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Sleep Issue #2: Narcolepsy

In our short series on sleep related disorders its time to turn our attention to narcolepsy which is not really the opposite of insomnia but it sure does have that initial appearance of being so. Narcolepsy is more neurologically based than are most cases of insomnia, impacting about one in three Americans each year. Ultimately while there are treatments to help there is no cure. Narcolepsy is a major disturbance of ones sleep/wake cycle, leading to frequent periods of unpredictable sleep lasting anywhere from a few seconds to a few minutes. Since the primary symptom of narcolepsy is falling asleep while engaged in anything from a conversation with a friend to driving, there are significant implications for ones daily routine.

Those with narcolepsy do not, somewhat surprisingly, get more sleep those without the disorder. On the whole they average about the same amount of sleep as an individual who does not have a sleep disorder. Also interestingly enough you can also have other sleep disorders in addition to narcolepsy. A handy way to think of it is an inability to sleep when you want to and rather the full taking over by your brain of when you’ll fall asleep.

According to the National Institute of Neurology and Stroke, first symptoms for narcolepsy generally emerge between the ages of 10 and 25. While there is a slight genetic component it this is not considered to be statistically significant. (National Sleep Foundation)

Narcoleptics are generally more likely to have accidents and have more difficulty with interpersonal relationships, which frequently have the expectation of mutual participation.

What are the symptoms?

Excessive daytime sleepiness tops the list. This isn’t “I am really tired and want to take nap” type sleep; this is hardcore, can’t stay awake even when you’re up and about sleepiness.

Cataplexy, which I’ll let the National Sleep Foundation describe: a sudden loss of muscle tone, usually triggered by emotional stimuli such as laughter, surprise, or anger. It may involve all muscles and result in collapse. It may only affect certain muscle groups and result in slurred speech, buckling of the knees, or weakness in the arms. Consciousness is maintained throughout the episode but the patient is usually unable to speak.

Hypnagogic hallucinations, which occur either just before sleep or as one is emerging from sleep.

Disrupted nighttime sleep.

Narcolepsy has significant implications for all aspects of one’s life. Professionally someone who struggles with narcolepsy may be seen as lazy, uninterested or perhaps even not being able to manage their social life, as ‘evidenced’ by their lack of capacity to be alert on the job. Relationships, especially new ones, can and do suffer when one partner is falling asleep or unable to engage in daily activities without fear of falling asleep.

While there are a number of medication options to address the symptoms there is nothing yet to address the underlying problem, which is generally thought to be a deficiency in the neuro-chemical hypocretin.

In terms of lifestyle options we return once again to the often-cited suggestion to exercise in addition to keeping a regular schedule, avoiding alcohol and nicotine as well as taking several short naps throughout the course of the day as well as avoiding allergy and cold medications as those tend to make you feel sleepy.

While it’s hard to imagine how to have a Thriving, productive lifestyle with such a debilitating condition one might suggest that a great deal of how one manages is all about the attitude you meet it with. Want help with narcolepsy? I bet there’s a neurologist out there for you! Want help with your attitude around it? I’m happy to be of assistance there! Give a call! Drop a note!

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