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Narcolepsy :- Symptoms, Causes, Treatment, Prevention, Diagnosis and General Care of Narcolepsy
Narcolepsy is a disorder that causes sudden episodes of deep sleep. These episodes can occur often and at inappropriate times, for example while a person is talking, eating or driving. Although sleep episodes can happen at any time, they may be more frequent during periods of inactivity or monotonous, repetitive activity.Narcolepsy can occur in both men and women at any age, although its symptoms are usually first noticed in teenagers or young adults. There is strong evidence that narcolepsy may run in families; 8 to 12 percent of people with narcolepsy have a close relative with the disease. It is estimated that there are as many as 3 million people worldwide are affected by narcolepsy. Narcolepsy usually begins in the teens or early twenties (10 to 20 years old), but this varies.
While the symptoms of narcolepsy usually appear during a person's late teens or early 20s, the disease may not be diagnosed for many years. Most often, the first symptom is an overwhelming feeling of fatigue. After several months or years, cataplexy and other symptoms of the disorder appear.
Cataplexy is an abrupt loss of voluntary muscle tone, usually triggered by emotional arousal. Attacks can range in severity from a brief sensation of weakness to total collapse lasting several minutes.
Other symptoms include:
Vivid dreaming when barely asleep
Sudden muscular weakness
Sleepy when excited/angry
Naps are refreshing
auditory or visual hallucinations
Cause of Narcolepsy
The cause of narcolepsy remains unknown. It is likely that narcolepsy involves multiple factors interacting to cause neurological dysfunction and sleep disturbances. Currently, the general consensus is that genetics accompanied by an environmental trigger of some sort-a virus, for example- may affect brain chemicals and contribute to the disorder
One of the main characteristics of the condition is the intrusion of rapid eye movement (REM) sleep at inappropriate times. During REM sleep the brain is very active and the muscles of the body relaxed (paralysed). In non-narcoleptic people REM sleep does not occur until sleep has been underway for some time. However, in people with narcolepsy REM sleep often occurs soon as they fall asleep on even as they are awake.
The doctor will perform a clinical examination and an in-depth medical history to rule out other causes of your symptoms. Narcolepsy can be diagnosed using specific medical procedures: the diagnosis of narcolepsy is usually easy if all the symptoms of the illness are present.
Two tests that are considered essential in confirming a diagnosis of narcolepsy are the polysomnogram (PSG) and the multiple sleep latency test (MSLT).
Polysomnogram (PSG)-is a multiple-component test that electronically transmits and records specific physical actions of the body while you sleep, such as muscle movement, breathing patterns and brain activity. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have a particular sleep disorder
The MSLT -This test, performed at a sleep disorders clinic, will confirm the daytime sleepiness by showing a short sleep latency of usually less than 5 minutes, as well as an abnormally short latency prior to the first rapid eye movement (REM) period. Other causes of daytime sleepiness, such as sleep apnea or periodic leg movements, are also excluded by the nocturnal recordings.
Blood test - A blood test that measures antigens, often found in people with a family history of narcolepsy, can also be done. The blood test is not conclusive but it can be helpful in establishing the possibility and probability of narcolepsy.
There is no cure for narcolepsy. Classes of antidepressant drugs have proved effective in controlling cataplexy in many patients: tricyclics and selective serotonin reuptake inhibitors. Drug therapy should be supplemented by behavioral strategies. The symptoms can be managed with lifestyle adjustments and/or medication. Medication can be very helpful for treating the symptoms of narcolepsy. Commonly prescribed medications for narcolepsy are:
Sodium oxybate. This medication controls cataplexy, sleep paralysis and hallucinations in people with narcolepsy. Sodium oxybate helps to improve nighttime sleep, a lack of which may contribute to excessive daytime sleepiness.
Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day.
Avoid caffeine, alcohol, and nicotine.
Avoid heavy meals
Regulate sleep schedules
Do not drive or operate dangerous equipment if you are sleepy. Take a nap before driving if possible.
Break up larger tasks into small pieces and focusing on one small thing at a time.
Alert your employers, coworkers and friends in the hope that others will accommodate your condition and help when needed.
Home Care of Narcolepsy
Join a support group.
Follow your sleep schedule.
Take at regular intervals of sleep during the day. Schedule daytime naps (10-15 minutes in length), they refresh you for a few hours.
Get regular exercise, it may help you feel more awake during the day and sleep better at night.
Carry a tape recorder, if possible, to record important conversations and meetings.
CALL THE DOCTOR
Call a doctor if:
You are excessively sleepy during the day.
If episodes occur while you are driving a car or operating machinery.
If you experience excessive daytime sleepiness that seriously disrupts your personal or professional life.
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