Narcolepsy is a disease that conditions social relationships, work and/or academic performance. Understand.
THE narcolepsy it is a chronic sleep disorder that can cause great disability and about which there is still a great lack of knowledge. It is a neurological disease; a type of hypersomnia. Let’s clarify the causes, symptoms and treatments available for this problem.
What is narcolepsy?
Narcolepsy is a neurological disease that is characterized by excessive and uncontrollable sleepiness during the day, and episodes of sudden sleep (attacks of irresistible sleep) may occur.
It is an uncommon pathology, which affects about 47 people out of every 100,000 inhabitants in Europe. It affects men and women equally and usually appears in adolescence or young adults. However, it can appear at any age.
It is an extremely disabling disease that greatly affects the quality of life of patients, affecting their professional, social and family activities. Compounding the natural incapacity that narcolepsy causes, there is still a great stigma related to this disorder, with patients often being wrongly labeled lazy and depressed.
People close to the patient with narcolepsy should be informed about the existence of the pathology and its symptoms. Employers should also be aware of the specifics of this disease, as frequent naps can interfere with working hours.
What are the symptoms of narcolepsy?
People suffering from this disease experience some of the following symptoms.
- Recurrent periods with an uncontrollable need to sleep, which occur during the day: Excessive drowsiness can occur at inappropriate times, such as during a conversation, a meal or while driving (so it may be wise to avoid driving), although it is more common to occur during monotonous or repetitive activities.
- Cataplexy episodes: episodes of sudden and involuntary loss of muscle tone (strength), which causes a kind of paralysis of some muscles. Patients may fall to the ground during these episodes. Mild and partial cataplexy attacks (for example, loss of strength in the hands) are not very serious. The most severe attacks of cataplexy can lead to dangerous situations (eg falling when crossing the road).
- Hallucinations when waking up or falling asleep: some patients may see images, hear sounds and experience unrealistic sensations.
- Sleep paralysis: patient’s inability to move, especially after waking up. This symptom only lasts for a few minutes.
What are the causes?
Not all the causes that lead to the appearance of this disease are known yet, but some important hypotheses have been put forward. See below.
- There is an associated genetic predisposition: first-degree relatives of patients with narcolepsy have a 1% to 2% risk of developing the disease.
- Narcolepsy appears to be associated with deficiency of a substance in the brain (called hypocretin/orexin) and a change in the normal distribution of sleep phases.
- In rarer cases, narcolepsy can be caused by tumors, strokes, head injuries, multiple sclerosis, Parkinson’s diseasesarcoidosis or other lesions in the regions of the brain that control sleep.
How is the diagnosis made?
The patient’s complaints, together with the symptoms of excessive sleepiness and cataplexy, are crucial for the diagnosis to be made. However, it is also recommended to perform a sleep study over the course of one night (polysomnography).
This study makes it possible to exclude other common causes of sleepiness, such as obstructive sleep apnea (sleep-related respiratory disease).
Another recommended exam is the multiple latency test, which allows you to assess how easy it is for the person to fall asleep, even after a night’s sleep, and the electroencephalogram, which records the electrical activity of the brain. This test consists of taking 4/5 naps of 20 minutes, every 2 hours, and allows you to measure how quickly you fall asleep and if there is drowsiness.
There are other specific tests that can be performed to confirm the diagnosis, the pertinence of which should be discussed with the doctor treating the patient.
What is the treatment for this sleep disorder?
Although this is a chronic disease, there are several treatments available to lessen and alleviate its symptoms.
The symptoms of narcolepsy can be alleviated with medication, the most common of which are stimulants, antidepressants and hypnotics.
In addition to pharmacological treatment, changing the patient’s lifestyle can be decisive:
- practice is recommended physical activity;
- there must be a good sleep routine – established schedules and sleep the appropriate number of hours;
- keep the dark room and with a nice weather;
- to do relaxing activitiessuch as reading or meditating;
- you stimulant foods and drinks should be avoided before bedtime;
- do not smoke;
- accomplish short naps during the day – 2 or 3 naps a day, of about 10/20 minutes. These naps help reduce drowsiness.
Much research into this disease continues to be carried out, so it is natural that new and better treatments may emerge in the near future.
If you suspect you may have narcolepsy, please do not hesitate to contact your GP, explain all the symptoms and discuss referral to a doctor experienced in sleep medicine.