Narcolepsy: Causes and Treatment

There are different sleeping disorders. Some people have poor sleep at night, some suffer from superficial sleep and don’t get full relaxation, others have lack of sleep because of their work specificity, etc. Any disruption of a healthy sleep leads to physical and mental deviations. One of the most severe sleeping disorders is called narcolepsy. People who cannot control their sleeping cycles suffer most of all. 

What Is Narcolepsy

Narcolepsy is a disease affecting the central nervous system and meaning lifelong incurable disorder of sleep, that causes severe fatigue and progresses into sudden and non controlled sleep attacks. Narcolepsy influences all the spheres of the human’s life. It is insecure, because a person can feel excessive drowsiness during a day and fall suddenly asleep while eating, working, or driving a car.

It was estimated that one of 2,000 people has the signs of narcolepsy and many people simply don’t know that they have this disorder. Narcolepsy can be traced in some families, but it is not always a genetic disease. In rare cases, it is met in kids. The reason of appearing narcolepsy are not revealed, but some recent researches show that low levels of the hypocretin neurotransmitter might be the cause.

Forms of Narcolepsy

There are two types of narcolepsy:

  • narcolepsy of the first form is caused by hypocretin (orexin) deficit. It can be followed by cataplexy or not. Cataplexy is a sudden weakness in muscles, caused by very strong emotions such as anger, joy, laughter, embarrassment, or surprise. The attack causes the unexpected muscular tonus loss, that leads to slurred speech, the head drop, jaw weakness, knee flexion, it influences all the body and in the most severe cases results in the complete palsy, and makes a person fall down. The seizure sometimes look like a swoon, and its severity differs. Sometimes, it’s a short time pricking sensation, numbness and muscle weakness, sometimes it’s the collapse of the whole body. It lasts from seconds to minutes to bring the body back under control;
  • narcolepsy of the second type occurs when you have continual extreme sleepiness, but no cataplexy. A person can fall suddenly asleep for several hours and awake refreshed, but in a very short period of time feels tired and sleepy again. It is a rare and not fully discovered form of the disease.

Both types are dangerous, but the latter is really bad. Let’s see why it happens, and if there is a way to combat the disease.

Causes of Narcolepsy

The factors that cause narcolepsy were identified partially at the 20th century. It turned out that the reason is in improper work of the brain sector, which is responsible for the fast and slow sleep phases, regulates vegetative nervous system, and controls many functions of the body, in particular motor function. If the level of hypocretin (orexin) neurotransmitter fall down, which is responsible for wakefulness, it can end up with narcolepsy.

The other causes include:

  • heritage;
  • brain injury;
  • diabetes;
  • infectious nervous system disease;
  • exhaustion and stresses.

The second type-narcolepsy can be also the result of severe infection that influenced seriously the hypothalamus, to make it work improperly. In this case, a person has delusions, muscle breakdown and spasm, or a stroke, up to full loss of motor control, and even death.

Narcolepsy Symptoms

The average age when the first signs of narcolepsy can be notices varies from 15 to 25, and it’s very important to reveal the malady as soon as possible, because within the first several years the symptoms usually progress. The common major narcolepsy symptoms are:

  • excessive daytime sleepiness (EDS) is the first and major sign of narcolepsy. Sudden and irresistible falling asleep and unbearable constant fatigue. All people who suffer from narcolepsy have this symptom;
  • about one half of people with narcolepsy have nighttime sleep disruptions. It means that a person falls asleep, but easily and frequently wakes up during the night, and has difficulties to fall asleep again;
  • hypnagogic, or hypnopompic, hallucinations are very bright and realistic delusions that occur while a person is falling asleep, or getting awake. Mostly visual, the nightmares can also include the spheres of hearing, tasting, and smell. A person feels like not being alone in the room, or somebody’s touches, or some sounds, and becomes very frightened;
  • sleep paralysis often follows delusions. A person loses the ability to move or talk for some seconds or minutes, breathes with effort, feels extremely scared and trying hard to make a move. It can occur while falling asleep or waking up;
  • memory troubles may happen when you are doing something without full concentration and feel relaxed. You forget what you say or do because of being half asleep.

Pay attention, some of these symptoms can be the bad signs, and definitely the reasons to call your doctor.

Tests and Diagnosis

Narcolepsy is considered to be a rare diagnosis and often it is not revealed in time. It is very  important to find the right doctor who can administer the necessary and effective treatment. Usually, neurologists help. Laboratory tests, which help diagnose narcolepsy, are:

  • a polysomnography is made in clinic, where a patient is given a separate room for night, equipped with special video and audio systems. A patient is attached with sensors on different parts of the body (head, chest and legs). During a sleeping period, a specialist registers the waves of the brain, heart beat, level of oxygen in blood, breathing, legs and eyes movements, etc. The test can also help you detect the apnea;
  • a multiple sleep latency test (MSLT) deals with day time sleepiness. It is a full-day test, which is held in a dark room and divided into five periods, when a patient tries to fall asleep. The period lasts 15 to 20 minutes with two hour breaks. Detectors check how easily you fall asleep, if you do, and the phases of your sleep. As a rule, narcoleptics flack out within the first minutes of the test.
  • the hypocretin level is measured rarely, because this demands a lumbar tap, but it shows if it is enough of this neurotransmitter in your blood. If there is a lack of orexin, a patient surely has narcolepsy of the second type.

Home tests cannot diagnose narcolepsy. The medical professional will also learn your sleep history (you will be suggested to fill in the quiz in the Epworth Sleepiness Scale to study your daytime drowsiness), and will learn your current circadian rhythms (you will monitor and write down in a diary all cases of drowsiness, the time when you go to bed, etc, during a couple of weeks). Sometimes, it will also involve actigraph.

Treatment of Narcolepsy

There is no single narcolepsy cure. But the experienced doctor can select special medication or complex treatment specially for you. The main means to overcome the disease include: stimulants, selective serotonin reuptake inhibitors (SSRIs), or serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and amphetamines.

Stimulants:

  • Provigil (modafinil) is the most common drug prescribed for narcolepsy treatment. It is a wakefulness-promoting nootropic, regulating chemical process in brain. It is less abusive than other stimulating chemicals, and has minimal side effects;
  • Nuvigil (armodafinil) is one more stimulant, very similar to its congener, safe and efficient;
  • Ritalin (methylphenidate) is an effective medication for narcolepsy treatment, due to its power to decrease daytime sleepiness and increase alertness (see Modafinil vs Ritalin). But it has more side effects and is recommended not to be used at least once a week.

Amphetamines are very effective, but much more abusive and have more serious side effects:

  • Adderall is a very powerful medication that highly increases attention concentration, cognition, and wakefulness, stimulating central nervous system;
  • Vyvanse is one more effective drug that has less side effects than Adderall, and does not violate sleep cycles at night.

Antidepressants:

  • Prozac belongs to SSRIs and is used to decrease cataplexy effects;
  • Anafranil and Tofranil are tricyclic antidepressants that also have good effects for narcoleptics;
  • Xyrem (Sodium oxybate) is helpful and the only approved drug for cataplexy patients. It inhibits CNS and helps in the situations when other medicines are useless. But side effects and interactions can be severe.

There is also homeopathic treatment and some herbs, such as Gotu Kola, Ginkgo biloba, or their mixes. Medical marijuana is not approved in the US, but in some cases it can become an alternative. Among other options, there is an experimental method of acupuncture.

Conclusions

To sum up, sleeping disorders, and narcolepsy in particular, are not a thing to ignore, as they ruin your normal life and seriously influence your health. But with the right treatment you can regulate and successfully overcome such troubles, as extreme sleepiness and narcolepsy. Reputed online pharmacies, and trusted and widely used products will help you to avoid negative consequences. Making the right choice is the most important, so do it carefully. It is always up to you, but weighing the ups and downs of all meds available, we would recommend you stop your attention of modafinil. Provigil, and its cheaper generics available online, are really safe, and the only nootropics officially approved for narcolepsy.