NARCOLEPSY EXPLAINED
e focus for this week will be on another primary sleep disorder known as narcolepsy. e disorder usually begins in adolescence or early adulthood. One study posits that narcolepsy occurs in 0.87–1.21 % of the world population though there may be underreporting due to misdiagnosis. People with narcolepsy have tantalising sleep episodes during waking hours, lapses into sleep or nap frequently, have sleep paralysis and cataplexy. Cataplexy is a situation whereby there is loss in individual’s muscle tone though have full consciousness and maybe preceded by anger, frustration or unexplained laughter. Because of the loss of muscle tone, individuals are fleetingly paralysed and as a result may drop things they are holding or fall to the ground themselves. In sleep paralysis, individual is unable to move or speak during the period of transition from sleep to wakefulness. In some situ- ations, there may be some hallucinations that happen during sleep which some people may misconstrue for a psychiatric diagnosis. For some individuals, symptoms of sleep disturbances characterised by several awakenings in the middle of the night and memory lapses may suffice. e distinction of narcolepsy with hypersomnia is that individuals often feel refreshed after waking up though there is often another cycle of sleep within 2 to 3 hours. is means then that in general, those with narcolepsy are never refreshed nor rested despite sleeping for several hours. e cause of narcolepsy is not clear but there is compelling evidence that deficit of a chemical known as hypocretin is associated with the disorder. Some studies have also highlighted a genetic basis to the disorder.
Hypocretin measurements are pivotal for the diagnosis on the basis that there is associated hypocretin deficiency. Narcolepsy cannot be cured but however symptoms can be managed with wake-promoting substances and
psychostimulants like amphetamines. As has been highlighted with other sleep disorders, lifestyle modifications towards proper sleep hygiene are highly encouraged under narcolepsy. Taking frequent naps have been seen to be helpful.