treatment for narcolepsy without cataplexy

Just as sleep intrudes during the day, unwelcome awakenings can occur at night, depriving people with narcolepsy of restorative rest and worsening their daytime drowsiness. This condition can be confused with mental illness because its symptoms resemble those of some psychotic disorders.ĭisturbed nighttime sleep. This usually happens just at sleep onset or upon awakening. A person may see prowlers or believe that his or her house is on fire. When REM dreaming occurs during wakefulness, the vivid and often frightening images, known as hypnagogic hallucinations, are difficult to distinguish from reality. Although muscle control usually returns within a few minutes, episodes can cause great anxiety. A terrifying feeling of paralysis may occur during the transition between wakefulness and sleep if the REM stage begins before a person is fully asleep. Laughter, anger, or other strong emotions often trigger cataplexy, which occurs when the brain mechanism that paralyzes muscles during REM sleep becomes activated.

Most attacks last for less than 30 seconds and may go unnoticed, but in severe cases, the person may fall and stay paralyzed for as long as several minutes. A person may suddenly lose muscle tone while awake, causing the head to fall forward and the knees to buckle. If REM sleep and dreaming occur immediately, the person sometimes makes conversation that is appropriate to the dream instead of the actual situation.Ĭataplexy. These attacks may be more frequent when a person is doing something monotonous or repetitive. A person may suddenly fall asleep for a few seconds to several minutes when relaxing or even while carrying on a conversation. Most people have more than one but only rarely have all of the following additional symptoms. In addition, they may have a number of other symptoms, most of which are manifestations of the REM sleep stage occurring during wakefulness. They speculated that the loss of hypocretin-producing cells may stem from an autoimmune process, in which the body attacks itself.Īll people with narcolepsy are excessively sleepy and struggle to stay awake during the day, which often causes them to have great trouble completing tasks. Researchers have also found a link between narcolepsy and variations in a gene that controls immune function. The discovery of the gene that makes hypocretin and the location of its production in the brain has spurred research into new ways to diagnose and treat this disorder. People with narcolepsy lose the cells that make hypocretin. In the late 1990s, researchers discovered that many cases of narcolepsy result from the lack of a brain chemical called hypocretin (also called orexin) that normally maintains wakefulness and helps regulate sleep.

If cataplexy occurs, it may be misdiagnosed as epilepsy or fainting. This is because sleepiness may be the only symptom. On average, it takes five years of symptoms and visits to five physicians before a diagnosis of narcolepsy is made. It affects men and women equally and has a genetic component: having a close relative makes a person 20 to 40 times more likely to have it. The disorder affects about one in 2,000 people and usually appears between ages 15 to 30. Sudden muscle weakness (known medically as cataplexy) also may occur, causing a person to suddenly go limp or to fall. The brain somehow skips the normal progression of sleep stages, entering into a dreamlike state immediately after a person lies down to sleep-or in the middle of daytime activities, such as talking, eating, or driving. These “sleep attacks” seem to arise from an abrupt switch from wakefulness into REM sleep. People with narcolepsy experience bouts of extreme daytime sleepiness and tend to fall asleep suddenly at inappropriate times. Narcolepsy is a disorder affecting the regulation of the sleep/wake cycle.

Treatment for narcolepsy without cataplexy