Narcolepsy

The desire for frequent naps may not sound like a serious illness. Most of us have experienced days and whole time periods where we feel almost uncontrollably sleepy. People who are unaware of the disabling symptoms of this neurological disorder often joke about narcolepsy.

These symptoms often emerge during the teens or early twenties where one of the hardest aspects for undiagnosed sufferers is the fact that the sleep urges are genuinely uncontrollable.

Non-pathological sleep urges will respond to self-control. This is one of the most debilitating aspects of the illness: the lack of recognition that there is a very real problem.

People are uncomfortable with presenting uncontrollable fatigue as the possible symptom of illness and so help is typically not sought for several years. The Stanford School of Medicine reports that the average time between symptom onset and diagnosis is a grueling 14 years with most narcoleptic patients as yet undiagnosed and therefore untreated.

For the one in one thousand American people who suffer from narcolepsy, this is an extraordinarily long time to suffer severe symptoms without diagnosis and treatment. Both men and women of all races are susceptible to this disease whose victims equal those of other neurological disorders like multiple sclerosis.

It is thought that the disorder may have a hereditary aspect to it that may or may not be triggered by viral and bacterial agents, accidents, illness, stress, hormonal changes or drug usage.

Narcolepsy is a neurological disorder that researchers associate with the absence of a particular neurotransmitter that normally produces hypocretin peptide, which is essential for the sleep-wake cycle in humans.

The disorder is directly related to the abnormal behavior of the REM function in sleep and medical researchers sometimes refer to the symptoms as the  "pathological equivalents of REM sleep".

The most obvious symptom of narcolepsy is what is known as Excessive Daytime Sleepiness (EDS). This may occur with or without warning and generally last for a few seconds to several minutes. In rare cases episodes may extend to an hour or longer. Also present is a more generalized feeling of constant drowsiness as a direct result of the abnormal REM sleep characteristic of this condition.

Cataplexy is another major symptom of the illness. It is an important aid for diagnosis as it is the only one that is unique to narcolepsy. This pathological equivalent of REM sleep causes the sudden loss of voluntary muscle control usually triggered by emotions like laughter, surprise, anger or fear. The patient may buckle at the knees or the head may drop and the jaws slacken.

Two other common narcolepsy symptoms are sleep paralysis and the vivid and unreal hallucinations that are associated with that condition.

Early diagnosis is a key element in a prognosis that has more to do with treatment than it does with cure, as one has not yet been discovered. The good news is that Narcolepsy is not degenerative and the typical pattern of the disease features an early onset followed by a lessening of intensity after age 60.

Early diagnosis is critical. Knowing that your condition is the result of a neurological malfunction is easier to live with than the belief that your life is out of control and you are unable to cope. Knowledge and awareness are two very important tools in the treatment of the disorder and they help to stem the development of secondary symptoms like fatigue, depression and low self-esteem.

Treatment for the condition includes a combination of medications and behavioral strategies. According to the national non-profit organization, Narcolepsy Network, the principal aim of treatment is "to increase day time alertness and to lessen recurring cataplexy".

Central nervous system stimulants like Ritalin and Dexedrine are cautiously administered to deal with EDS while certain tricyclic antidepressants and serotonin reuptake inhibitors have been used to help with cataplexy and other REM symptoms.

Behavioral strategies include scheduled napping routines aimed at reducing daytime drowsiness. Alternative herbal remedies and treatments may also be effective in the treatment of symptoms.

The clinical diagnosis of narcolepsy requires the presence of EDS accompanied by cataplexy. A laboratory test called a polysomnogam (PSG) at an overnight sleep disorders center can confirm the presence of EDS as well as other symptoms of pathological REM behavior.

This is typically followed by a Multiple Sleep Latency Test to measure sleep onset and the presence of REM sleep. Normal people experience an initial sleep period of up to 90 minutes preceding REM sleep. People with narcolepsy experience REM sleep almost immediately sometimes even prior to the closing down of awareness. It is this circumstance that causes the vivid hallucinations that are a symptom of this disabling disorder.