Many people experience occasional tiredness during the day, perhaps after a fitful night of sleep or after a heavy meal. While it may be annoying, the weariness usually is one-off deal, forgotten after the next night of sleep.
But in a minority of cases, daytime tiredness turns frequent and severe, causing the person to fall asleep even while conversing, driving or attending class. Such are the symptoms of narcolepsy, a chronic brain disorder that so impairs normal wake-sleep cycles that sufferers immediately surrender to sleep impulses no matter where they are or what they are doing.
Narcolepsy symptoms generally occur between the ages of 7 and 25 and the first symptom almost always is Excessive Daytime Sleepiness (EDS). (Read how EDS strikes others because of a wide variety of medical conditions, including those who are sleep deprived or those who consume caffeine, alcohol and nicotine.)
Those with narcolepsy find that the condition interferes with their daily activities even if they had sufficient sleep the previous night. But since an uninterrupted night's sleep is a rarity for them, most with narcolepsy spend no more time asleep than the general population. They often have no trouble falling asleep, but disruptions such as vivid dreams or leg movements wake them to face middle-of-the-night insomnia.
For an estimated 40 percent of people with narcolepsy, sudden sleep attacks are often of so short duration they are dubbed “microsleeps” lasting mere seconds, and the individuals appear to continue their activity or task via some sort of auto-pilot, without later recalling their actions. However, their performance usually is impaired – a writer’s scrawl may turn illegible, for example, or an auto driver may have an accident.
Gaining weight is common after development of narcolepsy. So is the emergence of cataplexy, episodes in which an active individual suddenly loses muscle tone and voluntary muscle control. The attack may be so mild and fleeting as to be imperceptible, or so severe that the person is unable to speak, move or keep their eyes open. (But even during these extreme attacks, the sufferer is fully conscious.) About 70 percent of the narcolepsy patients also experience cataplexy.
Among the possible causes of narcolepsy is a low level of a neurotransmitter called hypocretin, a body chemical that regulates wakefulness. While individuals can develop narcolepsy without a family history of the disorder, about 10 percent of individuals with narcolepsy and cataplexy say they have a close relative with the same symptoms.
Clinicians at NY Metro Sleep may include medicines in the treatment of narcolepsy patients, but only after a complete assessment of your condition and symptoms. There are medicines designed to raise your alertness during the day and others to help you sleep at bedtime. But these must be balanced and carefully prescribed. In addition, the sleep team will need a full list of medications you take for other conditions because some of them may interfere with your sleep.