What is narcolepsy?
Narcolepsy is the development of a long-term brain condition that results in a person falling asleep suddenly. It is a rare condition that impacts the ability of the brain to manage the sleep-wake cycle. This can significantly impact a person’s day-to-day life as they will constantly feel tired and unable to stay awake.
Symptoms
The symptoms experienced by those with narcolepsy differs from one person to the next. It also affects the regularity of the symptoms where some people will experience them more frequently than others.
Excessive daytime sleepiness
This is, in most cases, the first sign of narcolepsy. It causes a person to constantly feel tired and drowsy throughout the day which can have a serious impact on their day. This is because they will spend the day struggling to stay awake which means that it will affect their work or concentration levels at school.
Sleep attacks
This is where a person will suddenly fall asleep without a warning or any control. It is something that can occur at any time of the day. The duration that they stay asleep is something that will also depend on each person.
Cataplexy
This affects a person by causing them to temporarily and suddenly lose control of their muscles or causes them to weaken. It is often triggered by experiencing strong positive or negative emotions such as surprise, anger or joy.
Cataplexy can be displayed in several different ways, such as:
- Causing jaw to drop
- Slumping of the head
- Slurred speech
- Quivering lips
- Knees buckling up
Sleep paralysis
For some people with narcolepsy, they may experience what is called sleep paralysis. This is where a person will temporarily lose the ability to talk or move when they are either falling asleep or waking up.
Further symptoms include:
- Vivid dreams/nightmares disrupting sleep
- Experiencing hallucinations
- Headaches
- Problems with memory
- Depression
- Weight gain
- Exhibiting automatic behaviour, carrying out activities without having memory of it after
Causes
It is believed that the development of narcolepsy is caused by a loss of neurons in the brain that produces a neurotransmitter called hypocretin. This plays a vital role in helping to regulate sleep, mood, motivation and alertness. In a normal case the body releases antibodies to fight diseases and toxins, however, for some people with narcolepsy their immune system mistakenly attacks the hypocretin producing part of the brain.
There are also several risk factors that can increase the risk of someone developing narcolepsy or causing a problem with their immune system. These include:
- A genetic predisposition to it, inheriting a faulty gene
- Being given a flu vaccine called Pandemrix
- Significant psychological stress
- Hormonal changes
Secondary narcolepsy
This is caused by damage to the part of the brain that produces hypocretin. It can develop as a result of:
- A brain tumour
- A head injury
- Multiple sclerosis
- Encephalitis
Diagnosis
The first step is to visit your local GP who will ask about the symptoms you have been experiencing, your sleeping habits, your family medical history as well as your own. They will also carry out additional tests to rule out the possibility that these symptoms are being caused by another condition. The GP will then hand you a questionnaire to fill out called the Epworth sleepiness scale which will ask you to rank the chances of you falling asleep while carrying out different activities. If the score is concerning they will refer you to a specialist Sleep Centre. At this centre they will conduct a sleep study which will allow them to monitor the activity of the brain while you sleep. They will also perform a sleep latency test to measure the time it takes for you to fall asleep. A person with narcolepsy will fall asleep very quickly.
Treatment available
The treatment of narcolepsy involves a dual approach of medication and making lifestyle changes. This will help to make the symptoms more manageable whilst also limiting the impact it has on your life.
Lifestyle changes
There are several lifestyle changes that can be implemented to help you sleep at night and reduce the impact that excessive daytime sleepiness has on your day. They can include:
- Avoiding caffeine before bed as this may make it difficult for you to fall asleep
- Can try different things to help you relax and mentally unwind from a long and difficult day such as, taking a warm bath before bed
- Get into the habit of a sleeping routine where you go to bed and wake up at the same time
- Having an active lifestyle, do some exercise regularly but not before bed
- Eating a healthy, well-balanced diet
- Avoiding having large meals as they can make you feel sleepy
- Have a power nap, space them out throughout the day. You can meet with a specialist or GP and look at what makes up your day to find a time where you can fit in a quick nap
Medication
The medication that is prescribed is something that has to be discussed with all stakeholders so that they are able to find the type of treatment that is suitable for you. This will also involve weighing up the potential side effects of each medication along with the benefits.
A form of medication called stimulants can be prescribed to help reduce the impact of excessive daytime sleepiness. This is because they work by stimulating the central nervous system which can increase alertness and stop you from sleeping. The side effects of this type of medication includes headaches, insomnia and irritability, to name a few.
There are also some medications called antidepressants that can help with the treatment of cataplexy. This means that they can be used to help with a loss of muscle control. However, some of the common side effects with antidepressants include insomnia, dizziness and feeling anxious.
Mental health
This condition can have an impact on other aspects of your mental health like your mood, anxiety levels and, in some cases, depression. Therefore, it is important to be open about your feelings and what you are going through so you are able to get help. This could be by talking to a friend or family member, speaking to your GP or contacting a helpline.
