What Are The Symptoms Of Narcolepsy Or Excessive Daytime Sleepiness?

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Symptoms Of Narcolepsy

Affecting about 1 in 3000 Americans, narcolepsy is a chronic brain disorder that involves poor control of sleep-wake cycles. Symptoms include periods of excessive daytime sleepiness or sudden, uncontrollable bouts of sleep often accompanied with muscle weakness, vivid hallucinations. A good sleep hygiene and avoiding stimulants like alcohol, caffeine may help.

Welcome to the nightmarish world of narcolepsy, a strange place of sleep attacks, vivid hallucinations, and sleep paralysis. Affecting about 1 in 3000 Americans, narcolepsy is a chronic condition that impacts the brain and causes excessive daytime sleepiness.1

Feeling sleepy during the day? Or falling asleep all of a sudden? You might be suffering from narcolepsy.

People with narcolepsy often suddenly and unwittingly fall asleep. Normally, when we fall asleep we enter a sleep cycle that lasts about 100 to 110 minutes, moving from a phase of non-rapid eye movement (NREM) sleep to a phase of rapid eye movement (REM) after about 80 to 100 minutes.

If you are narcoleptic, you might start dreaming right after you fall asleep as you enter the REM phase directly, bypassing the NREM phase.

The REM phase is when we experience deep sleep, with increased brain activity and paralysis of the muscles that control movement. But those with narcolepsy seem to enter the REM stage minutes right after falling asleep.2

What Causes Narcolepsy?

The exact reasons for narcolepsy are unclear but many people with narcolepsy have reduced amounts of hypocretin, a neurotransmitter that encourages wakefulness. It is theorized that if you are narcoleptic, your immune system wrongly attacks cells that are associated with the production and functioning of hypocretin.

Your body can’t produce enough hypocretin, the neurotransmitter responsible for wakefulness, making you drowsy through the day.

Some factors that may contribute to the development of narcolepsy include hormonal changes (like those accompanying menopause or puberty), stress, a genetic flaw, changes in your pattern of sleeping, and infections like swine flu.

The condition might start after puberty or menopause, a brain injury, or swine flu.

If the part of your brain that is involved in the production of hypocretin is damaged for some reason, as in a brain injury or tumor, that can also cause narcolepsy.3

Features Of Narcolepsy

Narcolepsy might not have a seriously detrimental effect on your physical health but its many symptoms can be hard to cope with.4

1. Excessive Daytime Sleepiness

This is the most common symptom of narcolepsy, where people feel perpetually drowsy during the day. Many narcoleptics report being unable to think clearly, feeling low on energy, or being exhausted.

You would be likely to report low levels of energy, exhaustion, and unclear thinking.

Some people may suddenly and uncontrollably fall asleep for brief periods, say a few seconds, during the day (called a sleep attack), with about 40% automatically continuing with whatever they were doing – but without remembering what they did when they wake up.5 For example, if they were tidying up, they may not remember where they placed things. People are prone to make mistakes or have accidents when this happens.

2. Cataplexy

Cataplexy is a sudden, temporary muscular weakness. This can be mild or severe. But unlike a seizure disorder, even with a severe instance of cataplexy – like when a person collapses to the floor – there’s no loss of consciousness.

An intense emotion like anger or fear may suddenly paralyze all your muscles though you remain fully conscious.

Cataplexy is often initiated by intense emotions like anger, fear, or humor. It has been found that the brain cells that are responsible for stopping muscular activity during REM sleep are also involved in cataplectic attacks.

3. Sleep Paralysis

Sleep paralysis is like having a cataplectic attack that affects all the muscles of the body. The person can’t speak or move. This usually happens when narcoleptics are falling asleep or waking up. It is like the arresting of muscular activity that normally happens during REM sleep.

While falling asleep or when waking up, you might be unable to move, speak, and react. About 17 to 40% narcoleptics experience this sleep paralysis.

Just like a cataplectic attack, this too is temporary and people often remain conscious during these episodes. About 17 to 40% narcoleptics suffer from sleep paralysis.6

4. Disturbed Sleep

Most people with narcolepsy have trouble sleeping peacefully; their sleep may be disrupted by vivid dreams that have them acting out scenarios, insomnia, and incessant talking or mumbling.

5. Hallucinations

People with narcolepsy tend to hallucinate while they are sleeping or when they are waking up or falling asleep. The hallucinations can be extraordinarily vivid, and can seem real and frightening. They often accompany episodes of sleep paralysis.

6. Obesity

It’s been observed that many people put on weight when they get narcolepsy.7 This can be attributed to the low basal metabolism rate caused by low activity levels and change in eating behavior.8

The lack of hypocretin in your body affects the burning of calories and contributes to weight gain and obesity.

Another recently discovered cause is the deficiency in hypocretin (also called orexin). Hypocretin encourages the formation of brown fat, which helps burn calories. Lack of hypocretin also results in the lack of brown fat and causes the narcoleptic patient to gain weight.9

Living With Narcolepsy

There is no cure for narcolepsy but your doctor might be able to prescribe medication that can control some of the symptoms of narcolepsy.

Some habits can help improve your quality of sleep and manage daytime drowsiness and fatigue.10 These include:

Sleep at a regular time, eat a light dinner, and keep your bedroom cozy.

  • Waking up and going to bed at a regular time every day
  • Avoiding alcohol, smoking, and caffeine, especially before bedtime
  • Refraining from having huge heavy meals for dinner
  • Keeping your bedroom warm and comfortable

Afternoon Nap

Research has also found that taking a 15-minute nap in the afternoon can help people with narcolepsy.11

Take a 15-minute nap in the afternoon, practice yoga for insomnia, and try out hypnosis to alleviate some of the symptoms of narcolepsy.

Yoga And Hypnosis

Yoga too has been found to have a positive effect on how well you sleep. One study found that people suffering from insomnia who practiced yoga fell asleep sooner, slept longer, and woke up fewer times during the night.12 There is also some evidence that hypnosis can be helpful with some symptoms of narcolepsy like sleep paralysis.13

References   [ + ]

1, 2, 5, 7. Narcolepsy Fact Sheet, National Institutes Of Health. 2016.
3. Causes of narcolepsy, National Health Service, UK.2016.
4. Narcolepsy, National Health Service, UK. 2016.
6. The International Classification of Sleep Disorders, Revised. American Academy of Sleep Medicine.
8. Chabas, Dorothée, Christine Foulon, Jesus Gonzalez, Mireille Nasr, Olivier Lyon-Caen, J. Willer, J. Derenne, and Isabelle Arnulf. “Eating disorder and metabolism in narcoleptic patients.” Sleep-New York Then Westchester- 30, no. 10 (2007): 1267.
9. Sellayah, Dyan, Preeti Bharaj, and Devanjan Sikder. “Orexin is required for brown adipose tissue development, differentiation, and function.” Cell metabolism 14, no. 4 (2011): 478-490.
10. Narcolepsy Fact Sheet. National Institutes Of Health. 2016.
11, 13. Agudelo, Hernán Andrés Marín, Ulises Jiménez Correa, Juan Carlos Sierra, Seithikurippu R. Pandi-Perumal, and Carlos H. Schenck. “Cognitive behavioral treatment for narcolepsy: can it complement pharmacotherapy?.” Sleep science 7, no. 1 (2014): 30-42.
12. Khalsa, Sat Bir S. “Treatment of chronic insomnia with yoga: A preliminary study with sleep–wake diaries.” Applied psychophysiology and biofeedback 29, no. 4 (2004): 269-278.