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- $Unique_ID{BRK02035}
- $Pretitle{}
- $Title{Characteristics of Narcolepsy and Other Sleep Disorders}
- $Subject{narcolepsy sleep disorders sleep disorder sleepiness REM sleep rapid
- eye movement sleep paralysis cataplexy hypnagogic phenomena hallucinations
- multiple sleep latency test MSLT antigens HLA-DR2 hypoglycemia sleep apnea
- thyroid disorders thyroid disorder low blood sugar sedative medication abuse
- antidepressants antidepressant naps napping stimulants daytime}
- $Volume{}
- $Log{}
-
- Copyright (c) 1993 Tribune Media Services, Inc.
-
-
- Characteristics of Narcolepsy and Other Sleep Disorders
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- QUESTION: My daughter-in-law writes that they have discovered that some of
- the recent problems my son has been through have been the result of a
- condition called "narcolepsy". It is a frightening term, sounding like a
- mixture of narcotics and epilepsy. Can you help us overcome our deep anxiety
- by telling us what this condition is, where it comes from and any possible
- treatments. This is certainly a recent development for our son had no such
- problems before he was married.
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-
- ANSWER: Narcolepsy is neither connected with narcotics nor epilepsy but is
- one of the disorders of sleep that have been closely studied closely only
- during the past 20 years. It is not a rare disease, for it affects an
- estimated 200,000 Americans and often goes undiagnosed, even when many of the
- problems caused by the disease are evident in the patient's social history.
- Essentially the major symptom is excessive daytime sleepiness often showing as
- a sudden sleep attack during normal waking hours. The occur suddenly,
- sometimes several times a day in severe cases, and the sleep may last from
- minutes to hours. It is a stage of sleep known as REM sleep (for Rapid Eye
- Movements) which may be observed in the patient. Other associated symptoms
- include sleep paralysis (when upon falling asleep or awakening the patient
- wants to move but can't for the moment), cataplexy (momentary paralysis
- without a loss of consciousness often accompanied by sudden emotional
- reactions such as anger, fear or joy) or hypnagogic phenomena (vivid auditory
- or visual illusions or hallucinations). About 70 to 80 percent of people with
- narcolepsy experience one or more of these associated symptoms. In addition,
- nighttime sleep is often disrupted by frequent awakenings, cravings for food
- or sweets, and excessive leg movements during sleep.
- In the beginning, before the correct diagnosis is made, the patient is
- often suspected of being lazy, disorganized or neurotic. Problems at work, in
- the home, and even a series of work place and auto accidents may be the clues
- that something is going on that requires attention and help. Though the
- disease may strike first at any age, it most often begins during the patient's
- second decade of life, with the highest incidence in people ages 15 to 25.
- Although there are a number of tests that aid with the diagnosis, the most
- useful is the Multiple Sleep Latency Test (MSLT), which measures how rapidly
- the patient falls asleep and how quickly REM sleep develops. This pattern can
- be used to identify narcoleptic patients. There is also a strong relationship
- between narcolepsy and the presence of certain antigens in the blood
- (HLA-DR2). However there are no changes detectable in the brain itself.
- Narcolepsy must be distinguished from other causes of excessive daytime
- sleepiness which include sleep apnea, thyroid disorders, low blood sugar
- (hypoglycemia) and even sedative medication abuse.
- Although the disease is a chronic one, without a total cure, treatment is
- effective and can return the patient to a normal existence. In mild cases a
- series of short, scheduled naps during the day may be all that is necessary to
- reestablish a productive routine. These naps can reduce the daytime
- sleepiness while restoring the patient's alertness. Medications including
- stimulants are useful, and antidepressants are used when cataplexy is a
- problem. Patients need much psychological support, while those around them
- must be educated to the nature of the disease, with the all the explanations
- needed to help restore the patient's own self esteem and self confidence.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-