Narcolepsy

A narcoleptic teenager waiting for cataplexy to pass

Narcolepsy is a sleep disorder. It happens when the nervous system does not work properly. People with narcolepsy tend to fall asleep during the daytime, even if they do not want to. Very often, they do not sleep well at night, and during the day they fall asleep uncontrollably. There are two different forms. The classical (more common) form is the one with muscle failure (called cataplexy). There is also a less common form without cataplexy.

Narcolepsy affects the way the nerves work. It is not a mental illness, or caused by psychological problems. It is estimated that between 25 and 50 people, per 100,000 suffer from narcolepsy. Very few cases are reported.

The first description was given in 1877.[1] Jean-Baptiste Gélineau, a military doctor, first used the name narcolepsy in 1880.[2][3]

In certain countries, people diagnosed with narcolepsy may not drive a car.

Symptoms

Things that people with narcolepsy may experience:

  • Excessive Daytime Sleepiness: Being very tired during the day even after a full night of sleep. This is the most common symptom of narcolepsy.
  • Cataplexy: Suddenly having a muscle fail them. This can range from a slight weakness, and problems speaking clearly, to completely collapsing.
  • Sleep paralysis: When waking up, people are paralysed (unable to move) for a certain time. The paralysis eventually goes away.
  • Hallucinations, while falling asleep or waking up.
  • Automatic behaviour: People continue doing things while they are asleep. Later on they do not remember.

Hallucinations, sleep paralysis, and automatic behaviour can also occur in people who are not narcoleptics. This usually happens when people are very tired, and have not slept for a long time.

Causes

Some scientists think that narcolepsy is caused by a lack of hypocretin. Hypocretin is a chemical in the brain which wakes people up and regulates sleep. However, It is not yet known for sure what causes it. Quite a few sufferers also have another family member with the disease. This may point to the fact that some of the things that cause the disease may be passed from the parents to the children through genes.

Treatments

There are certain drugs that can treat the effects of narcolepsy. They can not treat the cause, since it is unknown. In general those drugs are special kinds of stimulants. General stimulants, like coffee, usually do not help. Some strategies for treatment do not rely on drugs:

  • Adapting the behaviour to avoid situations that trigger daytime sleep; this is generally known as Coping. It also involves changing the daytime rhythm to accommodate the sleeping phases
  • Sleep hygiene

References

  1. (German) C Westphal « Eigentümliche mit Einschlafen verbundene Anfälle » Arch Psychiatr Nervenkr. 1877;7;631–635
  2. (in French) Gélineau, Jean-Baptiste-Edouard: De la narcolepsie. Gazette des Hôpitaux 53: 626-8; 54: 635-7 (1880)
  3. Schenck, C et al.: English Translations Of The First Clinical Reports On Narcolepsy And Cataplexy By Westphal And Gélineau In The Late 19th Century, With Commentary, Journal of Clinical Sleep Medicine, Vol. 3, No. 3: 301-311 (2007)

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