Narcolepsy
(Uncontrollable Sleepiness)
In this condition factsheet:
Diagnosing Narcolepsy
There are many other causes of excessive daytime sleepiness. The most common are probably depression, sleep apnea (breathing problems during sleep), and sleep deprivation. None of these conditions, however, brings an urge to sleep that's as strong or as sudden as the urge felt by people with narcolepsy.
If your doctor suspects that you might have narcolepsy, they will likely refer you to a sleep clinic or specialist.
There are two tests that are be performed to diagnose narcolepsy. A polysomnogram (PSG) is an overnight sleep study which records brain and muscle activity, breathing and timing of REM sleep. It can rule out other conditions such as sleep apnea.
The second test is called the multiple-sleep latency test. The person spends the day at a sleep disorders clinic and is encouraged to take frequent small naps. Each time, they are hooked up to an electroencephalogram (EEG) and devices that measure eye movements and muscle tone. If someone tends to go into REM sleep as soon as they drop off, it's highly suggestive of narcolepsy.
A measurement of hypocretin levels in a person's cerebrospinal fluid (the fluid that surrounds the spinal cord) may also be done. A low hypocretin level helps to confirm the diagnosis of narcolepsy.
Specific changes in the brain of narcoleptic and cataplexic patients have been reported using various imaging techniques (MRI, SPECT, etc).
If the diagnosis of narcolepsy is made, the presence or absence of cataplexy determines which type of narcolepsy a person has. Type 1 narcolepsy is diagnosed if the person also has cataplexy; type 2 is diagnosed if they do not.
Treating and Preventing Narcolepsy
There's no cure for narcolepsy, but symptoms can be brought under control with medications. Medications called nervous system stimulants, which include amphetamines such as dextroamphetamine* and methylphenidate, are commonly used. Modafinil, pitolisant, and solriamfetol are other medications that may be used to help to keep a person awake.
Symptoms of cataplexy, sleep paralysis, and hypnagogic phenomena may be treated with tricyclic antidepressants (e.g., imipramine, desipramine, clomipramine), venlafaxine, or selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline). Sodium oxybate can be used for people who have cataplexy and narcolepsy, but because of potential abuse, this medication is tightly regulated in Canada.
It's unlikely that medication treatment will completely eliminate all desire to sleep during the day. The best way to deal with this is to take 1 or 2 short, planned naps of about 20 minutes each. If treatment can’t totally control symptoms, a person with narcolepsy may want to avoid work that involves long-distance driving or operating dangerous machinery for long periods.
Good sleep habits can also help with narcolepsy. Your doctor may suggest that you:
- go to sleep at the same time each day
- avoid having a TV in the bedroom
- have a warm bath or shower before going to bed
- avoid caffeine, alcohol, and nicotine before bed
- avoid medications that cause daytime drowsiness such as sedating antihistamines, sedatives and opioid pain relievers
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Narcolepsy
References
