What is Narcolepsy and What are its Causes and Treatment?

What is Narcolepsy?

Narcolepsy is a long-term neurological disorder that can affect the sleep-wake procedure. Your brain loses its ability to control sleep. People suffering from narcolepsy have excessive and uncontrollable daytime sleepiness. They find it difficult to stay awake for a long time and may get sudden sleeping attacks when doing an activity. Healthy people go into REM sleep more than an hour after falling asleep. Narcolepsy patients go into REM sleep as soon as they fall asleep or even when they are awake.

There are two types of narcolepsy, type 1 and type 2. Type 1 narcolepsy causes a sudden loss of muscle tone or cataplexy. Cataplexy is normally triggered by laughter or other strong emotions. As the person falls asleep during any type of activity, it not only affects their daily activities but also can be dangerous.

There is no permanent cure for narcolepsy. However, you can manage the symptoms with proper medications, lifestyle changes, and family support. Narcolepsy symptoms generally respond well to treatment.

Causes of narcolepsy

• In most cases, narcolepsy is caused by the lack of a chemical in the brain called hypocretin or orexin. Hypocretin is the chemical responsible for sleep regulation and control.
• Autoimmune response may be another reason for narcolepsy. Normally, your body releases antibodies to destroy toxins and disease-causing organisms. Sometimes, antibodies start attacking healthy cells and tissues in your body. This is called an autoimmune response. People with narcolepsy may have this problem. Studies point out that they produce antibodies against trib 2, a natural protein in your body. Trib 2 is produced in the same area of the brain where hypocretin is produced. This ultimately results in the lack of the chemical hypocretin. A low level of hypocretin causes narcolepsy.
• Variations in genes may cause narcolepsy. The contribution of variation in genes in causing narcolepsy is low but it cannot be ignored.
• Hormonal changes, especially during menopause, can trigger narcolepsy. A decrease in estrogen levels may affect the production of orexin or hypocretin. This can lead to changes in sleep patterns and symptoms of narcolepsy.
• Recent studies show that psychological stress and anxiety may be a reason for narcolepsy.
• Sometimes, a streptococcal infection may trigger an autoimmune response. It may cause the destruction of hypocretin in the hypothalamus. So, streptococcal infection and swine flu increase the risk of narcolepsy.
• Pandamrix is an H1N1 influenza vaccine. In 2009, it was found in Europe and Finland that it was associated with narcolepsy.

How to diagnose narcolepsy?

Narcolepsy is usually diagnosed with the help of a sleep analysis.

• You will be asked to fill out an Epworth Sleepiness Questionaire. Based on your answers you will be given a score. A score of 10 or below is normal. A score of 11 or above shows you have excessive daytime sleepiness. If you have a high score, your doctor will rule out other sleeping disorders like sleep apnea, epilepsy, hypothyroidism, and depression before making the final diagnosis.
• Your doctor may recommend polysomnography, a sleep test. You will be asked to stay in a sleep center. The specialists will monitor your body with electrodes, sensors, and bands. Many tests are carried out to analyze if you have normal eye movement, brain activity, and breathing when you are asleep.
• A multiple sleep latency test may be done to find how long it takes to fall asleep during the day. This test is used to study when you enter REM.
• A blood test may also be done to check if you have a genetic marker that is related to narcolepsy.
• Another diagnostic test is measuring hypocretin level by collecting cerebrospinal fluid.

Treatment for narcolepsy

There is no complete cure for narcolepsy but there are many ways to manage the symptoms.

1. Medications

• Stimulants - They are the most recommended medications to minimize the symptoms of narcolepsy. Stimulant drugs prescribed to treat narcolepsy include Modafinil, armodafinil, dextroamphetamine, sodium oxalate, pitosilant, and solriamfetol. These medications stimulate the central nervous system and help you to stay awake in the daytime. The most recommended drug for narcolepsy is Modafinil. It is the first FDA-approved medicine to manage narcolepsy. The best thing about Modafinil is it is not only effective but does not cause severe side effects. Modafinil for sale is available online. You can buy Modafinil online. It is easy to order Modafinil online and it is also cheap if you buy from reputed vendors.
• Antidepressants
  Experts are not sure about the effectiveness of antidepressants in treating narcolepsy. However, they may be effective to control cataplexy. They are not prescribed unless it is very necessary because they cause serious side effects and withdrawal symptoms.
• SNRI or Serotonin Norepinephrine Reuptake Inhibitors - They have the property to suppress REM sleep and improve the symptoms like sleep paralysis, hallucinations, and cataplexy. Insomnia and weight gain are the main side effects caused by SNRIs.

2. Lifestyle changes

• Stick to a strict sleep routine. Go to bed at the same time every day.
• Discuss with a sleep specialist to plan brief naps to avoid falling asleep when you are doing important activities.
• Avoid drinking caffeine during bedtime.
• Don’t eat heavy spicy meals for dinner.
• Your bedroom should be comfortable and quiet.
• Avoid nicotine and alcohol.
• Plan a moderate exercise schedule and stick to it but don’t exercise very close to sleep time. You should finish exercising at least two hours before going to sleep.

3. Support system

Others around you may not be able to understand narcolepsy and its symptoms. Sudden sleep attacks and cataplexy can be scary. So, talk to your friends, teachers, and office colleagues about your condition. It is illegal for employers to show discrimination against people with narcolepsy. With proper support from your near and dear, you will be able to cope with your condition.

Modafinil is the most effective drug to lower the symptoms of narcolepsy. Talk to your doctor about the dosage and usage. Never buy and use Modafinil without a doctor’s prescription. Follow your doctor’s guidelines to manage narcolepsy and lead a normal life.