Sleep Enough

What is narcolepsy?

Narcolepsy is an annoying sleep syndrome that can be serious, yet it is often mistaken for laziness. Constantly feeling tired all day and falling asleep in the middle of doing something are the chief symptoms which may indicate narcolepsy. Unlike normal tiredness which can be controlled, narcolepsy makes a person fall asleep without their having any control over it. Narcolepsy comes from the French word narcolepsie, a combination of the Greek words narke (stupor) and lepsis (seizure).

There are an estimated few million people worldwide who suffer from narcolepsy, with a few hundred thousand in the US alone. It appears narcolepsy runs in families, and teenagers and young adults below 40 being most often affected.

Narcoleptics experience what is called excessive daytime sleepiness (EDS), whether they get enough sleep at night or not. Sufferers feel really drowsy and may fall asleep anytime and anywhere. The sleep is refreshing, but only for a few hours. It goes without saying that people with narcolepsy have trouble holding a proper job and are always getting into trouble with the teachers for falling asleep in class!

Now I could be mistaken, but could narcoleptics be responsible for some traffic accident statistics? People with narcolepsy cannot help falling asleep, and so they may fall asleep even when they are behind the wheel. That is why narcolepsy is dangerous, and expert medical treatment should be sought as soon as possible.

Note that there is a difference between narcolepsy and fatigue caused by lack of sleep. During the days when I had very little sleep each night, I used to fall asleep when I was sitting in the toilet or bus, but it was not narcolepsy – because I could snap out of it. Narcoleptics can’t however.

The similarities are there though. It would be short spells of sleep lasting a few minutes to about half an hour. During these brief sleep spells, dreaming can, and frequently occurs. The line between wakefulness and sleep may be blurred, such that in real narcolepsy, the person may go on “auto pilot” and carry on what they were doing prior to falling asleep. When they wake up, they don’t remember what they were doing. It strongly resembles pronounced sleepwalking/somnambulism when this happens.

There are 5 common symptoms associated with narcolepsy:

• cataplexy
• sleep paralysis
• hypnagogic hallucinations
• automatic behavior
• chronic insomnia

These normally do not happen all together, and may not affect all narcoleptics. These symptoms also happen in other sleep disorders, but out of the four, cataplexy is unique to narcolepsy, and affects nearly 75% of patients.

Cataplexy causes sufferers to lose muscle control, and it happens when the narcoleptic experiences emotional shifts. This temporal paralysis is akin to the loss of muscle control during the normal process of falling asleep. The person may have trouble speaking or may experience temporal epileptic-like seizures.

Sleep paralysis normally happens during REM sleep, but in narcolepsy, it happens immediately when they fall asleep. On the other hand, hypnagogic hallucinations are vivid images that appear while the person is semi awake. Automatic behavior is as explained earlier, doing something while being asleep and yet having no memory of it upon awakening.

Narcolepsy is still a troubling condition which is mystifying. A brain chemical called hypocretin is absent or abnormally low in narcoleptic patients. At present it seems to be largely related to genetic anomalies (which is why it tends to run in families) and certain countries have a higher prevalence. There doesn’t seem to be a magic bullet to cure narcolepsy, but like other sleep disorders, lifestyle changes are absolutely necessary in bringing the condition under control.