Monday, February 25, 2013

Medical Mondays: Narcolepsy

You've probably heard of narcolepsy. Who hasn't jokingly labeled themselves as a narcoleptic when excessively tired? (No? Maybe that's just me then.)

Or watched the abundant YouTube offerings of narcoleptic dogs?

Narcolepsy is a real sleep disorder, usually characterized by four things:

1. Cataplexy
2. Hypnogogic hallucinations
3. Sleep paralysis
4. Daytime sleepiness

Cataplexy is emotionally-triggered muscle weakness. It can be only part of the face, or body and often causes a person to collapse.

Hypnogogic hallucinations are vivid hallucinations that happen while falling asleep. They can be visual, sound, or touch hallucinations and occur because of a mix of wakefulness and dreaming during the REM cycle. As you can imagine, they can be quite frightening.

Sleep Paralysis is the inability to move or speak on the first few minutes of waking or just before sleeping. Unlike cataplexy, this isn't triggered by emotions. People often feel like they are suffocating when this occurs.

Daytime sleepiness goes beyond what normal people might have with a little sleep deprivation. People with narcolepsy will often fall asleep at inappropriate times, called "sleep attacks."

How many people have narcolepsy? For every 100,000 people, about 25-50 people have narcolepsy. It tends to show up in the teens and twenties.

What causes it? Rare brain lesions can cause it, but most cases occur because of a loss of two neurotransmitters (the signaling chemicals between brain cells): orexin-A and orexin-B. The orexins promote and stabilize wakefulness and prevent inappropriate entrance into REM sleep. There also may be hereditary factors at play. There is also a debated autoimmune theory as well (body attacking itself in areas that cause narcolepsy).

How do you diagnose it? By symptoms, and by an overnight sleep study (polysomnography) and the Multiple Sleep Latency Test (MSLT).

How do you treat it? By treating non-narcolepsy sleep disorders; using medications that help keep patients awake during the day (stimulants); and REM-suppressing medications (like Effexor, or venlafaxine).

For those who would like more info on narcolepsy, here are some resources:

PubMed Health

And for your poor poodle with narcolepsy:

As much as narcolepsy is often used as a punchline in the media, I for one am glad I don't have it! It's a waking nightmare, if you ask me.


Medical Mondays is a series intended to help writers with their fictional scenarios. Please check out the boring but necessary disclaimer on my sidebar. :)


dolorah said...

This is freaky. I like a power nap in the afternoons - like, right after lunch - but I'd be scared if I just suddenly fell asleep.


Stephanie Thornton said...

I had a co-worker who was narcoleptic once. She seemed to do all right, but didn't like taking the meds because they made her drowsy all the time. Unfortunately, the students thought it was great when she'd fall asleep in class. Oops.

Old Kitty said...

Awwww that poor dog! :-(

The brain may be super powerful but it is such a delicate thing too! Take care

Dianne K. Salerni said...

All of those symptoms must be terrible for the sufferer.

But #2 and #3 have the most story-telling potential. I'm thinking horror story.

Can't help it. I'm just wired that way. :)

Natalie Aguirre said...

Sounds like something scary to get. Thanks for sharing this.

Theresa Milstein said...

This is a scary condition. I didn't know about all these facets of it.

Shelly said...

I haved joked about me having it, but now I'm thankful I don't!

Jemi Fraser said...

Wow - I didnt' realize it was that complex. More than a little terrifying for those who suffer from it!

Barbara Watson said...

Nicholas Benedict in The Benedict Society books suffers from this, and it offers such an interesting twist to certain plot situations!

Linda Gray said...

Wow, I did not realize narcolepsy was so complicated, and it sure doesn't sound like the available treatment offers a great solution--no REM? Isn't REM supposed to be critical to our functioning? Or maybe I've got that mixed up. Hmmm. Thank you for the full picture!

Elizabeth Seckman said...

That would be awful to suffer from. I can't even imagine!

Alex J. Cavanaugh said...

I never knew the details. Glad I don't have it. Although it was funny watching that dog fall over.

Unknown said...

Oh, those videos (yes, I started watching more of them) are so sad. I can't believe it afflicts dogs as well. I hope they can find a cure.

Kelly Polark said...

As much as I need the sleep, that would be awful! I suppose those afflicted couldn't drive safely in case of an attack.

One of my favorite songs by the band Three Eye Blind is titled Narcolepsy. Random fact. :)

mooderino said...

Narcolepsy is one of those jokey illnesses that must be quite a nightmare to have in real life.


Carrie Butler said...

Very interesting, Lydia! I always learn something here. :)

Michael Offutt, Phantom Reader said...

I have a friend with narcolepsy. He was prescribed caffeine and is overjoyed he can now drink coffee.

A Lady's Life said...

Oh I would not like to have that. Can you imagine going shopping. You can't drive that for sure.
We are never in control are we? lol

J E Fritz said...

Interesting. I've never heard of cataplexy before. Sounds pretty wild (in the scary way, not the fun way).

Krispy said...

Haha, I HAVE seen that video before! I think I saw it in one of my Psych classes. :)

I agree with you. It's kind of funny conceptually, but not so much in real life. Eek.

Misha Gerrick said...

Yeah it's definitely a sleep disorder that would be a nightmare for me, since I suffer from night terrors.

mshatch said...

Like Dianne I immediately thought, hmm, how can I use #2 in a story...

LTM said...

*snort* Dogs with Narcolepsy... :D

It's such a strange disease, but it totally makes sense the treatment would focus on other problems. Fascinating as always, Dr. K! <3

Karen Lange said...

A friend's mother had this. Once they treated her, she was fine. Interesting stuff.

Mark said...

Gosh, I didn't know stuff like this effected dogs, thanks for enlightening me:)

nutschell said...

I can imagine how much trouble it can cause to have narcolepsy!Thanks for this awesome post.

Anonymous said...

Best. Video. Ever.

S.A. Larsenッ said...

This was one of your most informative and interesting medical posts, at least for me. Wow. I learned a lot. Thanks!!

Unknown said...

Banned complain !! Complaining only causes life and mind become more severe. Enjoy the rhythm of the problems faced. No matter ga life, not a problem not learn, so enjoy it :)

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kate said...

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