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Narcolepsy Symptoms

For the one in every 1,000 people who have narcolepsy, it's a potentially embarrassing and socially debilitating illness they have to live with every day.

Narcolepsy is a sleep disorder which makes you fall asleep at inappropriate times and places. It can begin at any age but once you've got it, you've got it for life. Sufferers are often very sleepy most of the time, but then have trouble falling asleep at night. As soon as they drop off, or start to wake up, they can have vivid, often frightening dreams and can also get sleep paralysis - making them unable to move temporarily.

The most well-known symptom is the sudden loss of muscle control triggered by laughter, surprise, fear or anger. It can be anything from a slight feeling of weakness and limp muscles to sudden total body collapse, during which the person looks asleep, but is in fact awake and alert. The attacks last from a few seconds up to 30 minutes. This happened to a women I was introduced to once. We were sitting in a pub eating dinner with a group of mutual friends and she was entertaining me with funny anecdotes about suddenly falling asleep in inappropriate situations. Then she laughed and promptly collapsed on the shoulder of her boyfriend, who was sitting next to her. Ten minutes later, she was chatting again.

It's very important to tell anyone you see regularly if you suffer from narcolepsy. People are incredibly understanding if they know the details. Your work colleagues may have noticed that you're not very alert at certain times of the day - and this would offer an explanation. A woman who talked about her condition to me was incredibly open - and was met by fascination in her condition rather than ridicule.

WHAT'S THE CAUSE?

Scientists have found a chemical in the brain that patients with narcolepsy seem to lack. Also, their rapid eye-movement (REM) sleep, which is when you're most likely to dream, seems to be all over the place. Normally, someone falls into REM sleep after about 90 minutes of sleep, but someone with narcolepsy can fall into REM sleep immediately so they often experience dreamlike imagery before the brain's asleep. REM episodes occur now and then in the day too - which is why people suffer hallucinations while they're awake. Although symptoms of narcolepsy normally appear during adolescence, worryingly, it seems it's not being diagnosed. One study found that people had been suffering for about 15 years before it was recognised. If the only symptom is daytime sleepiness, sufferers are often treated for some other condition such as depression, which they may not have. This could make things worse - as some drugs used to treat depression can make the narcoleptic even sleepier. Children may be misdiagnosed with attention deficit disorder when they're actually just too tired to pay attention. As a result, they can give up on school.

TREATING NARCOLEPSY

It can't be cured, but with medication you'll be able to live a fairly normal life. The two main symptoms - daytime sleepiness and muscle weakness - are treated separately.

Modafinil - most commonly prescribed for excessive daytime sleepiness, it keeps you awake by working on the part of the brain that helps maintain alertness and has no side effects.
Ritalin - known as the medication prescribed to children with attention deficit hyperactivity disorder (ADHD) when it is used to calm them down and help them focus on their tasks. However, it helps to make people with narcolepsy more alert. But some people also suffer increased heart rate, rise in blood pressure and a jittery feeling.
Tricyclic antidepressants - these have been used to help improve muscle control and REM symptoms.


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