Narcolepsy is a lifelong neurological disorder, characterized by a lack of control over one's sleep-wake cycle. This can result in an individual feeling persistently worn out; furthermore, these individuals may have sudden bouts of muscle weakness that can have far-reaching consequences in daily life. Not only this, but the danger posed by narcolepsy is particularly acute as episodes of drowsiness or loss of muscle power can occur without warning when engaging in any activity - from walking and eating to driving. Indeed, due to the high potential for accidents, some states have laws prohibiting those with untreated narcolepsy from operating a car.
A large number of individuals with narcolepsy don't realize they have the sleeping disorder. Estimates state that around one in 2,000 people might be affected, though it is possible that half of those could go undiagnosed, making the true rate higher. It can commence at an early age and usually takes quite some time to diagnose, with the average wait being 8-10 years. In some cases there may be a hereditary link, but this is not always the case.
The total hours of sleep for those with narcolepsy is not necessarily more than that of people without the condition. In fact, often there are issues staying asleep throughout the night due to disruptions.
Some people who experience consistent daytime fatigue may think they have narcolepsy. However, sleep apnea, circadian rhythm disruption, and restless legs syndrome can mimic this condition. Additionally, certain medical issues, mental health problems, and medications or drugs may produce similar symptoms.
Narcolepsy type 1
This type of narcolepsy includes excessive daytime sleepiness and one or both of the following: cataplexy, which can cause slurred speech, buckling knees or complete paralysis, triggered by joy, surprise, laughter or anger; and low levels of the neurotransmitter hypocretin-1 (or orexin), which regulates arousal, wakefulness and appetite. A deficiency of hypocretin leads to narcolepsy type 1 even without exhibiting cataplexy.
Narcolepsy type 2
This type of narcolepsy results in excessive daytime sleepiness, yet does not involve cataplexy. A short nap can provide a temporary remedy, but only for a brief period; afterwards you will soon feel the effects of fatigue once more.
What are the Symptoms?
Narcolepsy typically begins between ages 15 and 25, though symptoms can show up earlier or later. Over time they may worsen, with the following being common:
Excessive Daytime Sleepiness
Narcolepsy is primarily characterised by extreme and uncontrollable sleepiness in the daytime. This can occur even if you have had a satisfactory night's rest, and the fatigue may come and go throughout the day. A quick nap can provide a momentary sense of energy; however, this feeling of alertness doesn't last long and will eventually wear off.
Hallucinations
Patients of narcolepsy can encounter sleep-related hallucinations, either when falling asleep or when waking up. These hallucinations have the potential to manifest as being in the presence of someone, or something, in the bedroom and cause a feeling of apprehension and terror. Other visualisations that may be present are those of flying and being engulfed in flames. Such experiences may be both visual and incorporate sound, touch, smell and taste.
Fragmented Sleep
Around half of those with narcolepsy struggle to remain asleep through the night. You could find yourself waking up often and having difficulty drifting back off.
Sleep Paralysis
You might find yourself unable to move and be feeling paralysed when going to sleep or waking up. This sensation normally only lasts a few moments or minutes. Although it can be scary, it does not prevent you from breathing. It is possible for sleep paralysis to occur alongside hallucinations, which can make the experience particularly frightening.
Memory Problems
It may be difficult to recall what other people say to you due to a lack of alertness at the time. Additionally, if you are drowsy while performing mundane tasks, forgetting can occur.
Sudden loss in muscle tone (cataplexy)
Narcolepsy type 1 is an entirely different story, with cataplexy being the main hallmark. This occurs when a strong emotion, like surprise or joy, provokes a sudden episode of muscle weakness. Your speech could become slurred and you might lose control over your limbs, or even end up completely paralyzed. Furthermore, narcolepsy sufferers are often also overweight, obese in some cases, and may have other sleep issues such as apnea or REM sleep behavior disorder. Additionally, psychiatric disorders and precocious puberty can be found in many affected by this type of narcolepsy.