Narcolepsy is a chronic neurodegenerative disease. It is characterized by features like excessive daytime sleepiness, cataplexy, sleep paralysis, and sleep-related hallucinations. In this condition, the patient feels very sleepy throughout the day even after sleeping for eight hours at night. The patient falls asleep involuntarily in the middle of any work or anything. The patient cannot focus on work or any other activities like writing, reading, eating, etc. In narcolepsy, the patient enters REM (Rapid Eye Movement) sleep just after 15 minutes of falling asleep. Normally a person enters REM (Rapid Eye Movement) sleep after one to one and a half hour of falling asleep.(1)
Is Narcolepsy A Mental Illness?
Narcolepsy is a neurodegenerative disease that affects almost 1 in 2000 people all over the world and is noncurable. It is not a mental illness or psychiatric condition. But people with narcolepsy are prone to suffer from other mental illnesses like anxiety, depression, etc. Many times when a patient has both mental illness and narcolepsy, it becomes difficult to diagnose narcolepsy. Some of the psychiatric conditions may have the same pathophysiology as narcolepsy and hence the disease may occur simultaneously.
The symptoms of narcolepsy last forever. The symptoms usually appear during adulthood or adolescence. It is a rare disease and that is the reason it takes time to diagnose it. Narcolepsy is diagnosed on the basis of clinical history and other diagnostic tests. Tests like multiple sleep latency test (MSLT) and polysomnography is used to confirm the diagnosis. In MSLT, the daytime sleepiness is observed and in this test, five naps are observed throughout the day separated by a duration of 2 hours. The test is positive when the mean sleep latency is of 8 minutes or less involving REM (Rapid Eye Movement) sleep in at least 2 out of the 5 naps. It is difficult to accurately diagnose narcolepsy because of the presence of other psychiatric conditions along with it. The symptoms of psychiatric conditions mask over the symptoms of narcolepsy and hence it remains undiagnosed for a long time. Many times sleep apnea is also present with narcolepsy. Sleep apnea also has psychiatric comorbidities like depression, anxiety, etc. Patients with depression feel tired as well as suffer from excessive daytime sleepiness and the presence of hallucinations can be confused with psychotic hallucinations, this way the disease is misdiagnosed due to masking of symptoms. Also, people with mental illness have trouble focusing at work and other activities and the same happens with patients who have narcolepsy, this makes it difficult to diagnose the disease.(2), (3)
What’s The Treatment For Narcolepsy?
Medications For Narcolepsy
Antidepressants. In order to treat narcolepsy, tricyclic antidepressants and adrenergic and serotonin reuptake inhibitors have been used. Tricyclic antidepressants are clomipramine, desipramine, etc. Noradrenergic and serotonin reuptake inhibitors include fluoxetine, venlafaxine, etc. These antidepressants are useful to control cataplexy.
Modafinil. This is a CNS (Central Nervous System) stimulant. It is the first medication to be prescribed as it is non-habit forming and has fewer side effects.
Sodium Oxybate: It is a sedative drug. It is taken at nighttime only. This drug is helpful in treating excessive daytime sleepiness as well as cataplexy.
Lifestyle Changes For Narcolepsy
Say No To Smoking: You must not smoke especially at nighttime.
Taking Short Naps. When you feel the sleepiest, you must keep those time periods in mind and then take short naps at exact that time.
Following Sleep Schedule. You can make a schedule and follow that and sleep accordingly at the decided time and wake up at the pre-decided time. This helps you to sleep better.
Relaxing Before Going To Bed. You have a nice warm bath before going to bed; this helps you relax your body. This will make it easier to fall asleep.(4)
Narcolepsy is a chronic neurological disease but it is not a psychological disease or a mental illness. However, patients with narcolepsy are prone to suffer from other mental illnesses like depression, anxiety, etc. Most of the times, mental illnesses are present along with narcolepsy and this makes it difficult to diagnose narcolepsy. So to conclude, narcolepsy is not a mental illness.
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