Narcolepsy in a Nutshell

Narcolepsy is a chronic neurological disorder that affects the brain's ability to control sleep-wake cycles.
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Narcoleptic Woman Asleep at Work

Narcolepsy Facts:

  1. Narcolepsy is a lifelong problem with limited treatment options including stimulants, antidepressants, and sodium oxybate (aka GHB).
  2. Narcolepsy is a very rare diagnosis affecting an estimated 0.05% of the world's population. This translates to about 1 Narcoleptic in every 2,000.
  3. Narcolepsy diagnosis requires a Polysomnogram (PSG or sleep study), which is an overnight recording of brain and muscle activity, breathing, and eye movements, AND a Multiple sleep latency test (MSLT), which assesses daytime sleepiness by measuring how quickly a person falls asleep and whether they enter REM sleep. A normal person enters REM sleep at around 60-90 minutes; whereas, a person with Narcolepsy enters REM sleep in 15 minutes or less.
    (Fun fact about the author: I personally entered REM sleep on all 5 of my MSLT naps, which is almost unheard of even for Narcoleptics, with an average time of 7 minutes.)
  4. Excessive daytime sleepiness (EDS) is a key symptom that all individuals with narcolepsy have and is often the most obvious symptom.
  5. Cataplexy is the sudden loss of muscle tone while a person is awake that leads to weakness and a loss of voluntary muscle control. This is a symptom only seen in Narcolepsy Type 1.
  6. Sleep Paralysis is the temporary inability to move or speak while falling asleep or waking up that usually lasts only a few seconds to minutes and can be a symptom in some cases of Narcolepsy.
  7. Hallucinations are very vivid and sometimes frightening images that may accompany sleep paralysis and usually occur when people are falling asleep or waking up. Hallucinations are another symptoms of Narcolepsy and are primarily visual although they can involve any of the other senses, as well.
  8. Another symptom of Narolepsy is fragmented sleep and insomnia. While individuals with narcolepsy are very sleepy during the day, they usually also experience difficulties staying asleep at night. Sleep may be disrupted by insomnia, vivid dreaming, sleep apnea, acting out while dreaming, and periodic leg movements.
  9. Automatic behaviors are arguably the most intiguing symptom of Narcoelpsy. Individuals with Narcolepsy may experience temporary sleep episodes that can be very brief, lasting no more than seconds at a time, or can last for a few minutes. A person falls asleep during an activity (e.g., eating, talking) and automatically continues the activity for a few seconds or minutes without conscious awareness of what they are doing or that they are asleep. This happens most often while people are engaged in habitual activities such as typing or driving. They cannot recall their actions, and their performance is almost always impaired. Their handwriting may, for example, degenerate into an illegible scrawl, or they may store items in bizarre locations and then forget where they placed them. If an episode occurs while driving, individuals may get lost or have an accident. People tend to awaken from these episodes feeling temporarily refreshed, finding that their drowsiness and fatigue has subsided for a few moments.
  10. The cause of Narcolepsy is not fully known, but there are a few theories including low levels of the naturally occuring chemical hypocretin, which promotes wakefulness and regulates REM sleep. Current research is lacking, but has also noted causes of Narcolepsy stemming from Autoimmune disorders, Family history, and Brain injuries. In a nutshell, Narcoelpsy may have many causes and needs extensively more research conducted to provide better understanding, treatments, and accommodations in society and the workplace.

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