and you’re still tired? Or that you were told that you had talked during your sleep? Maybe you’re having sleep disorders. Sleep disorders can be related to mental conditions, physical conditions or substance inducement. There are about seventy different sleep disorders which are divided into two categories. One category comprises disorders in which a person has hard time in getting sleep or staying asleep or falling asleep at improper time. For example, insomnia, narcolepsy, nocturnal leg syndrome. Sleep disorders which people experience physical events while they are sleeping, such as somnambulism, restless leg syndrome, are categorized in another group. The most common sleep disorder that is suffered by millions of people in the world is probably snoring, which is not medically significant; whereas some sleep disorders can actually be very dangerous as it might cause a sudden heart attack. One of the most interesting sleep disorders is narcolepsy.
Narcolepsy is a sleep disorder which is suffered by one in every 2,000 people in the United States. It can be very hard to live with. It is easy for people who know nothing about narcolepsy to think that those who are suffering from narcolepsy are simply because partied too much as people who fall asleep at inappropriate times must be having way too much fun until the early morning. But that’s a long way from the truth. Narcolepsy is a chronic neurological disorder that is caused by the brain’s failure to adjust sleep-wake cycles normally. People with narcolepsy experience temporary craving to sleep. Patients usually fall asleep for a period of few seconds to several minutes. In some cases, patients may even remain asleep for an hour or longer if the craving becomes overwhelming. Narcoleptic can easily fall into the REM stage of sleep within 10 minutes; whereas most people do not get into REM stage sleep after 90 minutes. Narcoleptic could not control when and where they fall asleep. They might fall asleep when waiting for the traffic light, or they could start snoring in the middle of an important meeting. So, narcolepsy can be very dangerous as patients fall asleep at improper times, such as driving, walking, and so on. Therefore, people with narcolepsy should have someone beside to take care of and avoid driving. Do you think people with narcolepsy seem to have longer sleeping time than normal person? In fact, they spend a weaker proportion of their time asleep during a day. Most of them do also experience frequent awakening during night time sleep due to daytime drowsiness and uncontrolled sleep.
How do you know you’re actually having narcolepsy? There are several symptoms you might have if you suspect you’re a narcoleptic. Cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness are common traces of narcolepsy. Cataplexy is an immediate loss of muscle tone that leads to a feeling of weakness and a loss of voluntary muscle control, such as limpness at the neck or knees, sagging facial muscles, or failure to speak clearly. The most critical attack results in a complete loss of tone in all voluntary muscles that leads to total physical collapse in which patients are incapable to move, speak or even keep their eyes open. Nonetheless, patients remain conscious throughout cataplexy. The attack can occur at any time during waking period but mostly triggered by instant emotional reactions, such as surprise, anger, fear or laughter. Episode can last for a few seconds or even several minutes. According to the National Institutes of Health, about 10% of all cases, cataplexy is the first symptom to appear and can be misdiagnosed as a sign of a seizure. Patients should avoid having extreme emotional changes to prevent the attack. Sleep paralysis which is also one of the symptoms can cause fleeting inability to move or speak while in both waking period and sleeping period. Sleep paralysis may too last for seconds or even minutes. Generally, patients remain breathing during sleep paralysis, but, it’s possible that some patients have experience a disheartening sensation of unable to breath. Hypnagogic hallucinations are dream-like experiences that appear before sleep. The sleeping mind beginning to dream earlier than the body has gone fully asleep is the cause of hypnagogic hallucinations, which means that whatever the patient’s conscious mind is thinking of will become full sensory hallucinations, similar to what happens in dreams. However, the difference between dreams and hypnagogic hallucinations is these images and sounds are occurring while someone is still actually awake. In additional, hypnagogic hallucinations are usually frightening and vivid. Generally, the excessive daytime sleepiness is the first symptom of narcolepsy to occur. The other symptoms may occur after months or year after the onset of the excessive daytime sleepiness. The excessive daytime sleepiness is mostly last permanently, but sleep paralysis and hypnagogic hallucinations may not.
How do we really confirm that if we’re infected by narcolepsy, as having some individual symptoms may not prove that we’re narcoleptics? For example, hypnagogic hallucinations can occur without narcolepsy. The symptoms of narcolepsy are like symptoms of other illness; therefore, it takes as long as 10 to 15 years to have narcolepsy diagnosed after the first symptoms occur. Narcolepsy is always misdiagnosed as learning problem, seizure disorders or even laziness. Nonetheless, there are some tests available, such as Multiple Sleep Latency Test(MSLT), Polysomnography, and the Hypocretin Test. In the MSLT test, patients are required to have a daytime nap for about 20 minutes every 2 hours. Normal people without narcolepsy usually fall asleep within 10-20 minutes; whereas patients with narcolepsy usually fall asleep within 5-8 minutes. This test also shows that how fast you get into REM stage of sleep which narcoleptics easily get into it. Polysomnography is an overnight sleep study which result brain activity, eye movements, heart rate, and blood pressure that can find out how quick one falls asleep, how fast one experiences a REM stage of sleep after sleeping and how often one wakes up during the night. The hypocretin test which has not yet become the main diagnosis tool for narcolepsy can measure the level of hypocretin in cerebrospinal fluid. Nacroleptics normally have lower level of hypocretin.
Narcolepsy is so interesting yet dangerous, but what causes narcolepsy? Some say heredity, some say infections. What is confirmed is that narcolepsy is a neurological sleep disorder. It is not caused by mental illness or psychological problem. In fact, scientists have also discovered that narcoleptics are usually lacking in hypocretin, also called orexin, which is a chemical in the brain that helps promote wakefulness. Nevertheless, the causes of low hypocretin level aren’t well understood. Researchers think that low hypocretin level isn’t caused by individual factor, it might be caused by several factors together, such as infections, brain injuries, heredity, and autoimmune disorders. Despite the disorder has been studied for a long time, the causes of narcolepsy are not determined.
However, World Health Organization has discovered some narcoleptics were actually born with a gene that increases the risk of having this rare disease. Scientists found that this gene might have joint effect with H1N1 swine flu vaccine to cause narcolepsy. This is because many cases of narcolepsy among children and adolescents that have been reported in 12 countries in 2009 have received the H1N1 swine flu vaccine earlier before as well. Patients are likely to develop narcolepsy symptoms between 2 and 10 weeks after receiving the vaccine. Researchers also claimed that the risk for those who got vaccinated to get narcolepsy is about 9 times higher than those who did not get vaccinated. There are also reports that show children who ages 5 to 15 are most likely to get narcolepsy. Nevertheless, cases which narcolepsy is linked to H1N1 swine flu vaccine have only been observed in Finland and Sweden, although the vaccine is used in all over the world. Hence, the link between H1N1 swine flu vaccine and the sleep disorder narcolepsy is still being investigated by the World Health Organization.
Due to the fact that the causes of narcolepsy are still not known, there is no known way to prevent this dangerous sleep disorder, even treatment of narcolepsy is only to reduce the number of attacks. The goal of treatment is to improve daytime alertness and minimizing symptoms such as cataplexy, hallucinations and sleep paralysis. Narcolepsy can usually be controlled with treatment, though. The treatment of narcolepsy is mainly changing in lifestyle. Patients should eat light meals during the day and try to avoid caffeine, alcohol and nicotine as these are factors that may increase the odds of an attack after meals. Narcoleptics may also take naps during the day for 20 to 30 minutes to maintain well functionality and social obligation. Medications can be used to control the symptoms as well. Medication such as Ritalin helps to reduce excessive daytime sleepiness and improves alertness. It has side effects such as headache, irritability, nervousness, notwithstanding its usefulness. Unfortunately, there are no surgical procedures for the treatment of narcolepsy at this time.
From the Chinese traditional medicine point of view, the cause of narcolepsy is explained by the “Ying-Yang theory”. Narcolepsy is developed because of the Ying of one’s body is greater than the Yang’s and in additional that one’s spleen is not functioning well. These are the two main points that cause one to experience drowsiness and also excessive daytime sleeping. However, in Chinese traditional medicine method, it seems to have better treatment than the normal western medicine method. The Chinese have recently invented a medicine that has no side effects for narcoleptics. According to the research done by Mrs. Yang in China who is a Chinese medicine practitioner, 68 patients who taken this healing method for a period of 90 days, 72% of them have obvious improvement, as in the excessive daytime sleeping has been fully cured; 24% of them have improvement, as in the excessive daytime sleeping has almost cured; the other 4% of them have no improvement. This is a great step of treatment for narcolepsy as 96% of patients have improvement after taking this healing method. Therefore, this healing method is now spreading out very quickly in China and also received tons of good comments.
In conclusion, narcolepsy is a devastating disorder that causes extreme fatigue and often results in the patient falling asleep immediately without warning. It often causes muscle weakness and comes with snoring. Narcoleptic experiences episodes of uncontrollable sleepiness several times a day and it usually happens after meals, but it may also happen at any inappropriate time during the day and last for about fifteen minutes. Patients will then awaken refreshed, only to become exhausted within the next hour or so. It is known that narcolepsy represents a neurological problem of sleep wake mechanisms in the brain yet the causes are still unknown. Although it is not fatal, it still has serious repercussion if the situation gets worse. Thus, it is a dangerous disorder without a cure as it actually affects the brain and muscles. In my opinion, narcolepsy is horrible as it may affect patients in several areas in their lives included daily activities, social functioning and working abilities, and it can result in total paralysis, leaving the patients to suffer for the rest of their lives.