Narcolepsy

What is narcolepsy?

Narcolepsy is a neurological condition affecting the area of the brain that controls waking and sleeping. The word comes from the Greek and means 'seized by sleepiness'.

Symptoms

The main symptom is falling asleep suddenly. About four out of five people with narcolepsy also experience cataplexy, a sudden loss of muscular tone and control which is usually triggered by emotion, for example laughter. It may cause the jaw to drop and the head to slump, or the legs to collapse.
These attacks can last for seconds or many minutes and can occur many times a day.
Other possible symptoms include temporary paralysis on falling asleep or waking up and visual hallucinations. People may wake during the night with their heart racing, feeling flushed and agitated, and with intense cravings for sweets.
Schoolchildren with narcolepsy may become the focus of ridicule and bullying in school and it becomes difficult for them to engage in usual school activities and study.
Later in life, it can affect someone's education, relationships and career prospects. Consequently, someone with narcolepsy often also has low self-esteem, depression and relationship problems.

Causes and risk factors

Narcolepsy appears to be a condition where normal elements of sleep – specifically elements of REM (Rapid Eye Movement) or dream sleep suddenly occur during a person’s wakeful state.
The cause of narcolepsy remains unclear. Research has identified several different factors which may play a part. Some people may be predisposed to the condition by their genetics – it is much more common among people with certain genetic profiles.There may be abnormal functioning of certain neurotransmitters (brain messenger chemicals) – for example research has identified that it may be caused by a shortage of the chemical brain messenger called hypocretin. Meanwhile other research suggests that narcolepsy may be the result of an autoimmune process, when the body attacks itself.
Suggested initial triggers include infections such as measles or mumps, accidents and the hormonal changes that take place in puberty (because for many people affected, narcolepsy begins in adolescence).
It's believed around one in 2,000 people has narcolepsy. Men and women are affected in equal numbers. It most often begins between the ages of 15 and 30.
Because narcolepsy tends to start in adolescence, the symptoms are often mistakenly put down to behaviour associated with this stage in life. Those who fall asleep in class may be labelled as lazy and blamed for staying up too late. Often the possibility of drug misuse is explored before the possibility of narcolepsy, adding to the distress suffered. These problems may explain why it takes an average of ten years before the real nature of the illness becomes apparent and as a result a diagnosis of narcolepsy is often not made until mid-life.
Many people are also misdiagnosed as having other medical conditions such as:

• Anaemia
• Heart conditions
• Low blood sugar
• Hypothyroidism
• Epilepsy
• Multiple sclerosis

To properly diagnose narcolepsy, the person’s sleep must be monitored overnight using an EEG or electrical tracing that demonstrates distinct brain wave patterns. Invariably it comes as a great relief for someone to know what their problem really is.

Treatment and recovery

Although it's not yet possible to cure narcolepsy, symptoms can be treated to enable someone to lead as normal a life as possible.
Sleep hygiene is important. This simply means taking steps to ensure plenty of good quality sleep, including a regular bedtime and between seven and a half to eight hours sleep every night. Frequent brief naps may also help and should be spaced evenly throughout the day. This can reduce excessive daytime sleepiness but should aim to not interfere with normal daytime activities.
Heavy meals and alcohol should be avoided. During the day rooms should be well ventilated, especially classrooms. It helps if schoolmates, teachers and family are made aware of the problem and how best to support the affected person who may otherwise be teased or bullied.
People with narcolepsy should avoid driving or operating heavy machinery when they are sleepy.
Stimulant drugs such as amphetamines improve symptoms in 65-85 per cent of patients but can produce side effects ranging from headaches and irritability to gastrointestinal problems. A newer drug called Modafinil also promotes wakefulness although it is not yet clear exactly how it works. Antidepressant drugs are often prescribed when cataplexy is a problem but experts have recently pointed out that there is little evidence to suggest they offer much benefit.
Attacks can be kept to a minimum by:

• Reducing stress
• Taking short naps throughout the day
• Taking regular exercise
• Keeping to strict bedtimes

READMORE:http://www.bbc.co.uk/health