Narcolepsy and Cataplexy – What Are They?

narcolepsyNarcolepsy is a condition that makes a person excessively sleepy during the day.  It’s a neurological problem that doesn’t have a cure and it disrupts a person’s normal sleep pattern.

Cataplexy is a sudden loss of muscle control and tone due to some strong emotion – for example laughter, excitement or anger.  It occurs as part of narcolepsy in about 50-90% of people with narcolepsy.

These conditions are quite complex so this is a brief overview.

Who gets narcolepsy?

It’s a pretty rare condition, occurring in about 25 of 100,000 Caucasian people and comes on around the time of adolescence.

It’s more common in men and there seems to be a tendency to inheriting it.

What might cause narcolepsy?

Scientists think that narcolepsy can come about if a person loses or hasn’t had a few of the brain neurons that produce a chemical (called hypocretin) which is involved in sleep/waking cycles.

Head injury, infection or a change in sleeping patterns (such as night working) is thought to perhaps trigger narcolepsy.

What are the symptoms of narcolepsy?

A person often has episodes where there is an overwhelming and uncontrollable desire to sleep.  These episodes can last a few minutes or a few seconds but can occur at any time – during conversations, while eating, at work or school etc, and when driving.

To an onlooker you may appear awake but not be aware of what’s going on or behave appropriately.

This can significantly disrupt daily life.

What are the symptoms of cataplexy?

  • The loss of muscle tone means that a person might have symptoms that are slight (feeling the facial muscles go slack for example) or more severe where he collapses to the floor.
  • There will be no loss of bladder or bowel function and the person will be able to breathe normally.
  • Speech may be slurred and there may be some double vision.

What will a specialist do for narcolepsy and cataplexy?

Your doctor will ask you about your sleep pattern.  Usually people with narcolepsy don’t sleep for longer than people without the condition, but their sleep is more fragmented during the days and nights.

He will also ask you about the meds you’re on, any alcohol or recreational drug use etc, family history and your lifestyle.

You may have an MRI scan and be asked to rate your sleepiness on the Epworth Sleepiness Scale.

A sleep study will look at what happens to you when you sleep at night and an EEG will look at your brain waves and activity.

Treatment for narcolepsy and cataplexy.

For yourself you can:

  • Make sure you have a regular sleep routine and get 7-8 hours’ sleep at night.
  • Have scheduled naps in the day.
  • Have regular exercise.
  • Talk to friends, family and co-workers about your condition.  Serious cataplectic attacks can be frightening for people around you.
  • Family and friends can learn to spot the signs of an attack so that they can help you prevent injury.

Drug treatments include:

  • Modafinil is a drug specifically for narcolepsy and may help cataplexy.  It is suitable for over 18s and most other people although there are some exceptions your doctor will discuss with you.
  • SSRI antidepressants
  • Benzodiazepines (like diazepam, temazepam) is used in people who don’t respond to other treatments.  These drugs may help consolidate daytime sleep into night time sleep.
  • For cataplexy drugs such as clomipramine (an antidepressant), SSRI antidepressants or venlafaxine/reboxetine (newer antidepressants) may work well.

There is no known cure for narcolepsy.  Cataplexy may reduce over time with treatment or improve of its own accord.

Elspeth Raisbeck

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