Narcolepsy is characterized by sudden episodes of excessive daytime sleepiness that can make normal activities dangerous. Information about this disorder needs to be well understood in order to have appropriate interventions. Thereby controlling symptoms well, improving alertness and enjoying life to the fullest.
What is narcolepsy?
Narcolepsy is a chronic neurological disorder that affects the part of your brain that regulates your sleep. This disorder is characterized by intense daytime sleepiness and sudden episodes of sleepiness. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances.
In some cases, narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy), which can be triggered by strong emotions. Narcolepsy that occurs with cataplexy is called type 1 narcolepsy, while Narcolepsy that occurs without cataplexy is called type 2 narcolepsy.
Narcolepsy can make normal everyday activities such as driving, cooking or even walking dangerous. Also, daytime sleepiness can be stressful for work, school, and close relationships. Narcolepsy has the potential to cause problems with memory and concentration. This disorder also affects your self-esteem and mental health.
Narcolepsy affects about 1 in 2,000 people. So far there is no cure, but there are many solutions to help you relieve the symptoms. A combination of lifestyle changes, self-help strategies, and medical support will help you manage Narcolepsy, improve your alertness, and enjoy an active and fulfilling life.
Causes of narcolepsy
Studies show that narcolepsy is caused by a lack of a chemical in the brain, called hypocretin (also known as orexin). This chemical has a sleep-regulating effect.
Hypocretin deficiency is thought to be the result of a condition where the immune system mistakenly attacks the parts of the brain responsible for hypocretin production. However, lack of this chemical is not the cause in all cases.
Factors that may be involved include:
1. Immune system problems
Normally, antibodies are secreted by the body to destroy disease-carrying microorganisms and harmful substances. When antibodies mistakenly attack healthy cells and tissues, it’s called an autoimmune reaction.
In 2010, Swiss scientists discovered that some people with narcolepsy make antibodies against a protein called trib 2. Trib 2 is also produced by the same area of the brain that produces produce hypocretin. This leads to a lack of hypocretin which makes the brain less able to regulate sleep cycles.
2. Trigger factors for narcolepsy
Several factors can increase a person’s risk of narcolepsy or cause autoimmune problems. Such as:
- A genetic error
- Hormonal changes, including those that take place during puberty or menopause
- Psychological stress is too great
- Sudden change in sleeping patterns
- Pandemrix flu vaccine
Signs of narcolepsy
Not everyone with narcolepsy will have the same symptoms. Some people have frequent symptoms. While others are less affected.
Symptoms may develop slowly over a number of years or come on suddenly over a few weeks. Narcolepsy is a chronic condition, although some symptoms tend to improve as you age.
Here are some common symptoms in people with narcolepsy:
1. Sleeping too much during the day
Excessive daytime sleepiness is thought to be the first sign of narcolepsy. It can have a significant impact on everyday life. Feeling sluggish throughout the day and having trouble staying awake will make it difficult to concentrate at school or work. People with narcolepsy may be misjudged as lazy or lacking in consciousness.
2. Sleep Attack
Episodes of drowsiness can cause you to fall asleep suddenly without warning. They can happen at any time. The length of sleep that lasts varies from person to person. If narcolepsy is not well controlled, episodes can occur several times a day.
3. Narcolepsy causes loss of muscle tone
Most people with narcolepsy will also experience cataplexy. This condition is also known as sudden temporary muscle weakness or loss of muscle control.
Typical symptoms of muscle tone loss are:
- Jaw falling down
- Head down
- Uncontrollably bent legs
- Double vision or difficulty focusing
Cataplexy attacks will often be triggered by a strong emotion. Such as laughter, excitement, anger, or surprise. These attacks can last from a few seconds to several minutes.
Some people with narcolepsy may have episodes of cataplexy once or twice per year. Whereas others get them several times per day. In an effort to avoid being attacked, some people may become emotionally withdrawn and socially isolated.
Some people with narcolepsy experience episodes of sleep paralysis (insomnia). This is a temporary inability to speak or move that occurs while sleeping or upon waking.
Episodes of sleep paralysis can last from a few seconds to several minutes. Although sleep paralysis doesn’t cause any harm, the inability to speak or move can be frightening.
5. Other symptoms
In addition to the symptoms mentioned above, narcolepsy can cause a number of other symptoms. Such as:
- Hallucinations: Seeing or hearing things that are not real, especially when sleeping or waking up. The presence of people or objects in the bedroom is the most commonly reported hallucination.
- Memory problems.
- Insomnia: Frequent awakenings, hot flashes, nightmares, or physical dreams, for example.
- Automatic Behavior: Continuing with an activity without any recollection of it afterwards.
What are the effects of narcolepsy?
Narcolepsy has many negative effects on both health and quality of life. The main influences include:
- Physical health and safety: Many normal day-to-day activities such as driving, cooking or walking can become very dangerous if you oversleep or experience a sudden loss of muscle tone.
- Mental health: Narcolepsy can disrupt your life to the point of causing undue stress. Prolonged exposure increases the risk of depression, anxiety disorders and other psychological problems.
- Social and professional relationships: The average person may view sudden episodes of uncontrollable sleepiness as humorous. Some people may think you are lazy, rude, or even fake.
- Intimate relationships: Your personal relationships, especially romantic relationships, may be affected. Excessive sleepiness can also cause low sex drive and lead to impotence.
- Memory and concentration: Narcolepsy can make it difficult to remember and concentrate. It causes more disruption to your daily activities.
Narcolepsy can often go undiagnosed or misdiagnosed. People with this disorder need to consult a doctor because the most common (even the only) symptom is excessive daytime sleepiness. However, this can be a warning sign of many diseases.
In addition, narcolepsy symptoms are often attributed to a sleep disorder or to other medical conditions (such as epilepsy or depression). The only specific symptom of narcolepsy is cataplexy (sudden loss of muscle tone), so the diagnosis of this condition can take a long time.
If you suspect you have narcolepsy, talk to your doctor about all the symptoms you’re experiencing. A formal diagnosis requires that you stay overnight in a medical facility for an in-depth analysis by sleep specialists.
Methods of diagnosing and determining the severity of narcolepsy include:
- Sleep history: Your doctor will ask you in detail about your sleep history. One part involves filling out the Epworth Sleepiness Scale – which uses a series of short questions to gauge how sleepy you are.
- Sleep diary: Your doctor may ask you to keep a detailed diary of your sleep patterns for a few weeks. This helps your doctor compare the relationship between your sleep patterns and your level of alertness. In addition, your doctor may also ask you to wear a machine that measures how long you are active and resting.
- Polysomnography: This test measures a variety of body activities during sleep. These activities will be recorded by electrodes and then the signal is transmitted to the computer. Your doctor will then read your sleep polygraph and let you know the results.
- Daytime nap test (MSLT): Used to measure the time it takes you to fall asleep during the day. You will be asked to take 4-5 naps, each about 2 hours apart. The therapist will observe your sleep patterns in detail. People with narcolepsy often fall asleep easily. Also goes to REM sleep quickly.
The tests mentioned can also help your doctor rule out other possible causes of your signs and symptoms. Other sleep disorders such as sleep apnea, chronic sleep deprivation, or use of sedatives can cause excessive daytime sleepiness.
Methods to treat narcolepsy
Although there is no specific treatment for narcolepsy, a combination of different approaches can be beneficial. The goal is to help control symptoms and allow you to enjoy normal activities.
Methods that may be used include:
1. Using drugs
Medication can be helpful in treating the main symptoms of narcolepsy. Commonly prescribed medications may include:
Central nervous system stimulants are thought to be the mainstay of treatment to keep people with narcolepsy awake during the day. Your doctor may prescribe the following medications:
- Modafinil (Provigil)
- Armodafinil (Nuvigil)
- Sunosi (Solriamfetol)
- Pitolisant (Wakix)
Some people may need treatment with methylphenidate (Aptensio XR, Concerta, Ritalin) or different types of amphetamines. These drugs work very well but can be addictive. Moreover, they also have potential side effects such as nervousness and heart palpitations.
Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) are often prescribed by doctors to prevent REM sleep. It also helps relieve symptoms of insomnia, sleep paralysis, and hypoglycemic hallucinations. Of these, fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor XR) are the most commonly used. Side effects can include insomnia, weight gain, and digestive problems.
In addition, your doctor may also prescribe tricyclic antidepressants. Such as imipramine (Tofranil), clomipramine (Anafranil), and protriptyline (Vivactil). These drugs work well with narcolepsy. However, many people complain of their side effects, often dizziness and dry mouth.
– Sodium oxybate (Xyrem):
This drug is highly effective for narcolepsy. Sodium oxybate (Xyrem) may help improve nighttime sleep, which is often poor in people with narcolepsy. In high doses, it can also help control daytime sleepiness. Sodium oxybate (Xyrem) should be taken in 2 doses, 1 dose at bedtime and 1 dose 4 hours later.
Sodium oxybate (Xyrem) can cause some side effects. Such as nausea, bed-wetting and, worse, sleepwalking. Using sodium oxybate (Xyrem) together with other sleeping pills, narcotic pain relievers, or alcohol can lead to difficulty breathing, coma, and death.
Notes when using the drug:
If you have other health problems, such as diabetes or high blood pressure, ask your doctor if medications you are taking for other conditions could interact with your anti-inflammatory drugs. narcolepsy or not.
Some over-the-counter medicines, such as cold or allergy medicines, can cause drowsiness. If you have narcolepsy, your doctor may advise you to avoid these medications.
2. Lifestyle change
Making healthy lifestyle changes can help you better manage your narcolepsy symptoms. Issues to keep in mind include:
– Exercise regularly:
Physical activity will increase your energy levels and help you relieve stress, which is a common cause of sleepiness. Regular exercise with appropriate intensity, especially in the afternoon, also helps you sleep better at night.
It is recommended to spend 30-45 minutes training with moderate-intensity exercises such as jogging, brisk walking or swimming. Avoid exercising three to four hours before bed, if you’re worried you might be able to fall asleep while exercising, consider finding a personal trainer or asking a friend to help.
– Early morning walk:
Sunlight can signal the body when it’s time to wake up in the morning. It also helps to clear your mind. Going outside for an early morning walk will make you more agile and get more vitamin D to boost energy levels.
In addition, walking at a low or moderate intensity for about 20-30 minutes also reduces the risk of cardiovascular and respiratory diseases. At the same time, it helps you better control your body weight and limit fatigue.
– Stay active throughout the day:
Light exercises during the day can help you energize and stave off drowsiness. Simple exercises like jumping rope or stretching can also help you fight fatigue. You should also stand while reading at school or at work. This will help fight sleepiness by keeping your mind busy.
Avoid driving if you feel stressed or drowsy:
Drowsiness while driving is believed to be one of the most dangerous aspects of narcolepsy. Additionally, you may find yourself more likely to fall asleep when stressed, upset, or angry. If this is the case, you should avoid driving. If you feel drowsy while driving, pull over to the side of the road and rest for a while.
– Reduce stress:
Excessive stress can lead to anxiety, lack of sleep, and daytime sleepiness. To avoid stress, you can practice yoga, meditation or tai chi exercises. At the same time, take the time to have fun and get enough rest. Simpler methods to relieve stress are deep breathing in a quiet place, listening to relaxing music, eliminating unnecessary tasks, etc.
– Give up smoking:
Cigarettes containing nicotine can stimulate the nervous system, causing sleep disturbances, sleep apnea, and daytime sleepiness. Studies have also shown that smokers often have a harder time falling asleep, and at the same time have difficulty getting a good night’s sleep. You can talk to your doctor about smoking cessation methods such as using patches, taking medication, or joining support groups.
3. Getting enough sleep improves narcolepsy
Getting enough sleep at night is the best way to stay awake and avoid daytime sleepiness. Some solutions to help you get enough sleep include:
Try to get a full night’s sleep:
If you wake up at night, try to go back to sleep instead of getting up. If necessary, the environment can be adjusted to make it easier to sleep. The amount of sleep each night depends on your lifestyle, age, and many other factors.
School-age children need about 9-11 hours of sleep each night and adults over 18 need 7-8 hours of sleep. Avoid alcohol and sugary foods 4-6 hours before bed because they are stimulants that keep you awake.
Set a schedule for sleep:
You should set a fixed time for going to bed at night and waking up in the morning. Try to stick to this time to help your body get used to a regular sleep pattern. At this time, the body and brain will follow the sleep schedule. This will prevent you from falling asleep at times when you need to be awake.
– Create a dark and pleasant space:
You should try to create an environment that can help support sleep. Please minimize light as well as noise entering the room. Should draw curtains or blinds to create darkness for the bedroom. When in a dark environment, the brain will start producing melatonin – the hormone that regulates sleep.
You can also wear an eyepatch to better block out the light. Keep the room temperature cool, usually between 18-24°C. The room must be well ventilated to avoid stuffiness.
Avoid using electronic devices before bed:
Screen light emitted from electronic devices reduces the amount of melatonin the brain produces. The lack of this hormone will make it difficult for you to fall asleep. Therefore, it is necessary to avoid devices such as smartphones, tablets, televisions, laptops at least 2 hours before going to bed.
– Relax while lying in bed:
If you have trouble falling asleep, relaxation solutions can help reduce stress. You can try listening to soothing music, reading a book, or doing breathing exercises. Or you can also do something relaxing until you are tired before going to bed.
– Sleeping on your side:
If you have health problems that make it hard to breathe at night, you need to change the way you sleep. Sleeping on your side will help you breathe easier and sleep better. Avoid sleeping on your stomach as this position can block your airways and increase acid reflux.
– Arrange nap time:
Taking a nap a few times a day can help improve daytime sleepiness. However, make sure to schedule the naps at the exact time when you feel the most sleepy. Or you can also arrange to nap 30 minutes after meals. Each nap should only last 15-20 minutes, avoid napping for more than 1 hour and in the evening.
– Control sleepiness at work:
Narcolepsy can make you sleepy at work. Especially for those who do office jobs, sedentary. You should schedule a nap when you go to work. Or set flexible start and end times. Maintaining coolness and light in the office will also help you stay awake. You should actively discuss with your superiors to help you work effectively when you have narcolepsy.
4. Adjust the diet
Diet plays a very important role not only with overall health but also with sleep. Especially for people with narcolepsy, dietary adjustments are essential to help control the disease.
Eat a healthy breakfast:
Skipping breakfast can make you feel tired throughout the day. A proper breakfast should have good protein, fresh fruit or vegetables, and a low-sugar and high-fiber starch. You can also add a few almonds or walnuts to add energy and regulate blood sugar.
Eat several small meals:
Instead of just eating 3 main meals, you can also eat many small meals throughout the day. This habit helps to increase the energy level and alertness of the body. Because the brain needs a regular supply of nutrients to maintain energy for the whole day.
Studies show that eating many small meals also helps regulate blood sugar and prevent feeling tired after eating. Meanwhile, a full meal increases the production of tryptophan, which causes drowsiness. You should eat 4-5 small meals a day to increase metabolism and prevent daytime sleepiness.
Apply a high protein diet:
Protein is a nutrient that helps increase energy levels in the body. Eating a protein-rich breakfast and lunch will help keep you energized for the day. However, it is important to choose healthy protein sources such as chicken, eggs, salmon, tuna, tofu, natural cheese, legumes and Greek yogurt.
– Reduce starch intake:
Consuming more starch causes the brain to receive more tryptophan, causing drowsiness. Try not to eat too many carbs in the morning or in the middle of the day. Instead, you can eat snacks before bedtime. For example, a slice of toast with peanut butter, cookies, cereal, and milk.
Avoid sugary foods and drinks:
This food group can give an instant energy boost. However, they also leave you feeling sluggish and tired throughout the day. Studies show that candy and sports energy bars in particular should be avoided because they do not provide a constant source of energy throughout the day. Moreover, it can cause obesity.
– Drink a lot of water:
Not drinking enough water can slow down your metabolism. This makes you feel tired and sleepy. Try to drink 8 250ml glasses of water every 2 hours. Sugar-free and caffeine-free electrolyte sports drinks can also help you stay hydrated.
Limit caffeine intake:
Caffeinated beverages can help you stay awake when you have narcolepsy. However, when combined with stimulants, it can cause restlessness, anxiety, heart palpitations or diarrhea. Therefore, try to limit caffeine intake and do not drink after late afternoon.
Limit alcohol intake:
Alcohol can disrupt your sleep at night. It will also prevent you from getting adequate sleep at night and cause drowsiness during the day. You need to try to reduce or, preferably, quit drinking to prevent narcolepsy.
5. Take advantage of herbs to treat narcolepsy
Some natural herbs are really beneficial for your sleep at night. It also reduces the symptoms of narcolepsy. Such as:
- Chamomile Tea: This is an herb that works to reduce anxiety, nausea, and insomnia. A cup of warm tea before bed can help you relax, get a full night’s sleep, and reduce daytime sleepiness. You just need to soak 1 teaspoon of dried chamomile flowers in 150ml of boiling water for about 10 minutes. Then filter it and drink it before going to bed.
- Use lemon basil: Lemon basil is an herb that works to relieve stress and support sleep very well. It is often combined with sedative herbs such as chamomile and valerian to help with relaxation. If you want to make your own lemon basil tea, you just need to steep 1 teaspoon of dried lemon basil leaves in 1 cup of boiling water for about 5 minutes. Then filter and drink before sleeping.
- Valerian Tea: Valerian is a popular herb that can be used as an alternative to prescription medications for insomnia and anxiety. This herb also helps to fall asleep faster and improves sleep at night. You can soak 1 teaspoon of dried valerian root in 1 cup of boiling water for 10 minutes. Then filter and drink before sleeping.
Narcolepsy can be embarrassing, scary, and cause serious disruption in your life. Therefore, when you notice suspicious symptoms, you should actively consult a doctor. Early remedial interventions help control symptoms and limit problems.