We’re all too familiar with that drowsy feeling just after a heavy meal or when we’re in the midst of a boring meeting; or when we’ve had a long day at work and we’re struggling to stay awake. For most of us, a cup of coffee or a stare from the boss will suffice to keep us from dozing off. But people who suffer from narcolepsy can fall asleep anytime and at any place. What’s more, they can then stay asleep for any number of hours.

What is narcolepsy?

This is chronic sleep disorder and mostly starts around adolescence; however, diagnosis usually happens several years later. Patients often fail to seek medical help even after years of excessive sleepiness, assuming that their sleepiness is not a ‘disease’ per se.

The cause of this condition is not known, though stress and genetics may have a role to play.

What are the common symptoms of narcolepsy?

  • People with narcolepsy fall asleep without warning at any point in time. They may sleep for a few minutes or even up to half an hour before they awaken. They often get up feeling refreshed, but soon fall asleep again.
  • They may experience decreased alertness throughout the day.
  • Cataplexy, which is the sudden loss of muscle tone, is a possible symptom of narcolepsy. Cataplexy is usually brought on by intense positive or negative emotions. This is seen as slurred speech, or drooping of the head or buckling of the knees. However, not everyone with narcolepsy experiences cataplexy.
  • People with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. This is known as sleep paralysis. These episodes usually last for one or two minutes and the person may not recall it later. However, many people without narcolepsy experience some episodes of sleep paralysis, especially during young adulthood.
  • People with narcolepsy may sometimes also have vivid and frightening hallucinations.

How does one diagnose this condition?

Mentioning frequency of long sleep episodes, usually accompanied by any signs of loss of muscle power can help the diagnosis. A detailed health check-up along with a brain scan may be required to rule out any other possibility.

Narcolepsy is a chronic condition that can be controlled with medication. Support from family, friends, employers and teachers can help you cope with narcolepsy. If you notice that you have been sleeping for longer hours than usual, it should warn you that you could have narcolepsy. People with this condition will not just feel drowsy but will also be unable to keep themselves from falling asleep and will actually sleep for more than 15 – 16 hours.

Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness. If you have narcolepsy, your doctor will most likely recommend that you avoid taking these medications.

How does narcolepsy affect a person?

Effect on your professional life: Since not many people know about narcolepsy, the ones suffering from this condition are simply thought to be lazy or unmotivated people. The lack of concentration brought on by this disease actually makes it difficult for people suffering from it to perform well at work or school.

Effect on relationships: The bouts of sleepiness are so strong that the person may even fall asleep during sex. Because intense emotions are a risk factor to bringing on an episode of narcolepsy or cataplexy, it may also lead to sexual dysfunction.

Effect on personal safety: It’s no surprise that people suffering from this condition are at a risk of causing harm to themselves and others, especially if they are driving or using machines or working near fire, sharp instruments and so on.

Effect on weight: People with narcolepsy are twice as likely to be overweight. Due to constant tiredness, the weight gain may be related to inactivity, binge eating, or a combination of factors.

Lifestyle and home remedies

Lifestyle modifications are important to manage the symptoms of narcolepsy. You may benefit from these steps:

  • Stick to a schedule: Go to sleep and wake up at the same time every day, including on weekends.
  • Take naps: Schedule short naps at regular intervals during the day. Naps of 20 minutes at strategic times during the day may be refreshing and reduce sleepiness for one to three hours. Some people may need longer naps.
  • Avoid nicotine and alcohol: Using these substances, especially at night, can worsen your signs and symptoms.
  • Get regular exercise: Moderate, regular exercise at least four to five hours before bedtime may help you feel more awake during the day and help you to sleep better at night.

What is the eventual outcome?

The prognosis is variable. Excessive sleepiness is almost always a lifelong problem. In some patients, cataplexy, hallucinations and sleep paralysis become less problematic over time. However, that doesn’t mean that narcolepsy needs to ruin your life. With an early diagnosis, proper medication and guidance you can live a regular life.

This was first published in the July 2014 issue of Complete Wellbeing.

Himanshu Soni
Dr Himanshu Soni is full-time consultant neurologist and epileptologist at Dr L H Hiranandani Hospital, Powai, Mumbai.


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