What makes us sleepy? Maybe the reason is a banal lack of sleep? Or is everything much more serious, and yawning in the mouth and drowsiness speak of a serious illness? Drowsiness can be caused by certain medications and even too much sleep. However, there is an interesting and incomprehensible disease in which a person not only wants to sleep, but literally falls asleep out of the blue. This condition is called narcolepsy.
Signs of narcolepsy: weakness after sleep
Someone may have already encountered the phenomenon of narcolepsy in films and books. In this regard, the heroine of the novel by Jonathan Coe “House of Sleep” is a vivid example. A girl named Sarah has all five of the following signs of narcolepsy. What are these signs?
Irresistible desire during the day to suddenly fall asleep;
Vivid dreams when falling asleep or waking up;
After sleep, already awake, a person cannot move his arms and legs;
With laughter, sharp negative emotions, at the moment of making love, muscle relaxation suddenly occurs, such that a person can fall or is forced to sit down to keep from falling;
The need to sleep several times (1–3 times) during the day in order to feel alert, while the sleep time is 3–5‑15 minutes.
The presence of at least two of the listed signs can indicate narcolepsy. But its two most striking signs are the ability to fall asleep in any circumstances, for example, when talking, and a sharp relaxation of the muscles during strong laughter — such that a person falls.
Sleep and its phases: rest and brain activity
Sleep is still a mysterious phenomenon in our lives. All sleep time is divided into phases. One phase is non-REM sleep. During this period, a person is in a state of deep sleep, his brain is unloaded. The other phase is REM sleep. In the phase of REM sleep, the eyes of a person under closed eyelids move, the frequency of breathing and heartbeat increase, the person moves, changes his posture. The brain is highly active. It functions with the same intensity as during the day, but the sleeper does not wake up. It is during the fast phase that we dream. For the discrepancy between the vivacity of the brain and the sleepy body, the slow phase of sleep is also called paradoxical.
With narcolepsy, sleep phases are included, as it were, partially. Inhibition, covering the cerebral cortex during sleep, is selective in this disease. In one case, it captures the cerebral cortex, but does not affect the underlying sections. The person falls asleep, but he can continue to sit and even walk during sleep. This state lasts seconds or 1–2 minutes. After sleep, a person continues to act calmly, sometimes without noticing it. Or the opposite state: suddenly immobility sets in, but consciousness is completely preserved. Thus, in narcolepsy, inhibition takes over different parts of our brain.
Patients with narcolepsy are characterized by the ability to fall without bruising. Before the onset of an attack, they may have time to sit down, group up, or even lie down. Attacks of narcolepsy are very similar to a variant of epilepsy, so doctors must conduct a differential diagnosis, that is, they prove that in this case there is precisely narcolepsy, and not epilepsy.
Sleep time — any time
What are the mechanisms of narcolepsy? Are they known? Even in the laboratories of Pavlov, who is best known for the theory of the conditioned reflex (when experimental dogs salivated at the bell), it was proved that there is a special sleep center in the brain. It is located deep in the brain, at the bottom of the third ventricle. Just from there, inhibition begins to spread, which then captures the cerebral cortex.
Later it was found that there are special substances — neurotransmitters or neurotransmitters that are involved in the transmission of this inhibition through nerve cells. And when the body is functioning normally, these neurotransmitters allow arousal to keep us awake. When there are not enough neurotransmitters, the excitatory impulse does not reach the cerebral cortex. And the man falls asleep. He falls asleep at the most inopportune moments, regardless of his own desire. The patient can fall asleep at work, at home, while eating and just on the go. This is a pathological, uncontrolled dream.
Treatment: not to be confused with epilepsy
In epilepsy, these electroencephalograms find the focus of excitation in the brain. And if we treat epilepsy with inhibitory drugs, then there is nothing to slow down here, the treatment will be different. Sleep with narcolepsy is short, after sleep a person is again included in life, but such people, of course, look strange, and not all of them can work. These people need medical help. How to treat this disease? The treatment is carried out by a neuropathologist, although the disease sometimes looks like a mental one.
To begin with, as already mentioned, the doctor must determine if the patient has epilepsy, because the treatment of these diseases is completely different. Secondly, you need to understand whether the signs of narcolepsy are a symptom of some more serious disease, for example, a tumor in the area of the brain that is responsible for sleep. Diagnosing narcolepsy is not easy. It is necessary to study sleep and study the brain in a dream with registration of the processes taking place in it.
If the diagnosis of narcolepsy is established, it is important to correctly distribute your forces during the day and night. Carefully regulated sleep and wakefulness is needed. In addition, it is necessary to exclude those professional activities in which a person, suddenly falling asleep, can harm himself and others. Such people definitely cannot work with machines, drive a car. At the same time, maintaining a daily routine, which can include several episodes of daytime sleep, allows them to function quite normally. That is, one can adapt to the disease: if a person needs to sleep during the day, he can find a job in which daytime sleep is acceptable.
Actually, the treatment of narcolepsy is carried out under very strict medical supervision. Patients are prescribed drugs that, on the one hand, tone, that is, stimulate, the brain during the day. As a result, impulses that excite the cerebral cortex, preventing it from slowing down and falling asleep, will reach it, and the person will be awake and feel great. On the other hand, it is necessary to weaken the inhibitory influence that comes from the sleep zone. There are two groups of drugs that will not let the cerebral cortex sleep at the wrong time. Thus, it is possible to correct painful disorders in the brain, which will allow the patient to live an almost full life.