What is narcolepsy?

-One of the commoner causes of severe excessive sleepiness.

-There are three basic reasons that a person could be too sleepy:

--INADEQUATE OR POOR QUALITY SLEEP. Best example: patients with sleep apnea. Their alertness will be restored once their sleep-related breathing problems are controlled.

--IMPAIRED BRAIN MECHANISMS THAT NORMALLY SHOULD KEEP ONE AWAKE. In such cases, even if sleep were perfect, the individual would still be too sleepy. Best example: narcolepsy.

--A COMBINATION OF BOTH OF THE ABOVE. For example, some people develop narcolepsy in late childhood or their teen years--and then, with increased age and weight, also develop sleep apnea: making an already bad situation worse.

CRUCIAL POINT! If a patient with both sleep apnea and narcolepsy is treated at a facility that focusses only on sleep apnea and if the diagnosis of narcolepsy is missed, the results can be disastrous.

Treatment of sleep apnea in individuals with both problems will make them "better but not better enough". The fact that management of sleep apnea will protect them against cardiac complications and stroke will be small consolation should they subsequently fall asleep at the wheel anyway, from their still untreated narcolepsy, with serious injury or death of self or others.

There is no law against having more than one sleep disorder or more than one cause of a single basic symptom such as sleepiness. It is important to ensure thoroughness of the care that you receive.

-Narcolepsy involves both "brain sleepiness" as explained above, and disturbances of REM sleep (a tendency for it to occur too rapidly after sleep onset and for its component parts to intrude into wakefulness--with distressing symptoms). Resulting possible symptoms:

--Dreaming in brief naps.

--Dream fragments occurring either prior to falling asleep or persisting after awakening (hypnagogic and hypnopompic hallucinations).

--Sleep paralysis.

--Cataplexy.

Only cataplexy is diagnostic of narcolepsy, and not all narcoleptics suffer from cataplexy.

Who develops narcolepsy?

-Narcolepsy can occur in people of both sexes. Symptoms--particularly sleepiness--usually begin in late childhood, the teen years or the early twenties. Narcolepsy can begin after age 30: but such is relatively uncommon. In contrast, while sleep apnea can develop in childhood, it more often becomes a significant and progressive problem later in life.

HENCE,TWO VALUABLE CLUES TO THE POSSIBLE DIAGNOSIS OF NARCOLEPSY IN A SLEEPY PERSON:

--Indications of cataplexy.

--Onset of sleepiness early in life, particularly if no severe snoring was noted then. For example, falling asleep more frequently in school than one's classmates, taking naps after school, and in some cases, hyperactive behavior (which in children, can be a manifestation of impaired alertness).

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