When you need an appointment with a doctor for narcolepsy: symptoms and diagnosis

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Nar­colep­sy is a sleep dis­or­der that affects up to 1 in 2,000 peo­ple. How­ev­er, it is not includ­ed in the cat­e­go­ry of “rare dis­eases”. It is some­times mis­di­ag­nosed as anoth­er sleep prob­lem because it has some com­mon symp­toms: tired­ness, fatigue, weak­ness. Untreat­ed nar­colep­sy can lead not only to prob­lems in the per­son­al and pro­fes­sion­al spheres, but also to threat­en life: a per­son can sud­den­ly fall asleep while dri­ving or while cook­ing. There­fore, at the first sus­pi­cion of it, you need to make an appoint­ment with a doc­tor by phone +7 (499) 519–32-56 and a detailed diag­no­sis of the body.

What are the main symptoms of narcolepsy?

What are the main symptoms of narcolepsy?

Sud­den and uncon­trolled falling asleep is one of the main symp­toms of this dis­ease. Her oth­er symp­toms:

    con­stant feel­ing of tired­ness

    drowsi­ness,

    fatigue and desire to fall asleep even in the mid­dle of the work­ing day,

    night sleep dis­tur­bance

    sud­den loss of mus­cle tone

    hal­lu­ci­na­tions,

    sleep paral­y­sis.

Nar­colep­sy is defined as a neu­ro­log­i­cal con­di­tion in which the brain’s abil­i­ty to reg­u­late sleep and wake cycles is impaired. Peo­ple with this dis­or­der often have trou­ble sleep­ing both at night and dur­ing the day, as dif­fer­ent stages of sleep occur at inap­pro­pri­ate times. Peo­ple with nar­colep­sy may fall asleep uncon­trol­lably while work­ing, dri­ving, cook­ing, and even laugh­ing, talk­ing, and hav­ing sex. “Sleep attacks” usu­al­ly do not last long — a few sec­onds or min­utes, but some­times they can drag on for up to sev­er­al hours.

What types of disease exist?

What types of disease exist?

Doc­tors clas­si­fy two types of nar­colep­sy. In the first case, patients have a low lev­el of hypocre­tin (orex­in), a sub­stance of the brain, which was dis­cov­ered only in the ear­ly 2000s. It plays a key role in main­tain­ing wake­ful­ness, help­ing reg­u­late cir­ca­di­an rhythms and the body’s ener­gy bal­ance. In the first type of nar­colep­sy, peo­ple expe­ri­ence such char­ac­ter­is­tic symp­toms as sud­den numb­ness and loss of mus­cle strength (cat­a­plexy), which may even cause the patient to fall while remain­ing ful­ly con­scious.

Type II nar­colep­sy, a milder form of the dis­ease, is not char­ac­ter­ized by severe hypocre­tin defi­cien­cy and cat­a­plexy attacks. Some­times the sec­ond type, due to lack of treat­ment, grad­u­al­ly devel­ops into the first. That is why a time­ly appoint­ment with a doc­tor and a cor­rect diag­no­sis are need­ed. Both types of nar­colep­sy are clas­si­fied as autoim­mune dis­eases.

The exact rea­son for the decrease in the lev­el of hypocre­tin in the body is still unknown. It is spec­u­lat­ed that this may be due to a mis­guid­ed attack by the immune sys­tem. Peo­ple are not born with nar­colep­sy, but rather may or may not have a genet­ic pre­dis­po­si­tion to devel­op the dis­ease. For those who have the pre­req­ui­sites for it, at some point the usu­al work of the immune sys­tem is dis­rupt­ed: in the process of fight­ing the flu or anoth­er infec­tion, it starts by mis­take to attack neu­rons that pro­duce hypocre­tin.

When is a doctor’s appointment required?

Unex­pect­ed and unex­plained “sleep attacks”, exces­sive day­time sleepi­ness, hal­lu­ci­na­tions, and sleep paral­y­sis are all signs of seri­ous prob­lems in the body that require an appoint­ment with a doc­tor. Because peo­ple with nar­colep­sy have dis­rupt­ed cir­ca­di­an rhythms, the most com­mon prob­lem is rest­less sleep at night. But the main symp­tom that is observed in every patient with nar­colep­sy is exces­sive day­time sleepi­ness.

Addi­tion­al­ly, REM sleep may occur at the wrong time. Dur­ing this stage, dreams occur, and the per­son­’s body is nat­u­ral­ly immo­bi­lized so that the per­son does not harm him­self by expe­ri­enc­ing events in a dream. In peo­ple with nar­colep­sy, the REM phase is poor­ly con­trolled by the brain and the bound­aries between sleep and wake­ful­ness are blurred, lead­ing to very vivid dreams and sleep paral­y­sis while awake.

How do doctors diagnose the disease?

To make a diag­no­sis, doc­tors care­ful­ly ana­lyze the symp­toms, con­duct a med­ical exam­i­na­tion of the patient, tak­ing into account a com­plete his­to­ry, includ­ing fam­i­ly dis­eases. This infor­ma­tion is need­ed to accu­rate­ly eval­u­ate the results of two types of diag­nos­tic tests:

    Polysomno­grams (PSG),

    Laten­cy sleep test (MSLT).

In the first study, the doc­tor asks the patient to spend the night in the hos­pi­tal to mon­i­tor and record body func­tions such as brain activ­i­ty, heart rate, blood pres­sure, and eye move­ments. This test helps to observe the phas­es of rapid and non-rapid eye move­ment dur­ing sleep to deter­mine the qual­i­ty of sleep.

The laten­cy sleep test is per­formed dur­ing the day after the test of the first type of study. It includes a series of five sched­uled naps through­out the day dur­ing which patients will be under med­ical super­vi­sion. It will deter­mine how quick­ly a per­son falls asleep and goes into dif­fer­ent phas­es of sleep, in par­tic­u­lar, in REM. It can some­times take up to 10 years after the onset of symp­toms before a diag­no­sis is made.

Because the symp­toms of nar­colep­sy can resem­ble those of oth­er con­di­tions (apnea, depres­sion, or seizure dis­or­der), delayed or inac­cu­rate diag­no­sis is com­mon.

What types of treatment are available?

There is cur­rent­ly no sin­gle cure for nar­colep­sy. But doc­tors have found that a com­bi­na­tion of cer­tain med­ica­tions and lifestyle adjust­ments can be very effec­tive in treat­ing the con­di­tion. Some­times the patient is pre­scribed anti­de­pres­sants, drugs for ADHD and psy­chos­tim­u­lants. In West­ern coun­tries, such drugs for nar­colep­sy as modafinil and methylphenidate are com­mon, which are not reg­is­tered in Rus­sia. They are designed to reduce day­time sleepi­ness. And anti­de­pres­sants are rec­om­mend­ed to con­trol cat­a­plexy.

But an impor­tant con­di­tion for treat­ment is a change in lifestyle and behav­ior, includ­ing the cor­rect sleep pat­tern (going to bed at the same time and sleep­ing for at least sev­en hours), play­ing sports, reduc­ing caf­feine and alco­hol in the evening. The doc­tor may advise the patient to take small breaks for day­time sleep or rest to reduce drowsi­ness and increase ener­gy.

i love you, love, romance
i love you, love, romance
i love you, love, romance
tiramisu, dessert, cake
tiramisu, dessert, cake

In the future, research sci­en­tists may lead to the arti­fi­cial pro­duc­tion of hypocre­tin to con­trol its defi­cien­cy in the brain. Doc­tors con­tin­ue to look for ways to pre­vent the destruc­tion of this neu­ro­trans­mit­ter in those who are genet­i­cal­ly sus­cep­ti­ble to nar­colep­sy.

By Yraa

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