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Narcolepsy

Definition:
Narcolepsy, which affects approximately 140,000 Americans, is a neurologic disorder characterized by frequent, involuntary, episodes of sleeping during the day. Sleep attacks may occur while driving, talking or working.

Causes:
The cause of narcolepsy is unknown, but it is thought to have a genetic component.

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.
  • Family members with narcolepsy
Symptoms:
Symptoms of narcolepsy usually start during the teenage years. Onset may range from 5 to 50 years old. Symptoms may worsen with aging, but may improve in women after menopause.

Symptoms include:

  • Excessive daytime sleepiness
  • Daytime involuntary sleep attacks
  • Unrefreshing sleep
  • Sudden loss of muscle tone without loss of consciousness (cataplexy)
  • Temporary paralysis while awakening
  • Frightening mental images that appear as one falls asleep
  • Memory problems
  • Symptoms may be triggered by:
    • A monotonous environment
    • A warm environment
    • Eating a large meal
    • Strong emotions
Diagnosis:
The doctor will ask about your symptoms and medical history, and perform a physical exam. If narcolepsy is suspected, you may be referred to a specialist in sleep disorders.

Tests may include:

Sleep Latency Test – measures the onset of rapid eye movement sleep, which occurs earlier than normal in narcolepsy

General Sleep Lab Study – helps rule out other causes of daytime sleepiness. The following things are monitored while you sleep:

  • Brain waves
  • Eye movements
  • Muscle activity
  • Respiration
  • Heart beat
  • Blood oxygen levels
  • Total nighttime sleep
  • Amount of nighttime REM sleep
  • Time of onset of REM sleep
  • Degree of daytime sleepiness
Treatment:
Treatment may include:
  • Stimulant medications that increase levels of daytime alertness include:
    • Methylphenidate
    • Pemoline (requires regular blood testing for liver function)
    • Dextoamphetamine
    • Methamphetamine
    • Modafinil
  • Antidepressants – to help treat many symptoms of narcolepsy, include:
    • Cataplexy
    • Hallucinations
    • Sleep paralysis
  • Other treatment options include:
    • Planned short naps throughout the day
    • Counseling to cope with issues of self esteem
    • Wearing a medical alert bracelet or pendant
Prevention:
There are no guidelines for preventing narcolepsy itself. However, you can try to prevent symptoms.
  • Avoid activities that carry a risk of injury from a sudden sleep attack, such as:
    • Driving
    • Climbing ladders
    • Using dangerous machinery
  • Exercise on a regular basis.
  • Get adequate sleep at night.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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