Many people don’t understand why they feel excessively sleepy during the day, even after a restful and peaceful night’s sleep. It’s not uncommon for these individuals to have genuine sleep attacks and, at any moment, fall asleep even in unusual situations, such as standing up or while driving. Most likely, these people suffer from narcolepsy.
Narcolepsy is a very common sleep disorder, whose main characteristic is excessive daytime sleepiness. It can become a very serious problem, as it often brings difficulties and embarrassment in social, professional, and academic life. Furthermore, a person affected by it may suffer a sleep attack precisely when they are driving, for example. The consequence can be fatal, so it is important to understand and treat narcolepsy.
What is narcolepsy?
Narcolepsy is a sleep disorder caused by an imbalance of certain chemicals in the brain, characterized by excessive daytime sleepiness that can occur even after a good night’s sleep.
Sleep is considered normal when it begins with the shutdown of muscle control, when we enter a slow-wave sleep phase. About 90 minutes later, we enter the REM sleep phase, when brain activity is intense. People affected by narcolepsy skip the slow-wave sleep stages, going directly to REM sleep.
All people affected by narcolepsy suffer from excessive daytime sleepiness; what changes is the number of episodes. Most common in late adolescence and after age 50, narcolepsy can be linked to genetic factors and low production of hypocretin, the substance that keeps us awake during the day.
The symptoms of narcolepsy include excessive daytime sleepiness, sudden loss of muscle control, and sleep paralysis.
It is important to be aware of the symptoms of narcolepsy, especially since it is from this awareness that the affected person will take the step to seek a sleep doctor for diagnosis and treatment.
The main symptom, of course, is excessive sleepiness. The affected person may even dream during brief periods of sleep, may take multiple naps during the day, and the sleepiness can manifest as an inability to stay alert or attentive.
Cataplexy is a symptom that is not present in all patients. It consists of sudden and recurrent episodes of skeletal muscle weakness during wakefulness, with the exception of the diaphragm muscle. Cataplexy can last from
a few seconds to ten minutes and is generally triggered by strong emotion, fright, laughter, or anger attacks.
Those who suffer from this sleep disorder may also experience a complete inability to move their limbs, head, or speak upon waking, as well as hypnagogic or hypnopompic hallucinations during the transition between wakefulness and sleep and vice versa. Nighttime sleep may be fragmented. Finally, the person may suffer from restless legs syndrome, another very common sleep disorder.
Diagnosis and treatment of narcolepsy
The sleep doctor will conduct a clinical evaluation and may use a sleep diary and polysomnography to diagnose this sleep disorder. Treatment is behavioral and pharmacological. The family and patient will receive specific guidance, naps should be scheduled, sleep hygiene is necessary, and the patient may utilize psychological support.
