Medically, narcolepsy is considered to be a neurological disorder, meaning that its origins are within the central nervous system, specifically the brain. The condition usually emerges between ages ten and twenty years. There is some genetic basis to narcolepsy, but it is not inherited. Instead, the genetic cause appears to be a mutation, so the disorder is not passed from parent to child. However, gene mutations, at least as we currently understand them in the context of this disorder, do not explain all incidences of narcolepsy. Other triggers remain to be identified. Narcolepsy is also not unique to humans, with numerous other mammals expressing the disorder. There are at least three core symptoms that make up the disorder: (1) excessive daytime sleepiness, (2) sleep paralysis, and (3) cataplexy.
Narcolepsy is a sleep disorder characterized by excessive sleepiness during the day, even when the person slept well at night. Sleep attacks can occur at any time and in unusual situations: standing on a bus, during the medical consultation, driving the car, or operating machines, for example.
Normal sleep begins with turning off muscle control. In this phase, it is a sleep of slow waves. About an hour and a half later, the person enters the REM sleep phase, in which the brain activity is intense and the eyes move. People with narcolepsy skip the slow wave sleep stage and suddenly go straight to REM sleep.
CAUSES
Genetic factors are involved in narcolepsy, which is caused by changes in the balance between some chemicals (neurotransmitters) in the brain, responsible for the appearance of REM sleep at inappropriate times.
In general, the disorder is associated with an allele linked to the major histocompatibility complex, that is, to a protein related to excessive sleepiness during the day. In dogs, the gene responsible for narcolepsy has already been isolated.
Cataplexy, that is, the sudden and reversible loss of muscle strength during wakefulness, is the only exclusive symptom of narcolepsy. The others are: excessive daytime sleepiness, REM sleep abnormalities, muscle paralysis and hypnagogic hallucinations.
DIAGNOSIS
Polysomnography and multiple latency tests are two important laboratory tests that help to establish the diagnosis of narcolepsy, which is different because it considers the characteristics of other sleep disorders, such as apnea and insomnia, for example.
TREATMENT
The person with narcolepsy may experience several episodes of irresistible sleep during the day. If you have the opportunity to take a nap when that happens, you will probably wake up more willingly, because those naps are usually restorative.
The treatments for excessive sleepiness and cataplexy are different, but the remedies indicated for one case can also improve the other.
A new substance called motofanil, in addition to the advantage of not causing important side effects on the cardiovascular system, has been shown to be effective in making people more alert. Antidepressants work better on cataplexy. Sometimes, the therapeutic solution is to combine smaller doses of the two classes of drugs (stimulants and antidepressants).
RECOMMENDATIONS
- Try to organize your schedule to take a short nap, which is always refreshing, in the sudden sleep crises that occur in cases of narcolepsy;
- Be aware: muscle weakness (cataplexy) can be triggered when the person is frightened or finds something funny and laughs;
- Remember that treating narcolepsy is important to remove the label of lazy and sleeper that bothers people with the disorder;
- Know that narcolepsy is not a serious disease, but it can endanger the lives of people who drive cars or operate machines;
- Avoid drinking alcoholic beverages or other substances that induce sleep, as they only help to worsen the condition.
