Narcolepsy Sleep Disorder

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Narcolepsy Sleep Disorder 

Narcolepsy Sleep Disorder   

This is a disabling neurological disorder of sleep regulation that affects the control of sleeping and wakefulness. It may be described as an intrusion of the dreaming state of sleeping (called REM or rapid eye movement sleep) into the waking state. 

Symptoms generally begin between the ages of 15 and 30. The four classic symptoms of the disorder are excessive daytime sleepiness; cataplexy (sudden, brief episodes of muscle weakness or paralysis brought on by strong emotions such as laughter, anger, surprise or anticipation); sleeping paralysis (paralysis upon falling asleep or waking up); and hypnagogic hallucinations (vivid dream-like images that occur at sleep onset). 

Disturbed nighttime sleeping, including tossing and turning in bed, leg jerks, nightmares, and frequent awakenings, may also occur. The development, number and severity of symptoms vary widely among individuals with the disorder. It is probable that there is an important genetic component to the disorder as well. 

Unrelenting excessive sleepiness is usually the first and most prominent symptom of this problem. Patients with the disorder experience irresistible sleeping attacks, throughout the day, which can last for 30 seconds to more than 30 minutes, regardless of the amount or quality of prior nighttime sleep. 

These attacks result in episodes of sleeping at work and social events, while eating, talking and driving, and in other similarly inappropriate occasions. Although this is not a rare disorder, it is often misdiagnosed or diagnosed only years after symptoms first appear. 

Early diagnosis and treatment, however, are important to the physical and mental well-being of the affected individual. Is there any treatment? There is presently no cure for narcolepsy; however, the symptoms can be controlled with behavioral and medical therapy. 

The excessive daytime sleepiness may be treated with stimulant drugs or with the drug modafinil (Provigil), which was approved by the FDA for this use in 1999. Cataplexy and other REM-sleeping symptoms may be treated with antidepressant medications. 

At best, medications will reduce the symptoms of this disorder, but will not alleviate them entirely. Also, many currently available medications have side effects. Basic lifestyle adjustments such as regulating sleeping schedules, scheduled daytime naps and avoiding "over-stimulating" situations may also help to reduce the intrusion of symptoms into daytime activities. 

What is the prognosis? 

Although this is a life-long condition, most individuals with the disorder enjoy a near-normal lifestyle with adequate medication and support from teachers, employers, and families. If not properly diagnosed and treated, this problem may have a devastating impact on the life of the affected individual, causing social, educational, psychological, and financial difficulties. 

What research is being done?

The NINDS supports a broad range of clinical and basic research on sleeping disorders.  NINDS has notified investigators that it is seeking grant applications in both clinical and basic sleeping and wakefulness research, including basic and clinical research into this problem.

In 1999, a research team working with canine models identified a gene that causes narcolepsy, a breakthrough that brings a cure for this disabling condition within reach. 

The researchers are currently searching for defective versions of this gene in people with narcolepsy. Selected references Broughton, R. Narcolepsy. In Handbook of Sleep Disorders. 

National Commission on Sleep Disorders Research Wake up America: 

A National Sleep Alert, Volume 1. Executive Summary and Executive Report. 

Report of the National Commission on Sleep Disorders Research, DHHS, (January 1993). Aldrich, M. 

The clinical spectrum of narcolepsy and idiopathic hypersomnia. Neurology, 46; 393-401 (1996). Organizations Narcolpsy and Sleeping Disorders: 

A Newsletter/ American Narcolepsy Foundation 528 Abrego Street PMB 149 Monterey, CA 93940 Tel: 831-646-2055 Fax: 831-646-2051 

Narcolepsy Network, Inc. 10921 Reed Hartman Hwy. #119 Cincinnati, OH 45242 Tel: 513-891-3522 Fax: 513-891-3836 

National Sleeping Foundation 1522 K Street NW Suite 500 Washington, DC 20005 Tel: 202-347-3471 (no public calls please) Fax: 202-347-3472

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