Narcolepsy: when sleep takes you by surprise

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For most peo­ple, sleep is part of the rou­tine: they fall asleep and wake up at a cer­tain time. But for some, the desire to sleep is some­thing sud­den. Sleep does not sneak up on them, but lit­er­al­ly unex­pect­ed­ly falls on them with an avalanche of sud­den and insur­mount­able fatigue at any moment of the day, more often right after din­ner, turn­ing off con­trol over mus­cle tone, at the moment when con­scious­ness is work­ing. By evening, drowsi­ness is often less than in the day­time.

In such cas­es, we are talk­ing about a dis­ease called “essen­tial nar­colep­sy” or “Gelinot’s dis­ease.” This pathol­o­gy is bur­den­some for the patient him­self, since sleep can take him by sur­prise at the most inop­por­tune moment. But, in addi­tion, it pos­es a threat to oth­ers if a per­son with nar­colep­sy dri­ves a car, per­forms any work in which the life of oth­ers depends on his reac­tion and con­trol, etc.

Zhe­li­no’s dis­ease caus­es prob­lems with mem­o­riza­tion, con­cen­tra­tion of atten­tion, cre­at­ing great inter­fer­ence with the patien­t’s dai­ly activ­i­ties.

Causes of the disease

Causes of the disease

This pathol­o­gy affects both females and males, but men are some­what more com­mon. Nar­colep­sy usu­al­ly man­i­fests at a young age, between 10 and 25 years of age. Accord­ing to med­ical sta­tis­tics, it occurs on our plan­et in one out of two thou­sand peo­ple.

Pre­vi­ous­ly, the devel­op­ment of nar­colep­sy was attrib­uted entire­ly to hered­i­ty. Today, doc­tors believe that the dis­ease may have oth­er caus­es:

    hormonal disorders;
    pregnancy;
    infectious pathologies of the brain;
    diabetes;
    brain injury;
    psychoemotional disorders;
    excessive fatigue;
    disorders in the immune system.

Mod­ern med­ical sci­ence knows why Geli­no’s dis­ease occurs. As author­i­ta­tive sci­en­tif­ic stud­ies have shown, the devel­op­ment of nar­colep­sy is based on a defi­cien­cy of orex­ins types A and B. These are neu­ro­trans­mit­ters that are pro­duced by neu­rons in the hypo­thal­a­mus. They help the body stay awake. In patients with neu­rolep­sy, a decrease in the num­ber of neu­rons respon­si­ble for the syn­the­sis of orex­ins is record­ed.

Diagnosis of sleep disorders

Diagnosis of sleep disorders

Nar­colep­sy is not always easy to rec­og­nize and it can some­times take more than 10 years to get a prop­er diag­no­sis.

It is not easy to dis­tin­guish Geli­no’s dis­ease from epilep­sy and some psy­cho-emo­tion­al dis­or­ders. There­fore, dif­fer­en­tial diag­no­sis should be based on objec­tive data from polysomnog­ra­phy and the sleep pat­tern test or its mul­ti­ple laten­cies (MSLT), which dif­fer in nar­colep­sy, epilep­tic brain activ­i­ty, etc.

Nar­colep­tics have unique sleep cycles. They can enter deep sleep imme­di­ate­ly after falling asleep, while it takes about 90 min­utes for most peo­ple. There­fore, they see vivid dreams, bare­ly hav­ing time to close their eye­lids, even if the dream occurs dur­ing the day and lasts only a few min­utes.

By some esti­mates, up to 50% of peo­ple with nar­colep­sy are unaware that they are a vic­tim of the dis­ease. There­fore, it is very impor­tant that each per­son has infor­ma­tion about the main symp­toms of this pathol­o­gy.

Loss of control of muscle tone without impairment of consciousness and other symptoms

Loss of control of muscle tone without impairment of consciousness and other symptoms

Learn about the five main signs of nar­colep­sy. If a per­son has at least one of them, it is nec­es­sary to tell a spe­cial­ist about it.

1. Uncontrollable desire to sleep, often at the wrong time

This is called exces­sive day­time sleepi­ness (EDS). A per­son with this symp­tom may feel con­stant­ly tired. It is dif­fi­cult for him to stay awake and keep work­ing dur­ing the day. He has unin­ten­tion­al sleep laps­es.

All peo­ple with nar­colep­sy have exces­sive day­time sleepi­ness, but they may not describe it in the same way. Some may report:

    feeling tired;
    increased irritability;
    difficulty concentrating;
    bad memory;
    sudden changes in mood.

2. Sharp loss of muscle tone

This phe­nom­e­non is called “cat­a­plexy”. A sharp loss of mus­cle tone can cause a per­son­’s head to fall, face to droop, jaw to weak­en, or knees to buck­le sharply, while con­scious­ness is pre­served. A per­son is aware of what is hap­pen­ing, but can­not resist it. A decrease in mus­cle tone can com­plete­ly cov­er the entire body and lead to a fall.

At the time of the attack, the fol­low­ing symp­toms are observed:

    decreased tendon reflexes;
    slow heart rate;
    redness or blanching of the skin;
    profuse sweating;
    when the tone of the neck muscles is lost, breathing becomes difficult.

Not all patients with nar­colep­sy have cat­a­plexy. But a sharp loss of mus­cle tone with­out loss of con­scious­ness can be a sign of Geli­no’s dis­ease.

3. Poor quality sleep at night or insomnia

It is quite nor­mal to wake up at night, from time to time. How­ev­er, when a per­son has a sleep dis­or­der asso­ci­at­ed with nar­colep­sy, it means that they often fall asleep quick­ly but then wake up con­stant­ly through­out the night.

You should tell your doc­tor about this, because inad­e­quate sleep can cause many health prob­lems.

4. Feeling unable to move or speak when falling asleep or waking up

This phe­nom­e­non is called sleep paral­y­sis. It occurs when a per­son falls asleep or wakes up, often before or after a long night’s rest. The body briefly par­a­lyzes, a per­son is only able to move his eye­balls and blink. Some­times it is impos­si­ble not only to utter a word or move the fin­gers, but also to breathe deeply, so the patient, quite nat­u­ral­ly, expe­ri­ences a strong feel­ing of fear.

5. Vivid, often frightening dreams upon falling asleep and waking up

In sci­en­tif­ic lan­guage, they are called “hyp­n­a­gog­ic hal­lu­ci­na­tions.” Sur­vivors often describe their dreams as night­mares or vivid fairy tale expe­ri­ences that seem real. Under the influ­ence of a hyp­n­a­gog­ic hal­lu­ci­na­tion, being on the thresh­old of sleep-wake­ful­ness, a per­son is able to hear sounds or words, have unwant­ed visions.

Sleep paral­y­sis is often accom­pa­nied by hyp­n­a­gog­ic hal­lu­ci­na­tions.

Impor­tant!

    To assume Gerino’s disease in a patient, one does not need to try to find all of the listed symptoms, the presence of only one is enough to suspect a pathology
    If you or someone you know has any of these symptoms, talk to a specialist.
    The diagnosis of narcolepsy can be made by a doctor only after a thorough analysis of the symptoms and the results of special studies.
    By making lifestyle changes and following all the recommendations of specialists, you can manage the symptoms of narcolepsy and regain control over your own life.

By Yraa

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