WHAT IS NARCOLEPSY
Narcolepsy is a sleep disorder that is unique in its manifestations. Daytime sleepiness is the key finding. Interestingly, prior to understanding the physiology of the sleeping brain, anyone who fell asleep inappropriately during the day was often labeled as narcoleptic. Today, narcolepsy is recognized as a less common cause of sleepiness especially when compared to sleep apnea or insufficient sleep.
To understand narcolepsy it is important to have a basic understanding of the sleep cycle. There are essentially four stages of sleep with stages 1,2 and 3 deeper levels. The fourth stage is REM sleep. REM stands for rapid eye movement, which is what is seen when a person experiences REM sleep. REM sleep is also the time of the most vivid dreaming and is a time when the skeletal muscles are paralyzed (in essence we cannot act out our dreams). Normally the stages follow each other and REM sleep occurs following the other stages of sleep.
Narcolepsy is a problem with the timing of the normal sleep cycle thus resulting in the classic narcoleptic symptoms consisting of daytime sleepiness, sleep paralysis, cataplexy, and hallucinations. Sleep paralysis is a frightening conscious awareness of the normal REM muscle paralysis because in narcolepsy sleep is fragmented with frequent REM periods. Cataplexy is the unique symptom to narcolepsy. It is the intrusion of REM sleep while awake resulting in acute muscle paralysis. At the extreme, the individual may be totally paralyzed and fall to the floor. However, minor partial paralysis may also be experienced, such as an inability to move a hand, an arm or weakness in any muscle area. Episodes of cataplexy can be precipitated by sudden emotions especially laughter. Experiencing hallucinations when going to sleep or upon awakening can be frightening for the narcoleptic because these can be very vivid. Again, this results from the intrusion of REM sleep at inappropriate times. Narcoleptics may also experience fragmented and difficult sleep, which at times may seem strange as it can be hard to stay awake during the day.
Narcolepsy may present as a mild problem or be very debilitating. The experts at DSM Sleep Specialists can diagnose and find the most effective therapy for narcolepsy.