Narcolepsy

Narcolepsy

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    Because the exact causes of narcolepsy are unknown, there is nothing you can do to prevent it. Narcolepsy may have a genetic component. Seek treatment for your narcolepsy to try to prevent its symptoms from interfering with your life.

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    Narcolepsy is a condition characterized by sudden sleep attacks during the day. Individuals with narcolepsy may fall asleep at inappropriate times and without warning several times a day. Other symptoms that may appear alone or in combination months or years after the daytime sleep attacks begin include:
    • Cataplexy
    • Sleep paralysis
    • Hypnagogic hallucinations
    The development, severity and order of appearance of narcoleptic symptoms vary, and not all people with the disorder experience all four symptoms. While excessive daytime sleepiness generally persists throughout life, sleep paralysis and hypnagogic hallucinations may not. The symptoms of narcolepsy, especially the excessive daytime sleepiness and cataplexy, may cause serious disruptions to personal and professional life and severely limit activities.
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    If you are caring for someone with narcolepsy, make an appointment for them to see their doctor about the condition. Then, ensure that they follow the instructions of their doctor. They should take all prescription medication as directed, and you should contact their doctor right away if they experience any problems. Also, encourage them to avoid smoking cigarettes and drinking alcohol, especially before bedtime. Try to ensure that they exercise regularly (though not at night), keep a regular sleeping and waking schedule, and take naps of less than 30 minutes at the same time every day. Tell their family, friends, and school about their condition so they understand their behavior. Make sure they do not drive or do other dangerous activities if their symptoms are not under control. Have them seek counseling or a support group if you think it will help them cope.

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    Cataplexy occurs when you have a sleep attack that is triggered by a strong emotion. This can happen when you are surprised, elated or even intimate with a partner. You may slur your speech or lose control of your limbs, or you may become completely paralyzed.

    Narcolepsy with cataplexy is frequently linked to increased weight, sometimes obesity. It is possible to have narcolepsy along with another sleep disorder, such as sleep apnea or rapid eye movement (REM) sleep behavior disorder. 
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    Behavioral changes may help treat some of your narcolepsy symptoms without medication. Avoid smoking cigarettes and drinking alcohol, especially before bedtime. Exercise regularly, but not at night. Keep a regular sleeping and waking schedule, and take naps of less than 30 minutes at the same time every day. Some people also find counseling or support groups to be helpful.

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    Your doctor may recommend lifestyle changes to help you manage the symptoms of narcolepsy. You will need to keep a consistent sleep schedule by going to sleep and waking up at the same time every day, including weekends. If possible, schedule short, 20-minute naps throughout the day. To increase your energy through the day, try to get regular exercise and avoid using tobacco, alcohol or drugs.
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    It's not unusual for people suffering from narcolepsy to visit a variety of healthcare professionals for years before they receive an accurate diagnosis. To get an accurate diagnosis, you should be seen in an accredited sleep center by a sleep specialist.

    Two tests are used to diagnose narcolepsy. The nocturnal polysomnogram (sleep study) involves continuous recording of brain waves and several nerve and muscle functions during nighttime sleep. It also includes monitoring your breathing pattern and oxygen levels while you sleep. When tested, people with narcolepsy fall asleep rapidly, enter REM (rapid eye movement) sleep early and may wake often during the night. The polysomnogram also helps detect other possible sleep disorders such as sleep apnea that could cause daytime sleepiness.

    The multiple sleep latency test (MSLT) measures the degree of daytime sleepiness and detects when REM sleep occurs. During this test, you're given a chance to sleep every two hours during normal wake times. A sleep specialist observes how long it takes you to fall asleep. People with narcolepsy fall asleep rapidly and enter REM sleep very early in their sleep cycle.
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    Narcolepsy can affect children as well as adults. Symptoms often begin appearing around age 10 through adolescence. Even preschoolers have been diagnosed with the condition, however. The younger the patient, the more severe the narcolepsy will likely be in adulthood. Untreated narcolepsy can contribute to behavior and learning difficulties. If you suspect your child has narcolepsy, contact their physician.

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    Many doctors prescribe the drug modafinil (Provigil) first for narcolepsy because it is less addictive and has fewer side effects compared to other stimulants. Other medications prescribed for narcolepsy include methylphenidate (Ritalin) or amphetamines.

    Selective serotonin reuptake inhibitors (SSRIs) and antidepressants are often prescribed to treat cataplexy and other narcolepsy symptoms, including hallucinations and sleep paralysis. The effects vary depending on the medication your doctor recommends. In severe cases of cataplexy, your doctor may prescribe sodium oxybate.
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    If you have narcolepsy, an antidepressant may help regulate your REM sleep cycle and alleviate the cataplexy, sleep paralysis, and hallucinations you may have. Prescription stimulants may help keep you awake during the day. Sodium oxybate may help you sleep only at night and may relieve cataplexy. All of these drugs can have serious side effects; as with all prescription medicines, be sure to follow your doctor's orders.

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