Narcolepsy Symptoms & Treatment

 

Narcolepsy

Narcolepsy is a neurological sleeping disorder that greatly influences the quality of life such as schooling, work, social gatherings and also results in serious accidents and injuries. 


It disrupts the normal sleeping process as the brain no longer controls the sleep-wake pattern in an individual. This occurs due to the lack or low level of a chemical, hypocretin (also known as Orexin) which helps in regulating sleep cycles in our body. 

Generally, the normal sleeping process includes a few stages in which REM(rapid eye movement) comes up in an hour or more after falling asleep. But in a person with Narcolepsy, this stage of REM begins within 15 mins or even less than that due to the changes in the brain activity. 


Types of Narcolepsy-

As per ICSD3(International classification of sleep disorders 3rd edition), Narcolepsy has been classified into 2 types:


Type1: In Narcolepsy type 1 (NT1), people will have cataplexy & also low levels of hypocretin. Though cataplexy is not shown in some people, it will gradually appear after some time. This is the most common type of narcolepsy shown in 90% of cases.


Type2: This is less common & prevails in less than 10% of the cases. In this NT2(Narcolepsy type2) people show the same symptoms without cataplexy and low-level hypocretin.

In some cases, those who develop cataplexy and low-level hypocretin in later years of diagnosis can be classified into NT1.


Cause: 

The exact cause of Narcolepsy is not known yet. But these are some of the factors that tend to influence the sleep cycle in the brain:

  • Lack of Hypocretin

  • Auto-immune response

  • An inherited genetic condition

  • Hormonal changes

  • Change in sleeping patterns

  • Infections like swine flu

  • Having flu vaccines like pandemic

Still, the research is going on some of the above to conclude their role in narcolepsy.


In some cases, Narcolepsy also occurs due to the damage of an area in the brain. This is considered Secondary Narcolepsy. Furthermore, a head injury, brain tumor, multiple sclerosis (MS) & encephalitis also results in Narcolepsy in a few cases. 


Symptoms:

  • Excessive Daytime sleeping

  • Hypnogogic hallucinations

  • Sleeping paralysis

  • Cataplexy(Sudden Muscle weakness)

  • Poorly controlled REM(Rapid eye movement)

  • Automatic behaviors like walking, driving, or eating for a few seconds or minutes after sleep.

  • Obstructive sleep apnea

  • Restless legs syndrome

  • insomnia


Treatment :

There is no cure for Narcolepsy but certain lifestyle changes & some medication which help to treat EDS( Excessive daytime sleepiness)

Medications to stay awake like Modafinil (Provigil®) or armodafinil (Nuvigil®) & solriamfetol (Sunosi®) and pitolisant (Wakix®).

Sodium oxybate- This is FDA approved medicine to treat narcolepsy.

Stimulants such as amphetamine /dextroamphetamineb or dextroamphetamine  mixed salts (Adderall®, Dexedrine®) and methylphenidate (Ritalin®, Focalin®, Concerta®) are used for narcolepsy therapy but they do have some side effects.

Antidepressant medications such as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are also effective in treating narcolepsy.


Proper monitoring is required while taking this medication for treatment. Along with this following, a regular sleep-wake schedule, healthy food intake & avoiding smoking, alcoholic habits are also necessary to treat Narcolepsy.



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