Narcolepsy – Symptoms, Diagnosis & Treatment

Narcolepsy is defined as a medical condition marked by an extreme propensity to fall asleep multiple times throughout the day, particularly while being seated or during calm and relaxing situations (Barateau et al., 2016). Scientists have identified two forms of narcolepsies, the first one being Type 1 which is characterized by acute daytime sleepiness and cataplexy and is caused by a massive loss of hypothalamic neurons generating hypocretin-1. In contrast, patients with Type 2 have revealed similar symptoms, however, thus far the causes underlying this type of disorder remain unclear (Barateau et al., 2016; Campion & Scammell, 2015).

Typically starting between the ages of 10 to 20, narcolepsy affects one in 2000 people in the general population and is commonly associated with other psychiatric disorders, such as depression and anxiety. Excessive daytime sleepiness is the central hallmark and the most impeding symptom of narcolepsy, as patients report short and involuntary episodes of deep sleep related to vivid dreams despite having adequate nighttime sleep (Campion & Scammel, 2015). As a result of this, patients affected by narcolepsy generally encounter difficulties remaining awake during and concentrating on daily activities which may lead to “declining grades at school, poor performance at work or a motor vehicle accident” (Barateau et al., 2016).

Additional symptoms of narcolepsy include hypnagogic or hypnopompic hallucinations, disordered REM sleep, which may occur at any time of the day, obesity, impeding sleep apnea, sleep paralysis, nocturnal myoclonus, and fragmented nighttime sleep with unpleasant dreams. Importantly, all of the afore-listed symptoms are generally more serious in Type 1.

As for the diagnosis, narcolepsy remains highly underdiagnosed within modern psychiatry. Nonetheless, a diagnosis is usually made based on patients' clinical history and overnight polysomnography along with several sleep latency tests on the following day (Barateau et al., 2016). Based on the data obtained from these tests, clinicians are additionally able to exclude any other possible causes of daytime sleepiness or other sleep disorders, which hence allows them to make a proper diagnosis. In conjunction with these tests, subjective measurements of daytime sleepiness are essential to assess the effectiveness of treatments.

Treatment options for narcolepsy may range from behavioral to pharmacological interventions, the most common being the administration of “wakefulness-promoting medication” (Barateau et al., 2016). In addition, collectively finding individualized strategies, such as avoiding potentially dangerous situations, for instance driving a car, keeping a nighttime sleep schedule, and planning afternoon naps throughout the day, may significantly reduce daytime sleepiness and provide further benefits to patients affected by narcolepsy (Campion & Scammel, 2015).

Through this research, I was able to gain an insight into narcolepsy, as I was not previously aware of the severity of this disorder and the potential dangers it may entail in patients’ daily lives. Therefore, it is highly important to find individualized treatments that can help people that are affected by narcolepsy along with considering new lifestyle changes. Throughout the treatment process, the significance of family and friends’ support was brought to my awareness.

References

Barateau, L., Lopez R., Dauvillier, Y. (2016). Treatment Options for Narcolepsy. CNS Drugs, 30(5), 369–379. doi:10.1007/s40263-016-0337-4 

Campion, E. W., Scammell, T. E. (2015). Narcolepsy. New England Journal of Medicine, 373(27), 2654–2662. doi:10.1056/NEJMra1500587