control or think you may be suffering from other symptoms of narcolepsy, see your doctor. Because its symptoms are sometimes associated with other disorders, narcolepsy can sometimes be difficult to diagnose.
You may want to consider asking your doctor to refer you to a sleep specialist for additional studies and evaluation. Trained sleep specialists can perform an in-depth analysis to properly diagnose any sleep disorder you might have and help determine your best treatment options.
To learn more about narcolepsy and potential treatment options available today, visit the National Sleep Foundation’s Web site at www.sleepfoundation.org, the Narcolepsy Network’s Web site at www.narcolepsynetwork.org, or Orphan Medical’s home page at www.orphan.com.
Courtesy of ARA Content