Narcolepsy is a rare long-term brain disorder that causes sudden uncontrollable episodes of deep sleep as a result find it difficult to stay awake, patient with this condition does not need extra hours of sleep, one just can’t control when they fall asleep.
The brain is unable to regulate sleeping and waking patterns normally.
The DSM-5 defines narcolepsy as recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. These must have been occurring at least three times per week over the past 3 months. At least one of the following must also be present:
Episodes of cataplexy (sudden muscular weakness triggered by strong emotions such as laughter, anger and surprise)-occurring at least a few times per month
Hypocretin deficiency
REM sleep latency ≤ 15 minutes, or a mean sleep latency ≤ 8 minutes and two or more sleep-onset REM periods
Symptoms include excessive daytime sleepiness (at least for three months), cataplexy (sudden muscular weakness triggered by strong emotions such as laughter, anger and surprise), hallucinations, sleep paralysis and is rare in young children.
This condition can occur any anytime generally peaking between ages 15-30 , but once one has the condition it is present for life.
Men and women are affected equally.
During the night, healthy people normally progress through several stages of sleep.
Normal sleep consists of three stages of NREM (non- rapid eye movement) sleep at first, followed by a short period of REM (rapid eye movement sleep), with NREM and REM sleep then alternating throughout the night. During the latter part of the night, REM sleep is more dominant.
During REM sleep, your brain waves resemble those of an awake person, visual dreams occur and muscle tone is slack.
In narcolepsy, the brain-wave pattern can skip some or all of the other sleep stages it can significantly affect sleep cycles and decrease the quality of sleep, one may wake several times during the night.
One may also experience REM sleep much earlier than normal after falling asleep, causing the person to move from the awake state immediately to REM sleep, or to awaken directly from the REM sleep stage as well as one may experience effects of REM sleep, such as dreaming and paralysis, while you’re still conscious.
Narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy), which can be triggered by strong emotion, there are two forms:
Narcolepsy type 1
Narcolepsy that occurs with cataplexy and a positive MSLT result or sleepiness plus hypocretin deficiency.
Some persons with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes daily.
Narcolepsy type 2
Narcolepsy that occurs without cataplexy
Sleepiness and a positive MSLT and the absence of type 1 markers.
Hypersomnia and/or MSLT findings must not be better explained by another sleep, neurologic, mental, or medical condition or by medicine or substance use.
Sleep studies are an essential part of the evaluation of patients with possible narcolepsy.
The combination of overnight polysomnography followed by MSLT can provide strongly suggestive evidence of narcolepsy while excluding other sleep disorders.
HLA typing may provide collateral data but is more useful for excluding the diagnosis by documenting that the patient does not have either DQB1*0602 or DQA1*0602.
Cause
Unknown
Weak immune condition where the body weak immune system attacks the brain stimulating protein (orexin, hypocretin)
Shortage of a brain-stimulating protein (orexin,hypocretin)- causing person to fall on the floor without losing consciousness.
Muscle weakness normally after a period of emotion , i.e excitement, laughing, anger, surprise?
Jaw pain and/or difficulty chewing, swallowing talking and/or slurred speech and/or difficulty in opening the mouth and /or difficult to eat?
Eye(s)/eyelid muscles drooping causing blurred or double vision, any visual problems,colour blindness, double vision,vision loss, difficulty focusing and/or pain behind eye (One or both eyes can be affected)?
Hand weakness and/or difficulty and pain when writing or gripping small objects?
Tilting head to one side regularly and/or head slumping?
Tingling sensation in one or both legs?
Movement of legs with no control while sleeping or a awake?
Difficulty using arms, body and legs, lack of stamina, walking difficulties?
Blurred vision?
General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
Hot flushes and/or flushed face and/or warm skin and/or slight sweating, and/or dislike to heat?
Difficulty sleeping and/or lack of sleep?
Falling asleep suddenly and without warning including daytime sleepiness (sleeping attack)?
Temporary inability to move and/or talk while falling asleep or awakening?
Dreamlike images that are seen during the awake state instead of during sleep these often-frightening visions are seen just as the person is falling asleep or waking up?
Complications /Information to beware of/General tips:
This condition can lead to:
Impaired performance at work and school
Difficulty in social relationships (some person do not socialise to avoid emotion, so they don’t experience muscle weakness)
Excessive daytime sleepiness can be disabling and may greatly diminish a person’s quality of life
Visual disturbances and headaches
Hallucinations – seeing or hearing things that aren’t real, particularly when going to sleep or waking up (a presence in the bedroom is the most commonly reported hallucination)
Memory problems
Restless sleep (hot flushes, waking up frequently, having vivid nightmares, or physically acting out dreams)
Automatic behaviour (continuing with an activity without having any recollection of it afterwards)
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Narcolepsy in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
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