Narcolepsy is a chronic neurological disease and there is a disturbance in the sleep-wake cycle basically in this disease. There is a neuropeptide in the brain that regulates the sleep-wake cycle called the hypocretin. In patients with narcolepsy, this neuropeptide is found to be decreased. Due to this, there is excessive daytime sleepiness amongst patients. The patient feels sleepy throughout the day even after sleeping for enough hours at night. This disease is accompanied by other symptoms like sleep paralysis, hallucinations, and cataplexy. There is excessive daytime sleepiness because the quality of sleep at night is poor than normal. There is no cure for narcolepsy it stays forever; it can be managed with the help of medications and lifestyle changes.(1)
Can Someone Have Narcolepsy And Sleep Apnea At The Same Time?
Yes, someone with narcolepsy can have sleep apnea, both at the same time. Both sleep apnea and narcolepsy are sleep disorders. Sleep apnea is a serious sleep disorder that is characterized by intermittent episodes of apnea (absence of breathing) while sleeping. The main symptoms of sleep apnea are feeling tired during daytime even after proper sleep at night. There are three types of sleep apnea: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. Obstructive sleep apnea is the most common type of sleep apnea. It occurs because of the relaxation of the muscles of the throat. Central sleep apnea occurs when the brain does not send signals properly to the brain for controlling breathing. Complex sleep apnea syndrome when above two types of sleep apnea are present at the same time.
In many of the cases, it has been reported that the patient had both narcolepsy as well as obstructive sleep apnea. Also, it has been seen that people with narcolepsy are obese and have raised BMI (Body Mass Index) so this might also be one of the reasons to cause obstructive sleep apnea in patients with narcolepsy. Many of the times patients with narcolepsy without cataplexy are diagnosed as sleep apnea. The main difference between sleep apnea and narcolepsy is the presence of cataplexy, it is present in narcolepsy and not in sleep apnea. When patients with narcolepsy are treated with CPAP, the state of the patient does not improve if he/she has sleep apnea. While patients with just sleep apnea show drastic improvement when treated with CPAP. Excessive daytime sleepiness is the main symptom in both of these sleep disorders, so the diagnosis becomes tough. Many times the presence of cataplexy in sleep apnea may be misdiagnosed as a seizure disorder.
Narcolepsy is diagnosed with the help of physical examination and sleep studies. Sleep apnea is diagnosed with the help of sleep studies; in these studies, a number of respiratory disturbances taking place during sleep are recorded.(2), (3), (4)
Treatment For Sleep Apnea
CPAP (Continuous Positive Airway Pressure): When the patient has moderate to severe kind of sleep apnea, he/she may benefit from CPAP, in this a machine is used to deliver air while you are asleep via a mask. While using CPAP, the pressure of air is kept on the higher side as compared to the pressure of air in the room, this helps to keep the airways open and hence prevents snoring and apnea. Many people find CPAP uncomfortable, but when used on a regular basis, the patient gets used to it. The mask used must be comfortable for the patient. You must contact your doctor immediately if you still snore at night even after using CPAP.
BPAP (Bilevel Positive Airway Pressure): If CPAP does not help, then BPAP can be used for such patients. This device delivers high-pressure air while inhalation and low-pressure while exhaling.
Auto-CPAP. This is a type of CPAP device; the only difference between this and CPAP is that this device adjusts the air pressure automatically on its own while you remain asleep while in CPAP you have to adjust the air pressure.
Oral Appliances. Oral appliances are available when you wear these appliances; they keep your throat open. These are easy to use as compared to CPAP. But CPAP is a more reliable option than these. There are many devices available you just need to find the one that suits you the best.(5)
Yes, narcolepsy and sleep apnea can occur together at the same time. There are many cases reported that have both of these sleep disorders. The difference between narcolepsy and sleep apnea is that there is no sudden loss of muscle tone in sleep apnea (cataplexy) as in narcolepsy. Many times, when these both are present are together it becomes difficult to diagnose narcolepsy.
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