Imagine you are driving and suddenly you realize that you have not remembered anything you have just seen. While you were driving and concentrating on the road, your brain has shut down. Without actually realizing it, you have just fallen asleep. You wake up and realize you’re on the wrong side of the road, but luckily nothing was coming. Why does this happen? The majority call this narcolepsy, a much misunderstood sleep disorder. The real question is, what is narcolepsy? Narcolepsy is the brain's inability to control sleep. The brain somewhat pauses, and mixes up sleep stages leaving the person extremely exhausted than before they fell asleep. The next day narcolepsy takes its toll and the person goes in and out of consciousness. Most of the time the attack wont be noticeable due to some automatic behaviors. A person may even talk but can be truly hard to understand. There are also other parts to narcolepsy. The most common is called cataplexy. When cataplexy begins the person will most likely falls to the ground and lose sense and muscle tone. Cataplexy can be just like a seizure, with a few differences. One way to tell is to ask if your patient if they remember the incident itself or had any strange feeling before it happened. Most of the time the event is remembered and has little warning before it happens. Also cataplexy can be brought on by certain emotions, like laughter. So what causes narcolepsy? Nobody truly can point out the cause, but there are several possibilities. There hasn’t been any links proven with genetics although the case of multiple family members having narcolepsy is 30-40 times higher than the general population. Another cause could be head trauma; this could cause what is called secondary narcolepsy. Another possibility could be a seizure, which is known to trigger many other disorders as they process through the brain. Some researchers have claimed that a sleep hormone called hypocretin is the source of the problem. Narcoleptics are shown through spinal taps to have decreased or complete absence of either the cells that recieve hypocretin, or hypocretin itself.
If a patient happens to complaining of excessive daytime sleepiness (EDS), missing lapses of time, paralysis upon awakening, or even dropping things you should have them tested. If they are shown to have EDS you should then order a sleep study to help confirm a narcolepsy diagnosis. A test to determine this is a MSLT. This is a series of twenty-minute naps every two hours the day following a regular over night study of sleep. Most of the time five to six naps are taken, and if the patient happens enters REM sleep in more than three naps a narcolepsy diagnosis could be confirmed. You have to be extremely careful not to mistake narcolepsy for A.D.D., depression, or epilepsy before the testing for it. Sleep studies are the most certain method to detect.
If you have been diagnosed with narcolepsy you must wonder how to treat it. You must remember that everyone is different and it could take nearly up to six months to find a perfect combination of meds to supplement you. Medications most commonly used are anti-depression meds, A.D.D. meds, and even amphetamines. Today the most common drugs that are prescribed to the patient would be Provigil and Xyrem. Provigil is a stimulant that you would most likely take in the morning, and in some cases a second dose is added in the afternoon to help compensate. Many people like Provigil because it makes you feel awake. However this drug can cause symptoms like irritability and depression. Provigil is generally the most common drug used. Xyrem works but in a different direction. It allows the patient to fall into a deep sleep at night, so they are more alert and awake the next day. This drug is highly controlled and usually only prescribed in cases with severe cataplexy. Neither is a real cure for narcolepsy, and the sad news is that a cure wont be expected to be found for many years to come.