Recognizing Cataplexy and Narcolepsy Symptoms

December 6, 2011 By Leave a Comment

The symptom, Cataplexy and Narcolepsy are often experienced together. Narcolepsy is a chronic sleep disorder characterized primarily by EDS or excessive daily sleepiness. Narcolepsy affects just a small percentage of the population. About 60 to 70 percent, of patients with Narcolepsy show symptoms of cataplexy.

Passing quickly from a state of wakefulness into REM or rapid eye movement sleep or experiencing distinct REM events during the day are considered symptoms of a neurological disorder. Narcolepsy’s cause and origin is still largely unknown, although data from studies conducted on humans and animals suggest that cataplexy and narcolepsy are associated with hypocretin system abnormalities and the loss of active neurons in a person’s hypothalamus.

Cataplexy and Narcolepsy Signs

Usually, excessive daytime sleepiness is the first symptom to appear. It’s characterised by several episodes of sudden sleepiness, lapses and naps during daytime. Although these episodes are most likely to take place in ordinary situations, it may also occur in very unusual situations like when one is eating, walking or even driving; leading to uncontrollable and sudden sleep attacks. The most common symptom of narcolepsy is cataplexy. Generally, it is observed as a dramatic loss of muscle control and tone triggered by sudden strong emotions. Usually, these emotions are positive: surprise, pride, and laughter; however, it may also be negative like anger. Stress, sleepiness, physical fatigue can stimulate factors that can worsen Cataplexy and make the symptom more common.

Cataplexy as a sign of Narcolepsy may be localised, or in worse cases, progressively affect all skeletal muscles; causing a patient to completely collapse on the ground. Commonly affected areas include the face, neck and knees. Fortunately, respiratory muscles cannot be affected. Since Cataplexy as a Narcolepsy symptom can also come in milder forms varying in severity and frequency, diagnosis is sometimes difficult. Mild feelings of weakness, being the sole clinical symptom, may completely pass unnoticed. Probing patients about his/her family members’ experiences involving head drops, sagging facial muscles, weakness of the jaw, slurred speech and knee buckling, is relevant. These narcolepsy and cataplexy symptoms can also vary in duration; ranging from a couple of seconds to minutes. Complete recovery always follows if the person doesn’t injure themselves while affected.

Other Narcolepsy symptoms experienced primarily at night are described in figure 01-02a:

Figure 01-02a – Other Narcolepsy Symptoms Accompanying Cataplexy

Nighttime Cataplexy and Narcolepsy Symptoms

Symptom

Brief Description

Disturbed Nocturnal Sleep

When this symptom is present, it has the tendency to improve in time. It is characterized by the inability or difficulty in having a quality sleep at nighttime, somewhat akin to insomnia. This narcolepsy and cataplexy symptom was underestimated not so long ago, although it is now recognized by most doctors as a major indication of the disorder in patients.

 

Hypnagogic  Hallucinations

This narcolepsy symptom is characterized by vivid hallucinations that may be auditory, tactile, visual or even as multisensory events. These may contain dreamlike elements and occur in the transition between the state of being asleep and wakefulness. The other way around, hallucinations while awake, are referred to as hypnopompic hallucinations.

 

Sleep Paralysis

This narcolepsy sign appears as the lack of movement capability during the same transitions as when the hypnagogic hallucinations occur.

 

 

Effect on a Person’s Life

Narcolepsy symptoms and cataplexy have a great impact on a patient’s quality of life. In the United Kingdom, the biggest problem for patients lies in their limited roles caused by physical difficulties. The time that affected people spend on their work is severely limited by the Narcolepsy signs and cataplexy. Even activities of leisure are shortened since patients usually avoid possible embarrassing situations. Narcolepsy and cataplexy also affect the schooling of many patients, hindering concentration; even making simple daily tasks like cleaning, cooking and watching the children very difficult. Furthermore, it’s been discovered that the accumulation of concern and worry due to narcolepsy and cataplexy can prove harmful to emotional health: greater than 50 percent of all subjects suffering from the disorder are suffering from at least a mild case of depression.

Predisposing Factors and Epidemiology

Narcolepsy’s prevalence is approximately an estimated to be 1:2000 of the American population. It may occur at any age, although it usually happens to people between ages 10 and 25. Also, there are slightly more men affected than women (approximately 1.6/1 relative risk). About 1 to 4 percent of the cases involving narcolepsy and cataplexy have a family member that is also affected. Narcolepsy’s running in families typically shows autosomal-dominant inheritance pattern. Although majority of narcoleptics show non-familial or sporadic narcolepsy, genetic factors remain important. A patient’s first degree relative faces a 1 to 2 percent risk of getting narcolepsy and cataplexy himself.

A main factor to narcolepsy and cataplexy comes from biological factors; according to studies, 25 to 31 percent of all monozygotic twins are prone to the disorder. Also, 90 percent of the patients with narcolepsy and cataplexy show undetectable or low concentrations of hypocretin-1-orexin A in their cerebrospinal fluid. Although this feature is generally specific to narcolepsy and cataplexy, it has also been observed in other CNS (central nervous system) pathologies like Guillain-Barre syndrome.

Recent decades of study have allowed scientist to make progress in understanding the narcolepsy symptoms and cataplexy.  They have identified genes strongly associated with the disorder.  Variant genes in the region of chromosome 6 referred to as HLA complex are strongly although not always, associated with Narcolepsy. This region contains related genes believed to regulate immune function.  It is also known that many of the genetic differences believed to be associated with narcolepsy and cataplexy are not sufficient to cause the disorder. There are many other genes besides those in the HLA complex may contribute to the development of narcolepsy.  Groups of neurons (brain cells) in the brain stem, thalamus, central brain and hypothalamus, interact to control sleep. Many different genes control these neurons’ activity making any of the genes capable of making one develop narcolepsy and cataplexy. Doctors can however look for marked genetic variations associated in narcoleptics to help confirm the diagnosis of narcolepsy. Scientists study narcolepsy in dogs as well and have identified a mutation that causes the disorder in Dobermans.

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Even Mild Narcolepsy Symptoms Should Be Treated

December 6, 2011 By 1 Comment

Mild narcolepsy symptoms, unlike severe symptoms of the chronic sleep disorder, can be effectively treated in a variety of ways. Lifestyle treatments of mild narcolepsy symptoms include a schedule of 3 or more napping/sleeping sessions each day. Narcoleptics must also avoid drinking alcohol and heavy meals since these can interfere with the sleeping schedule.

Most people experiencing mild narcolepsy symptoms may not require medication, and can maintain enough alertness to perform all their necessary daily tasks by just following the mentioned sleeping schedule. Doctors show conflicting opinions on whether these scheduled naps are necessary when a patient responds favourably to medications.

The approved medications for narcolepsy mild symptoms target cataplexy and sleepiness. Stimulants can be used to neutralize excessive daytime sleepiness; antidepressants and other similar compounds, on the other hand, target cataplexy. Cataplexy as a symptom of Narcolepsy indicates a severe case of Narcolepsy as the risk of injury is added to each activity. The FDA approved two specific drugs for treating narcolepsy and its mild symptoms and these two are now first-line treatments. They are Modafinil (Provigil) which is for uncontrollable and excessive daytime sleepiness, and sodium oxybate (Xyrem) to combat cataplexy.  Often doctors take no chances even with patients who only exhibit mild symptoms of Narcolepsy, and treat them for cataplexy, although it may not be chronically affecting them.  A sudden loss of muscle control due to a episode of cataplexy can leave people seriously injured depending on when the episode occurs.

Medications for Mild Symptoms of Narcolepsy

Provigil or Modafinil – is a drug that’s used to alleviate the mild narcolepsy symptom, excessive sleepiness, and other similar symptoms characteristic to other sleeping disorders. It has mainly replaced Ritalin (methylphenidate) and other similar stimulants as a treatment for narcoleptic sleepiness. However, patients who switch from methylphenidate to Modafinil tend to encounter a few problems once they start tapering off from the stimulant dose gradually.

Modafinil can help patients suffering from mild narcolepsy symptoms stay awake during daytime. While only a few actually experience the wakefulness of a normal person, those who take modafinil are likely to improve their capacity to stay awake and reduce the number of sleep attacks. Unfortunately, the medicine has not yet been verified to be safe for pregnant women; the benefits and risks should be wisely weighed for any patient. Figure 01-03a shows the benefits and risks of taking Modafinil for sufferers of narcolepsy symptoms.  Although extensive, the majority of the side effects are easily treated or uncommon.  Be sure to take a look at the benefits and side effects of any drug you take.  Narcoleptics, even those with mild narcolepsy symptoms, are often prescribed drugs. Those diagnosed narcoleptic should be prepared to deal with common moderate side effects and report on any major side effects they experience.

Figure 01-03a – Modafinil’s Benefits and Risks

Benefits

Possible Side Effects
  • It can be proven that Modafinil doesn’t affect the body’s hormones that play large roles in sleeping. Taking Modafinil will not affect daytime naps or nighttime sleep.  However it does ease mild Narcolepsy symptoms and act like a stimulant, making narcoleptics more alert during their waking hours.
  • Unlike stimulants it is not known to cause anxiety in consumers.
  • Unlike stimulants commonly prescribed for this illness, people with mild symptoms of narcolepsy experience near full relief from daytime sleepiness and do not crash like they would on a stimulant, when the drug wears off.
  • There is less potential to abuse Modafinil than commonly prescribed stimulants.

 
  • Headaches
  • Congestion of throat and nose
  • Dry mouth
  • Back pain
  • Nausea
  • Dizziness
  • Anxiety and nervousness
  • Difficulty falling asleep or insomnia
  • Decrease in the effectiveness of the pill. Women taking Modafinil may have to switch to another birth control method.
  • Mania, anxiety, suicidal ideation, hallucinations and other psychiatric effects can occur. Physicians should be cautious in prescribing the drug to patients experiencing mild narcolepsy symptoms and at the same time having histories of depression, mania or psychosis.
  • Serious, although rare, skin reactions like Steven-Johnson syndrome occur in patients experiencing mild narcolepsy symptoms.  Patients should discontinue taking modafinil immediately and contact their physicians right away if they develop a serious rash.
  • Modafinil may be habit forming so patients are usually taken of this drug slowly.
  • Modafinil is not yet approved for children; only for adults.

NuVigil (Armodafinil) - a relatively newer drug that’s almost identical to Modafinil, has also been prescribed as a treatment for narcolepsy and its mild symptoms. Clinical trials show that Armodafinil improves wakefulness, attention, memory and fatigue in persons with mild narcolepsy symptoms.

Stimulants –Because of the dangers of these drugs stimulants are not usually prescribed for mild narcolepsy symptoms any more. However many stimulants and even sedatives are used to treat sever daytime sleepiness and interrupted REM sleep at night if Narcolepsy affect a patient’s life dramatically.

Stimulants commonly prescribed include methylphenidate (Ritalin), Methamphetamine (Desoxyn), and Dextroamphetamine (Dexedrine). Dextroamphetamine and methylpheidate commonly last for two to five hours; both used to be standard drugs for treatment of excessive daytime sleepiness. These drugs are often very effective for people who are suffering more intense symptoms.  Mild Narcolepsy symptoms are often be treated with daytime naps that are regularly scheduled and by making room for more sleep to help ensure we get good night’s sleep. Stimulants can interfere with both of these treatment plans.

Whether dealing with severe or mild narcolepsy symptoms the medications themselves can become less effective with continuous use.  For this reason patients are often put on a schedule where they are on and off drugs.  On days when patients are not using their medication they may experience an increase in mild narcolepsy symptoms.  For this reason they should take special care in performing activities such as walking, running, etc.  As anyone can see the treatment plans are not perfect.  Those suffering from this illness are often forced to cope with at least mild symptoms of narcolepsy on top of the side effects of the drugs they take to treat it.

All of this information is sometimes discouraging to people who experience mild symptoms of Narcolepsy.  People often do not want to admit to a doctor that they suffer from it because of the affects it can have on their life. For example many narcoleptics are not permitted to drive a car and are not able to obtain a driver’s license.  It is however important to start treating even mild symptoms of narcolepsy as close to the onset as possible.

Remember just because the signs and symptoms are minor doesn’t mean they cannot suddenly get worse.  That is the danger of untreated narcolepsy.  An attack of cataplexy (which occurs in 60% of narcoleptics) can occur suddenly and without warning causing injury to the patient and others.  These unfortunate realities can be quite depressing for those who are faced with severe or mild narcolepsy symptoms.

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Signs of Narcolepsy: Overview

December 5, 2011 By Leave a Comment

Narcolepsy is a strange neurological disorder with conditions of excessive sleepiness during the daytime; it is a condition that also causes muscle weakness. This disorder generally begins at the age of 15 to 25 years and can cause Cataplexy (muscle weakness), Hallucinations (vivid dreams occurring while asleep) and sleep paralysis (where the sufferer cannot move or speak, and which might last for few minutes after the sleep attack).

Narcolepsy Diagnosis

Narcolepsy is a rare and a complex neurological disorder that is commonly misdiagnosed. A doctor will assess the symptoms of this problem very easily by conducting certain laboratory tests as well as going through the patients’ history. A person who has this disorder can fall asleep frequently irrespective of the time and place.

Generally, an overnight polysomnogram is used for monitoring the person during the sleep and it also records the necessary details about the patient’s brain waves, eye movements, body position, heart rate, breathing or the muscle activity. A genetic blood test would also be taken if needed.

The multiple sleep latency test is usually taken from the patient in the day times. The other tests include Hypocretin test which tests the Hypocretin fluid present in the spinal cord using a lumbar puncture. When there are low levels of this fluid, people get Narcolepsy which promotes wakefulness.

It can be difficult to diagnose this condition if the signs and symptoms of Narcolepsy are very mild. At times, it might take even ten to fifteen years to diagnose since the symptoms get pronounced gradually. Thus, based on the patient’s family and medical history, laboratory test results, and by physical examination, the doctors could diagnose Narcolepsy in an individual.

Narcolepsy Risk Factors

The actual root cause of Narcolepsy is not known, however scientists have identified that it occurs by a genetic mutation, which results in abnormal sleeping patterns. The genetic cells control the brain chemicals that are responsible for sleeping cycles. Certain scientists proved that Narcolepsy occurs due to the presence of low levels of the Hypocretin (fluid that surrounds the spinal cord).

The Hypocretin fluid plays a major role in regulating the wakefulness and the sleeping patterns in an individual. Thus, there are numerous factors like hereditary, infections, brain injuries, auto immune disorders or low levels of histamine that contribute to interact between REM sleeping disturbances and the neurological dysfunction.

Many genetic factors largely contribute to the causes of Narcolepsy and around eight to ten percent of people having this disorder tend to have other victims in the family. However, it is not be the only factor but is usually combined with other immune problems. Sometimes even the environmental toxic substances like pesticides, weed killers and other chemicals contribute to the causes of Narcolepsy.

This neurological disorder affects both men and women, and usually the symptom starts to appear from the teenage but it’s quite rare to be found in children under five years of age. This disorder is considered to be a lifelong condition, but some narcoleptics can change their lifestyle with proper guidance and thus greatly improve the way that the condition presents in their day to day lives.

Narcolepsy Symptoms

Usually, the Narcolepsy disorder may be diagnosed at a very later stage with the symptoms such as cataplexy, hallucinations, sleep paralysis, micro sleep, and night time wakefulness, rapid entry into REM sleep and many other signs and symptoms.

The most common symptoms among them are cataplexy (muscle weakness) and extreme day time sleepiness. The patients affected with Narcolepsy tend to get these signs and symptoms when they experience deep emotional state of happiness, frustration, sadness or excitement. The symptoms may vary from person to person.

Cataplexy is a muscle weakness where there is a sudden loss of muscle tone in their body which is normally triggered by strong emotions. Hallucinations are vivid dreams that may be very sensual or frightening which occurs when they are awaken or at sleep.

Sleep Paralysis is a condition where the person is unable to move the body or unable to speak at the stage of awakening. The Micro sleep is a very short sleep that occurs less than five minutes when the person is involved in an activity.

Nighttime wakefulness is a condition where people are continuously awake the whole night, complete with fast heart rates and intense alertness. The Rapid entry into REM sleep is a condition where the person immediately reaches this stage once he falls asleep but usually it might take about ninety minutes for most of the people.

These symptoms might be either mild or even severe depending on the individual. There would be an automatic behavior of the persons affected with this disorder like falling asleep while eating or in the midst of any other activity.

Narcolepsy – Stages of the Disease

Usually, each patient affected by the Narcolepsy disorder has different symptoms that vary from person to person. The various stages involved in this disorder occur in various aspects of life. Most commonly, the physical well being of a person gets affected as he might unexpectedly fall asleep in the midst of activities like working, walking, driving, and cooking, which could be quite dangerous.

The mental health of a person is affected, which leads to depression, anxiety or stress. This can affect the social and professional relationships as well. One may think that the people affected by Narcolepsy are lazy by nature but this is not so. Due to extreme tiredness and sleepiness, impotency and low sex drive is often experienced by the victims of Narcolepsy. Even the memory and the attentive power is affected which results in forgetting things frequently.

Conclusion

There is no cure for the Narcolepsy disorder but the people affected by it can bring in some significant changes to their lifestyle and lead a better life. With proper medical help and guidance, patients can improve their alertness and can enjoy an active life by reducing their symptoms.

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Help For Identifying Narcolepsy Symptoms

December 4, 2011 By 1 Comment

Narcolepsy is a serious chronic sleep disorder occurring when the brain is unable to control the body’s regular sleep cycle. A person suffering from Narcolepsy symptoms tends to feel drowsy throughout the day and experiences sudden episodes of uncontrolled sleep. It may happen anytime, regardless of what is happening before the “sleep attack”.  Because the person can literally be doing anything and fall asleep suddenly the disorder can seriously affect a person’s daily life.  People with Narcolepsy often have their licences taken away and are not allowed to drive motor vehicles.

Narcolepsy is independent of gender, age or sex.  Often the first signs of the disorder are seen between the ages of 9 and 21. The severity of the disease may vary with age however Narcolepsy is a life long illness.

Narcolepsy and Its Symptoms:

See figure 01-01a for a list of the common major systems of Narcolepsy.

Figure 01-01a – Major Symptoms Narcolepsy

Signs And Symptoms Most Common In Narcoleptics

Symptom/Sign

Description
Excessive Daytime Sleepiness – one of the most visible symptoms of Narcolepsy, which affects all people suffering from the disorder.  

Of all the symptoms and signs of Narcolepsy, EDS or Excessive Daytime Sleepiness is the main symptom. It causes the affected person to feel tired throughout the day. This feeling of sleepiness persists often, regardless of a quality night time sleep. These symptoms of narcoleptic people come with a lack of energy and mental cloudiness. It also affects and impairs memory, causing depression in many.

People suffering from this symptom suddenly feel strong urges to sleep regardless of the time. It happens without warning; although these “sleep attacks” usually take place when they are inactive, such as when attending classes or meetings, watching television, or reading a book. However, it is still very possible for these sleep attacks to take place while one is talking, walking, eating, playing, or worse; while driving.

A typical sleep attack lasts for fifteen minutes to one hour with few exceptions. However, these attacks tend to recur within an hour or several hours after the previous attack. After sleeping, the person suffering from symptoms of narcolepsy wakes up refreshed, but then becomes tired again after one or two hours of consciousness. This cycle is repeated throughout the day.

As a first treatment for this Narcolepsy symptom, Xyrem (Gamma-Hyrdroxybutryric acid) and Provigil (Modafinil) may be administered.
Cataplexy – sixty to a hundred percent of people suffering from Narcolepsy symptoms also experience this.

Cataplexy is unique to Narcolepsy and its symptoms. It’s characterized by a sudden decline or loss of muscle tone and losing control over voluntary muscles. In mild cases of this Narcolepsy symptom, the person experiences slight feeling of muscle limpness or weakness in limited body areas. For example, the muscles in the neck weaken, which in turn causes sagging and drooping of facial muscles as well as drooping of the head. The person’s speech is also affected by the symptoms of Narcolepsy, making him/her slur. Narcolepsy may also cause loss of arm strength and buckling of the knees. In cases of severe Cataplexy attacks, the body collapses completely.

Cataplexy episodes are not like epilepsy where patients become unconscious as the attack is happening. In cataplexy, the patient stays conscious throughout the attack. This attack usually lasts from a few seconds to thirty minutes. Strong and sudden flares in emotion such as laughter; which is the most common catalyst of cataplexy, as well as anger, surprise, fear and excitement, trigger the episodes of a cataplexy attack.
DNS or Disturbed Nocturnal Sleep – like most other Narcolepsy symptoms, DNS does not affect all people suffering from Narcolepsy. It does, however, affect sixty to ninety percent of all patients.

People suffering from this Narcolepsy symptom suffer from insomnia or poor sleep during night. They also tend to experience an increase in body movements even while they are asleep. This includes increased heart rate, intense alertness and hot flashes. Due to the lack of sufficient sleep at nighttime, these people’s daytime sleepiness worsens drastically.
Hypnopompic and Hypnagogic Hallucinations – these symptoms and signs of Narcolepsy affects up to sixty-six percent of all patients.

Narcolepsy and its symptoms can be terrifying.  Often a sign that someone is suffering from Narcolepsy is that they experience sensory hallucinations.  Often visual and audio hallucinations can be particularly scary events.  When these occur while the person is asleep, they are referred to as hypnogogic hallucinations, while those that take place when he/she is waking up are termed hypnopompic. Hallucinations occur when the person falls to REM sleep suddenly. When we dream during these fast passages to REM sleep we may perceive the dreams as part of reality.  This can be confusing and scary for those suffering from Narcolepsy.
Sleep Paralysis – this Narcolepsy symptom affects sixty percent of patients.

Sleep paralysis happens when the patient experiences an inability to speak or move temporarily. Loss of muscle control can happen upon waking up or while falling asleep. A few hear strange noises that may sound like voices or footsteps, while others feel like someone else is inside the room or somebody sitting on their chests. Although this condition is relatively harmless and rarely causes danger, it can scare people; especially those who are experiencing it for the first time.
Automatic Behaviour – of the signs and symptoms of Narcolepsy, this one is among the rarest conditions.

This happens during brief “sleep attacks” and episodes of this are also referred to as “microsleep” and often “sleepwalking”. When this happens, the affected person does not cease to function even when he/she is sleeping. People suffering from this Narcolepsy symptom perform routine activities that have already become familiar to them when they suddenly fall asleep while in class, taking showers, or driving. Although they continue to function, they obviously cannot properly perform their respective activities.  This symptom relates to automatic behaviour while unconscious.

All these Narcolepsy symptoms may prove very hard to cope with and they can affect a person’s social, professional and family life. It may isolate a patient from the rest of society, eventually leading him/her to depression. Fortunately, they can learn treat and adapt to Narcolepsy symptoms.

If you experience any of the mentioned symptoms, you might mention Narcolepsy to your Doctor so that they can confirm or disprove if you have a chronic sleep disorder. Learning more about Narcolepsy symptoms could prove useful to those with this disorder as well. Information about Narcolepsy should be absorbed in abundance.  We will learn things such as how changes in our lifestyle, sleep therapy, lifestyle changes, and prescription drugs may help us greatly reduce our symptoms of Narcolepsy.

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Narcolepsy Depression, Another Side Effect

October 27, 2011 By Leave a Comment

Narcolepsy and depression are two ailments that can exist free of each other, but are more often than not linked due to the stress a person goes through when living with narcolepsy. Depression is one of the secondary signs and symptoms of narcolepsy, which without treatment, can really make someone, feel like their life is “in a hole”. A person with narcolepsy may discover that friendships and/or personal relationships are suffering because of their disorder. Maybe they are a college student and their grade point average has dropped off. Whatever the case, these are signs that depression is playing a role in their life. By exploring depression and the symptoms of narcolepsy we can begin to understand what a person goes through when living with both of these disorders.

Signs of Depression and Narcolepsy Symptoms

  • Excessive daytime sleepiness (E.D.S.) is a narcolepsy symptom that causes a person to feel extreme sleepiness during times when they should be alert and awake. This can cause ridicule from co-workers or friends if they do not know about the person’s condition. This in turn can lead to a state of depression, and possibly suicidal thinking, in the person suffering with narcolepsy.

  • Cataplexy is the sudden and uncontrollable loss of muscle control associated with narcolepsy. This loss of muscle control usually affects the face muscles and/or leg muscles, the latter causing falls and possible serious injury. This in turn can leave a narcoleptic patient filled with self-doubt, and feeling useless or worthless, which is a major sign of depression.

  • Sleep paralysis is when the brain shuts off or disconnects from the body, leaving a person aware of their surroundings, but unable to move or speak. This happens when the person is falling asleep, which is called hypnogogic, or when they are entering R.E.M. (rapid eye movement) sleep, which is called hypnopompic. This is a frightening experience for the person due to the hallucinations that usually accompany this paralytic state. This can leave a person with this chronic sleep disorder feel like their life not based in reality and that they are actually going insane.

  • Hallucinations or hallucinating is when a person sees and/or hears things that are not there. This dream-like state is very vivid and extremely convincing. This can leave the narcoleptic person with the feeling of being haunted by demons, which induces a fear of sleeping.

  • Insomnia is a sleep disorder that causes the inability to stay asleep at night. If this is left untreated it can lead to other narcolepsy symptoms such as cataplexy, E.D.S. (excessive daytime sleepiness) and even hallucinations. These symptoms combined can lead to severe depression in narcolepsy patients. Sleepwalking is common for people with insomnia.

Other Signs

Some other signs of depression associated with narcolepsy are:

  • Forgetfulness
  • Lack of interest in activities
  • Lack of interest in food/loss of appetite
  • Avoiding social situations
  • Failing relationships (friends, family, co-workers, dating)

Ways to Treat Narcolepsy Depressions

Anyone can have a chronic sleep disorder. These disorders know no age or color and can happen any time, day or night. If the person does not act to prevent their narcolepsy and depressive disorder, severe health issues will take control of their life. Luckily for the world there is advanced medical research that can help take the symptoms of narcolepsy and depression away.

The drugs used in the treatment of narcolepsy are antidepressants, stimulants and sodium oxybate. Each of these drug types have their own purpose, and are prescribed depending on the symptoms found in the patient.

  • Stimulants are used to treat E.D.S. and cataplexy. They serve as a jump start for the central nervous system, which helps the person stay awake and alert. Common stimulants used to treat narcolepsy patients are Provigil and Nuvigil. Ironically, these stimulants are not recommended for people with a history of depression, as the number one side effect is suicidal thinking.

  • Antidepressants are used to treat cataplexy, hallucinations due to sleep paralysis and depression itself. The most popular antidepressants prescribed by doctors are Prozac and Zoloft. The side effects for both of these are minimal.

  • Sodium oxybate is the “out in left field” drug amongst the others, as it is a liquid and must be taken in small doses throughout the night. Sodium oxybate is used to help a person fall asleep, to control cataplexy, E.D.S. and sleepwalking during the nighttime. If this drug is abused, coma and even death may occur.

  • Tricyclic antidepressants are a type of medication that is not commonly prescribed anymore, due to the severe side effects they produce in narcolepsy patients. These types of drugs were said to have been excellent in the treatment of cataplexy.

Other remedies for treating narcolepsy and depression are the non-medical changes made to the daily living routines by the patients themselves. These include:

  • Stretching and deep breathing to lessen mental stress
  • Join support groups
  • Seek counseling
  • Avoid alcoholic beverages and illegal drug use
  • Avoid over the counter medications that produce drowsiness
  • Maintain a healthy diet by avoiding fats, sugars, nicotine and caffeine
  • Avoid nighttime work
  • Follow a set schedule for meals, medications and bedtime
  • Plan naps for controlled time sleep
  • Try walking to work instead of driving
  • Tell the boss/co-workers, friends, family… be open
  • Stay positive
  • Wear a medical alert bracelet or dog tags
  • Tell your doctor EVERYTHING

These treatments are usually best when combined with the medications prescribed by the doctor. Together with the help of loved ones and/or co-workers, narcolepsy and the depression that can accompany its symptoms can be addressed correctly.

No one who has narcolepsy and depression has to suffer. The first thing people in this situation should do is realize that they are not alone, as over three million people in the world today has narcolepsy and around sixty-five percent of these people also suffer from depression. With the proper encouragement from peers and a comprehensive treatment plan, narcolepsy and depression can be conquered.

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Signs of Narcolepsy- What Doctors Look For

October 26, 2011 By Leave a Comment

Narcolepsy is a chronic sleep disorder that has been found in an estimated three million people in the world today. To have a chronic sleep disorder means that the signs and symptoms will gradually get worse if left untreated. In this day and age there is hope for anyone suffering with a sleep disorder, as scientists have developed many types of medications to treat any symptom associated with narcolepsy.

Narcolepsy can, however, go misdiagnosed or even undiagnosed due to lack of information on the signs and symptoms of narcolepsy. This can cause a narcoleptic person to have health issues that can be truly frightening. Narcolepsy symptoms should be reported to the doctor immediately. This means that anyone that suspects even the slightest sign of narcolepsy should get more information on the matter by visiting their local sleep clinic.

Narcolepsy Signs and Symptoms

Narcolepsy has a host of symptoms that can leave a person feeling dreadful. These symptoms can be misdiagnosed due to similarity to other ailments, leaving the patient without the proper medication and other therapies needed to cope with narcolepsy. The symptoms and signs of narcolepsy are:

  • E.D.S. or excessive daytime sleepiness. This is the most common complaint by people with narcolepsy. E.D.S. is exactly as it sounds, which is the feeling/need for daytime sleep and the inability to control it. E.D.S. is often made far worst if the person also has insomnia.

  • Cataplexy is probably the most dangerous symptom related to narcolepsy. Cataplexy is the sudden and uncontrollable loss of muscle control. This is especially dangerous if it happens when the person is driving a car or operating machinery. Usually a person with cataplexy will be walking and suddenly fall down due to the loss of muscle tone, which can result in injury. This can happen any time, day or night with warning.

  • Sleep paralysis is a sort of disconnection of the brain from the body. This can happen when a person is falling sleep, which is called hypnogogic, or when they are entering R.E.M. sleep or waking up, which is called hypnopompic. When this happens it leaves the person totally aware of everything in the room, but leaves them unable to speak or move. Usually hallucinations of a very frightening nature ensue during episodes of sleep paralysis. People experiencing sleep paralysis may not necessarily have narcolepsy, although it is a symptom of narcolepsy.

  • Hallucinations are when someone hears voices or sees things that aren’t really there. These visions can be extremely real to the person, which can cause terror to fill their mind. Hallucinations are commonly associated with sleep paralysis, but there have been cases of narcolepsy with hallucinations and no sleep paralysis.

  • Insomnia is another narcolepsy sign that can be independent of the disorder itself. Insomnia is the inability to sleep well during the nighttime, or when a person falls asleep, but is unable to remain asleep, causing episodes of daytime sleepiness.

There are other narcolepsy signs that are secondary to these primary symptoms. Usually the medications and therapies will work to solve these secondary signs, but only if these are paid attention to and properly diagnosed. The secondary signs of narcolepsy are:

  • Irritability
  • Sleepwalking
  • Forgetfulness
  • Clumsiness
  • Poor performance in work or school
  • Friendships or personal relationships suffer
  • Depression

With the proper treatment, narcolepsy and signs and symptoms associated with it can be managed effectively. If a person has the least idea that they may have narcolepsy, then they should act immediately by going to a sleep clinic or to their family doctor.

Narcolepsy Treatment Options

Narcolepsy symptoms can be treated by medication and therapies in the home, which most call lifestyle changes. These changes will have a positive effect on the signs and symptoms of narcolepsy, lessening the stress and strain that people go through when incidents arise. When combined with the proper medication, narcolepsy patients have been known in some cases to live practically incident free. This gives them a new lease on life by allowing them to live daily life like everyone else. These lifestyle changes are:

  • Maintain a nutritious diet
  • Schedule changes for better sleep management
  • Planned daytime naps each lasting about 10 minutes
  • Tell employers, friends, family, co-workers about this condition
  • Seek counseling and support groups
  • Avoid the use of alcohol, caffeinated beverages, and illegal drugs
  • Take all medications as prescribed by doctor
  • Write down all episodes and incidents that occur concerning this condition

With all of these changes in mind, let’s look at the list of medications which should be added to them. These include:

  • Stimulants help to promote a better working central nervous system. Stimulants are usually prescribed for the treatment of E.D.S. and cataplexy. Commonly prescribed stimulants are Nuvigil and Provigil. Patients with a medical history of depression or psychiatric issues should not take stimulants, as they have been known to produce intense suicidal thinking.

  • Antidepressants are usually prescribed to treat depression, but in narcolepsy patients it’s a common treatment for cataplexy and hallucinations associated with sleep paralysis. Common antidepressants used to treat narcolepsy symptoms are Prozac and Zoloft.

  • Sodium oxybate is a drug that is unlike the other drugs used in the treatment of narcolepsy. Sodium oxybate is a liquid that, when taken correctly, provides the patient with a time of peaceful sleep. This drug must be taken very strictly as prescribed to avoid accidental overdose. The best known version of this drug is Xyrem.

As with all medications, medical science works to create better versions of the medicines we use, which can cause older medications to be discontinued. The reason for this research is to provide people with a better product that has the least amount of side effects. Such is the case with the older versions of antidepressants called tricyclics. The list of side effects far outweighed the benefits of these drugs, causing them to lose popularity, although they were said to be amazing when used to treat cataplexy.

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Narcolepsy and REM Sleep: a Portrait of Narcolepsy Symptoms

October 26, 2011 By Leave a Comment

In narcolepsy, nighttime REM sleep is disturbed.  The aspects of REM sleep are then displaced and sometimes they are experienced separately. This phenomenon is confusing to the patient and makes diagnosing narcolepsy difficult for the physician.

Main Aspects of REM Sleep

REM usually takes about 90 minutes to occur and lasts around 10 minutes. NREM or Non-Rapid Eye Movement sleep occurs before REM in normal healthy sleep cycles.  In Narcolepsy, REM sleep can occur much faster, sometimes even as soon as the patient falls asleep. This is referred to as Sleep Onset REM or SOREM.

  • Physical Sleep

During REM sleep, the body loses muscle tone and falls “asleep” It is slack and is completely relaxed.

  • Mental Sleep

When unconsciousness is achieved, this is mental sleep.  This aspect of sleep is the most widely used to define the act of sleeping.

  • Dreams

REM or Rapid Eye Movement is an expression used to describe the physical marker for dreaming. Dreams occur when the body is in a complete sleep state.

  • Vital Signs

Breathing and heart rate becomes erratic during REM sleep. Even though the major muscle groups are paralyzed, brain activity is heightened and vital signs reflect this activity.

Symptoms of Narcolepsy

As explained earlier, in narcolepsy, REM sleep is dysfunctional. The symptoms of narcolepsy have clear similarities to the normal aspects of REM sleep or are directly related to the disruption of REM sleep, as in the case of Excessive Daytime Sleepiness or EDS.

  • EDS

EDS is exactly what it sounds like, the patient experiences an excessive desire to sleep that tips the border into need.  Narcolepsy patients do not sleep more than people with healthy sleep habits; they have interrupted nighttime sleep, or suffer from insomnia.  EDS is the result of the bodies needs to make up for the loss of sleep.

People who experience EDS tend to fall asleep at unexpected and sometimes dangerous times, like while driving a car.  EDS is not really random.  It often occurs after meals or during times when there is little stimulation. Relaxed settings are the bane of the narcoleptic. EDS can be embarrassing for many patients, especially if the uncontrollable sleep attack strikes at a particularly inappropriate time like during a history lecture or while on a date at the movies.

A mild symptom of EDS can be treated with simple lifestyle changes such as adhering to stricter bedtimes scheduling daytime naps and dietary changes like lighter, more frequent meals.

When EDS is more severe, doctors may add stimulant drug therapies to the treatment.  Drugs used to treat EDS are: Methylphenidate, Amphetamine, Modafinil or Selegiline.  When drug treatment is necessary, lifestyle changes are still utilized to optimize the effects.  When carefully managed, a person with EDS can generally enjoy a normal life.

  • Cataplexy

The most common displaced aspect of REM sleep narcolepsy patients experience is the sudden and complete loss of muscle tone and control.  Cataplexy is experienced by seventy percent of people with narcolepsy.

Cataplexy occurs when the patient experiences strong emotion. Anger and hearty laughter are reported as the biggest triggers for cataplectic episodes.

Narcolepsy with cataplexy can also have mild symptoms. Sometime the episode gets filed as “gee, I am clumsy today” or is a barely perceptible drooping of an eyelid.  Cataplexy often affects the face and head.  Sometimes a sudden loss of muscle control in the neck will cause the head to flop forward.  It can be as fast as a few seconds and go unnoticed.

Cataplexy can also have severe episodes.  During one of these attacks, a subject can lose complete control and collapse; it can last over an hour. An interesting aspect of cataplexy is that the person who suffers from it is completely alert and awake during the whole thing.

Sometimes, antidepressants are given for cataplexy, but the only drug that is approved by the FDA to treat the symptom of cataplexy gamma-hydroxybutyric acid (GHB). It is produced for theUSas sodium oxybate, and packaged under the brand name Xyrem.

Sodium Oxybate is a highly effective sedative and paradoxically, it is a stimulant at low doses.  It is a highly controlled substance as it is a heavily abused chemical.  It has been used as a date rape drug and as it stimulates the production of the human growth hormone, it is abused by body builders as well. It is, however, highly effective in the treatment of both EDS and cataplexy

  • Sleep Paralysis

Like cataplexy, an episode of sleep paralysis affects muscle control and tone. Unlike cataplexy, Sleep paralysis is always complete paralysis, never partial. And it is not determined by strong emotion. Instead, sleep paralysis is experienced during the twilight between wake and sleep. And it is often accompanied by hallucinations.

Sleep Paralysis is not strictly a narcolepsy symptom.  Anyone can experience sleep paralysis. Many people do have one or two episodes during their life.  It is more common in youth.  Narcoleptics that have sleep paralysis as a symptom experience it more regularly.

Antidepressants are sometimes effective treatment for sleep paralysis and so is sodium oxybate.

  • Hallucinations

The experience of hallucinations makes narcolepsy a sometimes terrifying situation. Hallucinations can be experienced with other symptoms of narcolepsy or independent of them.

Hallucinations are like the waking dreams of REM sleep and in the case of sleep paralysis; they can appear dark and sinister giving the sufferer a feeling of detachment. Historically, hallucinations that were experienced during sleep paralysis would sometimes be misdiagnosed as paranormal occurrences such as possessions or out of body experiences.

Often, narcolepsy patients who suffer from hallucinations have a weak or unstable handle on reality. A misdiagnosis of schizophrenia is sometimes made when reality becomes hazy for the patient.

Conclusion

Disturbed REM sleep and narcolepsy disorder are found hand in hand in the sleep clinic and while several things can cause disturbed REM cycles, Narcolepsy is always affected by them.

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Sleep Paralysis Narcolepsy Symptom

October 26, 2011 By Leave a Comment

Narcolepsy is a chronic sleep disorder that is suffered by an estimated three million people worldwide. Although narcolepsy can have bad effects on a person’s life, there are far more scary aspects to this disorder than just falling asleep during inopportune moments. Narcolepsy and sleep paralysis are both sleep disorders that are linked by their unpredictability. This factor alone can lead to accidental falls that can cause serious physical injury to people with narcolepsy.

Sleep paralysis and narcolepsy are disorders in which the brain’s function controlling the body’s sleeping and waking cycles is interrupted, which can sometimes cause hallucinations and the inability to distinguish fantasy from reality. Sleep paralysis is suffered by as many as four out of ten people worldwide in many different age groups. A high percentage of people suffer from narcolepsy symptoms and sleep paralysis combined. A person who suffers with both of these symptoms combined usually has great trouble living life on a day to day basis.

Narcolepsy and Sleep Paralysis Symptoms

People who suffer from narcolepsy often experience:

  • E.D.S. or Excessive Daytime Sleepiness
  • Cataplexy, which is the loss of muscle control during a narcoleptic attack
  • Sleep Paralysis
  • R.E.M. sleep disturbances that can change dramatically
  • Hallucinations
  • Disturbed nocturnal sleep such as insomnia, nighttime sleepwalking, sleep talking and/or acting out during dreams
  • Obesity

As well as these symptoms, people suffering from sleep paralysis often experience:

  • A temporary loss of speech and the ability to move while falling asleep
  • Being aware, but unable to react. Similar to cataplexy
  • Panic attacks while sleeping
  • Hearing voices
  • Hallucinations

Although the loss of muscle control as with cataplexy, and speech are temporary, the impact on the lives of people suffering from the symptoms of narcolepsy and sleep paralysis can be drastic. Imagine the embarrassment and helplessness that a person feels when having dinner in a public setting and falling asleep, while remaining totally aware that it’s happening, but being completely unable to do or say anything about it. People may fall asleep during classes or while working, leading to disciplinary action or even serious physical harm. Falls are fairly common among people suffering from narcolepsy.

The symptoms and signs of narcolepsy and sleep paralysis and their limitations include:

  • Inability to operate machinery or vehicles
  • Losing items or storing items in random places
  • Illegible handwriting
  • Memory lapses
  • Inability to concentrate when faced with a passive situations

Other Characteristics

It should be noted that while people suffering from narcolepsy often suffer from sleep paralysis, not all who suffer from sleep paralysis suffer from narcolepsy. Scientists have hinted at genetics as the cause of sleep paralysis.

Other causes include:

  • Jet lag
  • Lack of sleep
  • Changes in sleeping schedules
  • Bipolar disorder or high stress
  • Environmental changes
  • Substance abuse

Sleep paralysis can occur at two different times during a person’s sleep cycle. The first is when a person is just falling asleep, which is called hypnogogic. The second is when a person is waking up, which is called hypnopompic.

Common occurrences during both of these include:

  • Hearing noises or strange sounds
  • Hearing voices
  • The feeling of being watched
  • A severe sense of being suffocated
  • The feeling of being held down

Hypnogogic Sleep Paralysis

When trying to fall asleep, people generally become more and more relaxed and less aware until sleep finally settles upon them. The transition from being awake to being asleep is usually not noticed. In hypnogogic sleep paralysis, a person becomes aware while falling asleep, but remains unable to speak or move.

Hypnopompic Sleep Paralysis

While sleeping, a person experiences two types of sleep. The first is N.R.E.M. or non-rapid eye movement sleep and there is R.E.M. or rapid eye movement sleep. N.R.E.M. sleep takes as much as seventy-five percent of a person’s normal sleep time. During this time the body is recharged. R.E.M. sleep is the state a person enters when dreaming, characterized by the eyes moving quickly in a back and forth motion. During the end of R.E.M. is when a person begins to wake up. If someone becomes aware of their surroundings, but is unable to speak or move while waking up, they suffer from hypnopompic sleep paralysis.

Treatments

Generally a person suffering with sleep paralysis does not need to seek medical treatment unless the symptoms worsen or begin to cause insomnia, sleepiness during the normal day or anxiety.

Certain lifestyle changes must be made to prevent the symptoms of narcolepsy and sleep paralysis. So people in otherwise good health can who have chronic sleep disorders can live relatively normal lives.

These habits are as follows:

  • Avoid stressful situations
  • An improved or more balanced diet
  • Trying not to sleep while still hungry (Although it should be stated that one shouldn’t eat right before bedtime)
  • Monitored caffeine intake
  • Change sleeping positions, Try to sleep on sides instead of back
  • Seek medical treatment for mental disorders (Although it should be stated that sleep paralysis is not commonly linked to psychiatric issues)

Supernatural Views of Sleep Paralysis

In folklore, the signs and symptoms of sleep paralysis have often been called the hag phenomenon. This is said to happen when an old hag leaves her body to temporarily sit on the chest of her targeted victims. Tales like this give a familiar ring to the symptoms people experience when suffering from narcolepsy paralysis. Evil or menacing presences, hearing voices, the feeling of being watched or physically harmed by demons, and alien abductions are all stories that date back centuries. Cultures from around the globe have tales of demonic creatures that thrive on causing terror to helpless humans, especially at night.

The horror novelist, Steven King has also touched on the supernatural topics concerning sleep paralysis in his story-made-movie “Cat’s Eye”. In one part of this story, a young girl is terrorized by an evil gnome while she is sleeping. The gnome sits on her chest and tries to suck the life out of her. Her parents blame the cat for this sleep disturbance, which is a common urban legend about cats. In the end the cat becomes her ally in the fight against the demonic gnome, which changes her parent’s perspective on their pet.

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Mild Narcolepsy Symptoms: Treated with Lifestyle Changes

October 25, 2011 By Leave a Comment

Narcolepsy is a chronic, neurological sleep disorder that is a constant source of drama in the lives of over three million people in the world today. This drama is not intentional, far from it. The situations that may arise due to the symptoms of narcolepsy can leave a person feeling unsure of where they stand in life.

Narcolepsy Mild Symptoms

Medical attention and therapy in the home and workplace can often lessen strong symptoms of narcolepsy, making them mild symptoms of narcolepsy. There are many different ways to test and be certain of how mild or advanced the narcolepsy has become, and the treatments that should be used depending on the form of narcolepsy.

  • Problems with school work
  • Problems sustaining a proper relationship
  • Sustaining a quality of life outside of their personal space environment
  • Certain physical impairments

With every symptom that occurs with mild narcolepsy there is a treatment offered and available that can either be suggested by a physician, therapist, or even done by the patient with the narcolepsy. Certain treatments can be a form of life style change, diet, exercise, and even medicine.

Medication for Mild Narcolepsy Symptoms

Some of the medication that is prescribed for narcolepsy also treats mild forms of depression. Even with the medication and availability of physicians that treat narcolepsy, there is not a definitive cause behind why certain people experience this and why others do not. There are around three million people with narcolepsy.

Cataplexy is a symptom of narcolepsy where the brains protein hypocretin-1 is deficient, having narcolepsy that is coupled with cataplexy can also lead to misdiagnosis and then treatment would become incorrect. Cataplexy is not helped by the stimulants that are popular with narcolepsy. This process of diagnosing and misdiagnosing narcolepsy with cataplexy has been the bane of most physicians practices, because there are many different signs of narcolepsy that are similar to psychological disorders like that of say epilepsy, and bi-polar disorder.

  • Adderall this medication is also used to treat attention deficit disorder, as well as Attention deficit hyperactivity disorder. The highest dosage for Adderall is 60 milligrams.
  • Methylphenidate this medication is also used to treat a.d.d. and a.d.h.d. the highest recommended dosage is also 60 milligrams.
  • The methylphenidate improves the scores on standardized tests but does not improve the levels of health control. Adderall will keep a person and stimulate he system to where the patient will be more active and less prone to fall asleep while doing tasks.

With these symptoms being characterized and better diagnosed it is making it easier for physicians to diagnose narcolepsy more effectively, but not one hundred percent. The tests that are performed to diagnose narcolepsy, have come a long way in the 21st century, now physicians  can tell if a mood disorder along with a sleep disorder such as insomnia, is narcolepsy or a different health issue to diagnose.

Recognizing the Symptoms

Recognizing the mild narcolepsy symptoms can start at the early age of 15 and sometimes even earlier than that, there is an increased anxiety rate, mild depression, and urges to sleep at all times, no matter what the activity is. If feeling tired all the time then that is most likely not narcolepsy this could be a form of sleep apnea or insomnia.

Sleep paralysis is another sign of narcolepsy this happens when falling asleep or waking up, the body goes into a state of extreme relaxation, and will not move and the person cannot respond to questions because they cannot speak, because of the sleep paralysis.

Narcolepsy can also cause hallucinations, at any random moment. Not only can the hallucinations affect the sight but it can also affect the other senses hearing, taste, smell, and even touch.

The hallucinations seem so real that they can affect reading, writing, sexual activities, eating food, or drinking, even listening to a favorite song. These are all signs of narcolepsy with cataplexy; to diagnose narcolepsy without cataplexy requires a completely different system and method of diagnosis.

Narcolepsy without cataplexy is primarily diagnosed when extreme sleepiness occurs for more than three day a week for longer than three months, and nine hours of sleep throughout the day. With this being the primary symptoms of narcolepsy without cataplexy, it becomes harder to diagnose, for people that have night jobs and require them to stay awake all night.

Also narcolepsy without cataplexy, gives off the symptoms of extreme fatigue, and restless leg syndrome, because the leg feels tingly and the urge to move becomes over powering but when sleep paralysis hits the urge cannot be met because the body will not move.

Lifestyle Changes

Besides medication to treat narcolepsy, there are different things that can help:

  • keeping a regular sleep schedule
  • stay away from alcohol
  • no smoking
  • relaxing activities
  • staying stress free

All of these changes can greatly help with narcolepsy and gaining control over the urges that takes place in the body.  Another thing that will help with narcolepsy is regular exercise and a good balanced diet that goes along with certain life styles. Caffeine is another thing to stay away from if narcolepsy has been diagnosed.

Some of the safety precautions that should be taken are:

  • While driving always have another person in case of an episode
  • do not cook without someone being in the house

Support groups even help with copping with narcolepsy, and all of the symptoms that go along with the disorder. Having strong emotional reactions, even laughing can cause a narcoleptic attack.

Most people with narcolepsy have a tendency to become isolated, and have a label of being lazy and uncommitted. That is because that not a lot of people are aware of the problems that narcolepsy can cause and a majority of the population find narcolepsy a funny and unconventional means of a joke. In the world population over one percent has narcolepsy and less than that is diagnosed yearly. Most diagnosis that should have been classified as narcolepsy is diagnosed as depression, a.d.d., a.d.h.d., and even bi polar disorder. So to get a proper diagnosis, explain every symptom, and occurrence to your physician, and go through a sleep study.

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Cataplexy and Narcolepsy Basics

October 25, 2011 By Leave a Comment

There are several narcolepsy symptoms and cataplexy is among the most common.   About seventy precent of people who suffer from narcolepsy also report cataplexy as one of their symptoms.   Cataplexy is a condition that although rare, is serious and disabling.  There is no none cure for narcolepsy or cataplexy. But there are treatments that can lessen the frequency and severity of the episodes.

The most common symptom of narcolepsy is cataplexy. When narcolepsy and cataplexy are together, it has its own biological markers that set it apart from narcolepsy without cataplexy. In “Narcolepsy, A clinical Guide” by Meeta Goswami, the predisposition to narcolepsy is looked at in a cross disciplinary fashion with both genetic studies and environmental factors getting equal scrutiny.  Goswami explains that as many advances have been made in recent years in the understanding of narcolepsy and that “in international classifications, narcolepsy with and without cataplexy are now two different diagnostic entries.”

Narcolepsy Diagnosis

Narcolepsy is a chronic sleep disorder; People who have a chronic sleep disorder like narcolepsy have problems sleeping. This nervous system disorder is characterized by the inability to control sleep cycles, extreme daytime sleepiness and a tendency to fall asleep at inappropriate times, like while driving or walking.  Although there are times when an attack is more likely, like after meals, times of impaired health or during high stress situations, a narcoleptic episode can happen at any time.  The disorder itself is not fatal, however, falling asleep while operating Machinery can be. For this reason, Narcolepsy sufferers often seek to control their disorder with drugs and behavior modifications, like scheduled short daytime naps and night sleep insomnia medication.

Cataplexy as narcolepsy Symptom

Experts recognize cataplexy as sign of narcolepsy.  Cataplexy is when a person has a sudden loss of muscle control and becomes weak. Cataplexy attacks are usually triggered by the act of laughter and extreme emotions.  Vigorous laughter is perhaps the most common trigger for a cataplectic attack.  There are several degrees a person can experience cataplexy.  A mild version of the symptom is when just the face goes slack or the eyelids droop.  This can happen for as little as a few seconds.  In extreme cases, control over the entire body is lost and can last for several minutes.  Unlike with plain narcolepsy, Cataplexy is experienced while completely awake, and alert.  So although they may be completely limp, they are aware of everything that is going on around them. This is what makes cataplexy frightening, especially the first time it is experienced.  A similar symptom is experienced in nighttime hours as sleep paralysis.

Protein Deficiency

No one knows what causes narcolepsy, but recent data indicates that the reduction of the Protein, Hypocretin-1 in the hypothalamus may be the cause of cataplexy in narcoleptic patients. A study was conducted in a sleep center in Brazil by Dr. F Coelho, by testing the spinal fluids of narcolepsy patients. It confirms that a reduction Hypocretin-1 is at least a positive biomarker for cataplexy. Patients without Cataplexy did not show reduced Hypocretin-1 levels. This makes it an effective biomarker for Cataplexy but not for Narcolepsy.

Autoimmune Disease Implications

It is well known that trauma can bring on both Narcolepsy and Narcolepsy with Cataplexy. Goswami states that in the genetics studies, there is a suggestion of possible autoimmune basis for the disease when cataplexy is present and hypocretin is deficient, because of the hypocretin cell destruction.  If this proves to be true, then scientists will have a new direction to look and new treatment options to explore.  Other Autoimmune diseases include Multiple Sclerosis and Rheumatoid Arthritis.

Cataplexy and Narcolepsy Symptoms in Children

Cataplexy and narcolepsy signs that develop in school age children are very uncommon and are usually misdiagnosed due to cataplexy diagnosis currently being based at 100% specific on medical history. The impact narcolepsy can have on a child’s life can be devastating. E.D.S. or excessive daytime sleepiness can cause sleep attacks at unusual periods throughout the day and is commonly linked to cataplexy. The child experiencing this will lose control of his or her muscle functions while being awake. This is usually triggered by laughter and the end result is a fall, which can cause physical harm.

There are several narcolepsy signs and cataplexy is only one. Sleepwalking, for instance is a common symptom. Sleep paralysis is another symptom that is often reported. This can be a horribly frightening experience for children, as they are totally aware of their surroundings, but are unable to move or speak. Other symptoms that have been noted are depression of various ranges, obesity and sleep disturbances in which the child may not be able to distinguish reality from dreams.

Treatment for narcolepsy in children is a highly demanding effort, which includes medication as well as non-medical treatment. Correct diagnosis is paramount for children to gain benefits from treatment. The medicines include sodium oxybate, stimulants and antidepressants. The extra treatments include scheduled napping, environmental adjustments and understanding. This strategy can help children who suffer from narcolepsy to attain a meaningful life.

Narcolepsy/Cataplexy Studies

Narcolepsy has been extensively studied, but the exact cause remains a mystery. It has been suggested that excessive daytime sleepiness is a genetic factor, but narcolepsy is rarely found in relatives. Narcolepsy studies point to disorders of the cerebral pathways that control a person’s ability to stay awake or asleep.

Cataplexy, although defined, is not very precise by that definition; meaning that the distinction between typical and atypical cataplexy is not well recorded. Recent studies have been aimed at finding a more distinct definition for cataplexy as well as grading it by levels of severity. The patients included in the study were those with recorded cataplexy histories and hypocretin-1 deficiencies. A questionnaire containing items that covered a wide range of cataplexy symptoms, including triggers, duration, associated aspects and limitation in a person’s daily life, was given to these patients.

The results placed 60% of the patients with spontaneous cataplectic attacks, with 45% of these patients having both partial and complete cataplectic attacks. Of the patients as a whole, only 15% had symptoms lasting more than 2 minutes. Of triggers, laughing ranked lower than anger as a whole, with laughing hysterically triggering more attacks, which showed that intensity of certain emotional states has a direct impact on cataplexy. Of all the muscles affected during cataplectic attacks the jaw and facial muscles showed a higher rate of involvement in partial attacks.

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