Narcolepsy is a chronic neurological disorder the affects the sleep-wake cycle and leads to excessive sleepiness despite adequate sleep. It is a rare condition and approximately affects 1 in 2000-3000 people but most patients are only diagnosed 7-10 years after the initial symptoms. The onset of narcolepsy is seen usually in early childhood or late adolescence.(2)
How Do You Know If You Have Narcolepsy?
How will you know if you have narcolepsy? Mainly by symptoms, then you can consult a doctor who will examine you and do certain investigations to diagnose the condition. The symptoms of narcolepsy are lifelong, they can improve with time and does not usually, get worst. Only 10-25% of patients will experience all the symptoms mentioned below.
Excessive Daytime Sleepiness (EDS). Almost all patients with narcolepsy have EDS; this is the main symptoms of narcolepsy. Even after a good night sleep still, if you still feel sleepy during the daytime. It’s more like a sleep attack where an irresistible sense of sleepiness comes. In-between the sleep attacks you will be alert and continue work normally.(1)
Cataplexy. Acute onset loss of muscle tone which leads to muscle weakness and loss of muscle movement is called cataplexy. Usually, this loss of tone is triggered by your emotions such as anger, fear, laughter, excitement or stress. Cataplexy can appear weeks or even after years of EDS. Some people only experience one or two attacks during their lifetime while others experience cataplexy more often. In 10% of narcolepsy patients, cataplexy is the first symptoms and can be diagnosed as a seizure disorder mistakenly. Most of the cataplexy attacks involve only a few muscles and will only experience a small weakness such as drooping of eyelids. The most severe attack is the collapse of the whole body where the person is unable to speak, move or even keep the eyes open, however, the consciousness remains intact which enables the doctors to distinguish cataplexy from a seizure. Most episodes resolve in a few minutes, even though the episode sounds scary it’s not dangerous if the person collapses in a safe place. Cataplexy resembles the muscle paralysis that occurs during the REM phase of the sleep cycle. Cataplexy is characteristic of narcolepsy.
Sleep Paralysis. Sleep paralysis is the inability to speak or move temporarily while going to sleep or waking up. This only lasts for a few seconds and it resembles cataplexy except this occurs at the time of falling asleep or waking up. There is no permanent dysfunction with sleep paralysis.
Hallucinations. Hallucinations are vivid sometimes scary images that are seen by the person usually at the time of sleep paralysis when going to sleep or waking up. Most hallucinations are visual but auditory, tactile and other sensory hallucinations can occur.(1)
Other symptoms are:
Fragmented Sleep And Insomnia. Some of you might find it difficult to fall asleep or maintain sleep at night. The sleep is disturbed by insomnia, vivid dreams, periodic leg movements, sleep apnea, and acting out dreams.
Automatic Behaviors. Narcolepsy people will experience temporary sleep episodes, each episode lasts for a few seconds. These sleep episodes usually occur while you are engaged in routine activities such as talking, eating driving or typing. You will fall asleep while doing the activity and continue the activity for some time unconsciously then wake up feeling refreshed without being sleepy or drowsy.(1)
Diagnosis. A physical examination excludes other causes and you will be advised to maintain a sleep journal which will give more specific details. Investigations such as polysomnogram (sleep study) and multiple sleep latency test are specialized tests to diagnose narcolepsy.
If you have symptoms like excessive day time sleepiness, cataplexy, sleep paralysis, hallucinations, fragmented sleep, insomnia, and automatic behaviors it can be due to narcolepsy. Then you need to consult a doctor so, that a physical examination can be carried out and investigations such as polysomnogram and multiple latency test can be done to diagnose narcolepsy.
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