Narcolepsy: Causes and Treatment

There are different sleeping disorders. Some people have poor sleep at night; some suffer from superficial sleep and don’t get full relaxation; others have a lack of sleep because of their work responsibilities, etc. Any disruption of healthy sleep leads to physical and mental deviations. One of the most severe sleeping disorders is called narcolepsy. People who cannot control their sleeping cycles suffer most of all.

What Is Narcolepsy

Narcolepsy is a disease affecting the central nervous system and means a lifelong incurable disorder of sleep that causes severe fatigue and progresses into sudden and non-controlled sleep attacks. Narcolepsy influences all spheres of human life. It is insecure because a person can feel excessive drowsiness during the day and fall suddenly asleep while eating, working, or driving a car.

It is estimated that one in every 2,000 people has the signs of narcolepsy, and many people simply don’t know that they have this disorder. Narcolepsy can be traced to some families, but it is not always a genetic disease. In rare cases, it is found in kids. The reasons for the emergence of narcolepsy have not been revealed, but some recent research shows that low levels of the hypocretin neurotransmitter might be the cause.

Forms of Narcolepsy

There are two types of narcolepsy:

• Narcolepsy of the first form is caused by a hypocretin (orexin) deficit. It can be followed by cataplexy or not. A cataplexy is a sudden weakness in the muscles caused by very strong emotions such as anger, joy, laughter, embarrassment, or surprise. The attack causes unexpected muscular tonus loss, which leads to slurred speech, the head dropping, jaw weakness, knee flexion, and it affects all the body and, in the most severe cases, results in complete palsy and makes a person fall down. The seizure sometimes looks like a swoon, and its severity differs. Sometimes it’s a short-time pricking sensation, numbness, and muscle weakness, and sometimes it’s the collapse of the whole body. It lasts from seconds to minutes to bring the body back under control.
• Narcolepsy of the second type occurs when you have continual extreme sleepiness but no cataplexy. A person can fall suddenly asleep for several hours and wake up refreshed, but in a very short period of time, feel tired and sleepy again. It is a rare and not fully discovered form of the disease.

Both types are dangerous, but the latter is really bad. Let’s see why it happens and if there is a way to combat the disease.

Causes of Narcolepsy

The factors that cause narcolepsy were partially identified in the 20th century. It turned out that the reason is improper work of the brain sector, which is responsible for the fast and slow sleep phases, regulates the vegetative nervous system, and controls many functions of the body, in particular motor function. If the level of hypocretin (orexin) neurotransmitter falls, which is responsible for wakefulness, it can end up with narcolepsy.

The other causes include:

• heritage;
• brain injury;
• diabetes;
• infectious nervous system disease;
• exhaustion and stresses.

The second type of narcolepsy can also be the result of a severe infection that seriously influenced the hypothalamus to make it work improperly. In this case, a person has delusions, muscle breakdown and spasms, or a stroke, leading to a full loss of motor control and even death.

Narcolepsy Symptoms

The average age at which the first signs of narcolepsy can be noticed varies from 15 to 25, and it’s very important to reveal the malady as soon as possible because within the first several years, the symptoms usually progress. The most common major narcolepsy symptoms are:

• Excessive daytime sleepiness (EDS) is the first and major sign of narcolepsy. Irresistible sudden and irresistible falling asleep and unbearable constant fatigue. All people who suffer from narcolepsy have this symptom.
• About one-half of people with narcolepsy have nighttime sleep disruptions. It means that a person falls asleep, but easily and frequently wakes up during the night, and has difficulties falling asleep again.
• Hypnagogic, or hypnopompic, hallucinations are very bright and realistic delusions that occur while a person is falling asleep or getting awake. Mostly visual, the nightmares can also include the spheres of hearing, tasting, and smell. A person feels like not being alone in the room, or somebody’s touch, or some sound, and becomes very frightened.
• Sleep paralysis often follows delusions. A person loses the ability to move or talk for a few seconds or minutes, breathes with effort, feels extremely scared and tries hard to make a move. It can occur while falling asleep or waking up.
• Memory troubles may happen when you are doing something without full concentration and feeling relaxed. You forget what you say or do because you are half asleep.

Pay attention, some of these symptoms can be bad signs and definitely reasons to call your doctor.

Tests and Diagnosis

Narcolepsy is considered to be a rare diagnosis and often is not revealed in time. It is very important to find the right doctor who can administer the necessary and effective treatment. Usually, neurologists help. Laboratory tests that help diagnose narcolepsy are:

• A polysomnography is conducted in a clinic where a patient is given a separate room for the night, equipped with special video and audio systems. A patient is attached with sensors on different parts of the body (head, chest, and legs). During a sleeping period, a specialist registers the waves of the brain, heart beat, level of oxygen in the blood, breathing, legs and eye movements, etc. The test can also help you detect sleep apnea.
• A multiple sleep latency test (MSLT) deals with day time sleepiness. It is a full-day test, which is held in a dark room and divided into five periods, when a patient tries to fall asleep. The period lasts 15 to 20 minutes with two hour breaks. Detectors check how easily you fall asleep, if you do, and the phases of your sleep. As a rule, narcoleptics flack out within the first minutes of the test.
• The hypocretin level is measured rarely, because this demands a lumbar tap, but it shows if it is enough of this neurotransmitter in your blood. If there is a lack of orexin, a patient surely has narcolepsy of the second type.

Home tests cannot diagnose narcolepsy. The medical professional will also learn your sleep history (you will be suggested to fill in the quiz on the Epworth Sleepiness Scale to study your daytime drowsiness) and will learn your current circadian rhythms (you will monitor and write down in a diary all cases of drowsiness, the time when you go to bed, etc., during a couple of weeks). Sometimes, it will also involve a kinetic graph.

Treatment of Narcolepsy

There is no single narcolepsy cure. But the experienced doctor can select special medication or complex treatment specially for you. The main means to overcome the disease include stimulants, selective serotonin reuptake inhibitors (SSRIs), or serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and amphetamines.

Stimulants:

• Provigil (modafinil) is the most common drug prescribed for narcolepsy treatment. It is a wakefulness-promoting nootropic, regulating chemical processes in the brain. It is less abusive than other stimulating chemicals and has minimal side effects.
• Nuvigil (armodafinil) is one more stimulant very similar to its congener, safe and efficient;
• Ritalin (methylphenidate) is an effective medication for narcolepsy treatment due to its power to decrease daytime sleepiness and increase alertness (see Modafinil vs. Ritalin). But it has more side effects and is not recommended to be used at least once a week.

Amphetamines are very effective, but much more abusive and have more serious side effects.

• Adderall is a very powerful medication that greatly increases attention, concentration, cognition, and wakefulness, stimulating the central nervous system.
• Vyvanse is one more effective drug that has fewer side effects than Adderall and does not violate sleep cycles at night.

Antidepressants:

• Prozac belongs to SSRIs and is used to decrease cataplexy effects.
• Anafranil and Tofranil are tricyclic antidepressants that also have good effects on narcoleptics.
• Xyrem (Sodium oxybate) is helpful and the only approved drug for cataplexy patients. It inhibits the CNS and helps in situations when other medicines are useless. But side effects and interactions can be severe.

There is also homeopathic treatment and some herbs, such as Gotu Kola, Ginkgo biloba, or their mixes. Medical marijuana is not approved in the US, but in some cases it can become an alternative. Among other options, there is an experimental method of acupuncture.

Conclusions

To sum up, sleeping disorders, and narcolepsy in particular, are not something to ignore, as they ruin your normal life and seriously influence your health. But with the right treatment, you can regulate and successfully overcome such troubles as extreme sleepiness and narcolepsy. Reputable online pharmacies and trusted and widely used products will help you avoid negative consequences. Making the right choice is the most important thing, so do it carefully. It is always up to you, but weighing the ups and downs of all the meds available, we would recommend you stop your attention to modafinil. Provigil and its cheaper generics, available online, are really safe, and the only nootropics officially approved for narcolepsy.