Narcolepsy is a disabling neurological condition that causes sudden, overwhelming fatigue, loss of consciousness, and even seizure-like symptoms. It strikes unexpectedly, causing people to fall asleep or experience loss of bodily control at inappropriate, sometimes dangerous moments.
People who suffer from narcolepsy can display a wide range of symptoms from mild to severe, and the disorder can wreak havoc on their daily lives. Here is some basic information about this debilitating disease, its causes, and the newest information on statistics and treatment.
What is narcolepsy and how does it develop?
Sleep disorders such as chronic insomnia or snoring are a common global problem, afflicting more than 40 million people and counting. Chronic dysfunctional sleep can impact every aspect of a person’s life, from work to relationships to personal safety.
Narcolepsy is the most severe sleep disorder, and can completely disable its sufferers, preventing them from working or enjoying many of life’s normal daily activities, such as driving, swimming, or anything that requires a person to be awake reliably. While most people could easily take this for granted, narcoleptics are forced to consider the consequences of losing consciousness at any moment. This is a difficult reality to manage, and it is no surprise that many narcoleptics also find themselves battling anxiety and depression over their condition.
People are not born with narcolepsy. Although its causes are not yet solidly identified, the newest research upholds that it is an autoimmune condition that targets certain cells in the brain. Our brains contain a small organ called the hypothalamus which is responsible for producing a number of substances critical to our daily bodily functions. One of those substances is a neurochemical called hypocretin, which controls our ability to voluntarily stay awake. The mechanisms of narcolepsy are thought to produce antibodies against that portion of the hypothalamus that secretes hypocretin, resulting in a loss of production, so it’s important to understand the first symptoms of Narcolepsy.
As a result, the narcoleptic person suffers bouts of sudden, uncontrollable somnolence, described as being comparable to the fatigue of being awake for 48 hours straight. In addition to daytime sleepiness, narcoleptics often experience difficulty sleeping at night, worsening their daytime condition.
A secondary complication called cataplexy strikes about 70% of narcoleptics. Cataplexy elicits a stroke-like effect triggered by strong emotional responses like excitement or laughter, and causes the person to suddenly lose muscle control, slur words, and become temporarily disabled by physical weakness. About 10% of these cases also experience the extreme symptoms of temporary muscle paralysis or hallucinations.
How common is narcolepsy?
Narcolepsy is not common; the incidence is about one out of every 2000 people, an estimated 200,000 Americans and 3 million people worldwide. It occurs in every country and across every demographic, but there is a higher incidence in Japan. Narcolepsy can occur at any age, but usually strikes in the late teenage years or early adulthood.
Misdiagnosis is a common issue with narcolepsy. It is estimated that only 25% of narcoleptics have received a diagnosis and are under appropriate treatment. Narcolepsy shares a pattern of symptoms with other neurological disorders that makes it sometimes difficult to distinguish from epilepsy, atypical migraines, or other neurological issues.
Narcolepsy also shares some similarities to other sleep disorders such as snoring/sleep apnea which can also cause daytime sleepiness. Because there are mild forms of the disease, people may be slow to seek medical help or it may be dismissed as a less severe sleep disorder. In fact, it takes an average of seven years for people with narcolepsy to finally be diagnosed.
What causes narcolepsy?
The exact causes of narcolepsy are still unknown, but studies support that a combination of genetic and environmental factors are to blame, as they often are for autoimmune disorders. According to the latest research, one gene has been positively identified as causing narcolepsy. Other possible contributing factors are exposure to certain viral and bacterial illnesses, like H1N1 influenza (swine flu) and streptococcus, hormonal changes due to puberty, or the biochemical changes that can accompany extreme stress. In the few cases where the cause is directly known, the disease is called secondary narcolepsy. This can occur in the case of an acute head injury or due to encephalitis (swelling of the brain) from an infection.
Many of these are theoretical assumptions at this point. While some of its causes remain a mystery, it is known that autoimmune disorders can be caused by any stimulus that “overexcites” the immune system, rendering it unable to shut off properly and increasing the likelihood that a person’s own tissue will become a target. Such may be the case with specific cell markers of the hypothalamus or with the chemical structure of hypocretin itself, which are inappropriately targeted by immune activity.
How is narcolepsy treated?
Narcolepsy is mostly managed by using medications that help control symptoms. Stimulants such as Provigil can be used to overcome daytime sleepiness. Antidepressant medications are prescribed to alter the brain chemistry to control cataplexy, help improve night-time sleeping, and to help with depression symptoms as well.
People with narcolepsy are also encouraged to use “sleep hygiene” practices to maximize their night-time rest, and to seek healthy support methods to help deal with the disorder, such as exercise, talk therapy, and meditation. If snoring and/or obstructive sleep apnea is contributing to daytime symptoms, it too should be treated.