If you’re experiencing symptoms associated with narcolepsy, it is crucial to prioritise seeking a diagnosis and treatment from a specialist team who are experienced at diagnosing and treating this condition. At Manse Medical, we specialise in providing accurate diagnoses and tailoring personalised treatment plans for Narcolepsy, ensuring you can effectively manage this condition and alleviate its symptoms.
What is narcolepsy?
Narcolepsy is a chronic neurological sleep disorder that affects the brain’s ability to regulate sleep-wake cycles. The exact cause of this sleep condition is not fully understood, but it is believed to involve a combination of genetic and environmental factors.
In most cases, it is caused by a deficiency of a neurotransmitter called hypocretin (also known as orexin). Hypocretin helps regulate wakefulness and REM sleep, and its deficiency in individuals can lead to the symptoms associated with the disorder.
In short, people with Narcolepsy have an inability to suppress sleepiness.
What are the symptoms of narcolepsy?
Narcolepsy is characterised by a range of symptoms that can significantly impact a person’s daily life. The primary symptoms, which vary greatly in intensity from person to person, include:
- Persistent and overwhelming drowsiness during the day, regardless of adequate nighttime sleep.
- Excessive daytime sleepiness, which can lead to sudden and uncontrollable episodes of falling asleep during daily activities.
- Irresistible urges to fall asleep, often resulting in unintentional napping or dozing off at inappropriate times.
- Sudden loss of muscle tone (Cataplexy). This ranges from mild weakness (such as drooping facial muscles or slurred speech) to complete muscle paralysis. typically triggered by emotions like laughter, surprise, or anger.
- Temporary inability to move or speak upon waking up or falling asleep (Sleep Paralysis), often accompanied by a sense of pressure or hallucinations.
- Vivid and often unsettling dream-like experiences that occur when falling asleep.
- Frequent awakenings or disrupted sleep patterns, leading to poor sleep quality and difficulties maintaining a consistent sleep schedule.
- Performing tasks or actions without conscious awareness or memory of doing so.
- Difficulties with memory recall, attention span, and overall cognitive function.
- Shifts in eating patterns, increased food cravings, and potential weight fluctuations.
How is Narcolepsy diagnosed?
The diagnosis of Narcolepsy involves a comprehensive evaluation by healthcare professionals with expertise in sleep disorders. The diagnostic process typically includes the following steps:
Medical history
Your doctor will discuss your symptoms, sleeping patterns, and medical history to gain a better understanding of your overall health and any potential underlying conditions that could contribute to your symptoms. This history will also include an exploration of past history of infections, as the onset of narcolepsy often follows an infective illness or vaccine.
Sleep diary
Keeping a sleep diary for a certain period can provide valuable information about your sleep patterns, including timing and duration of sleep episodes and any associated symptoms.
Sleep studies
Polysomnography and Multiple Sleep Latency Test (MSLT) are the two main types of sleep studies used in narcolepsy diagnosis.
- Polysomnography involves monitoring various physiological parameters during sleep, such as brain waves, eye movements, muscle activity, heart rate, and breathing patterns. It helps rule out other sleep disorders and assess the quality of your sleep.
- Multiple Sleep Latency Test (MSLT) measures your tendency to fall asleep and assesses the presence of rapid eye movement (REM) sleep during daytime naps. It helps evaluate excessive daytime sleepiness and the presence of REM sleep abnormalities, which are characteristic of Narcolepsy.
Exclusion of other conditions
It’s important to rule out other potential causes of excessive daytime sleepiness, such as obstructive sleep apnea, restless legs syndrome, and certain medications or substances.
How is Narcolepsy treated?
In order to treat your Narcolepsy, we at Manse Medical will devise a personalised treatment plan tailored to your specific needs. These treatment plans can include;
Medications
Medications are commonly prescribed to help manage narcolepsy symptoms, including excessive daytime sleepiness and cataplexy. Stimulants, such as Modafinil or Armodafinil, can promote wakefulness and reduce daytime sleepiness. Amfetamine stimulants (dexamfetamine, methylphenidate, lisdexamfetamine) are also used frequently and can be very effective at low doses. Sodium oxybate, also known as gamma-hydroxybutyrate (GHB), can also be effective, although it is very expensive and difficult to access in Australia. Other stimulant medications that are available overseas, such as pitolisant and solriamfetol, are available in other countries but not in Australia. Different medications may be required to treat cataplexy and even to stabilise night time sleep.
Scheduled naps
Lifestyle modifications can play an important role in managing Narcolepsy. Planned and strategic short daytime naps can help combat excessive daytime sleepiness. These scheduled naps, typically lasting for about 10-20 minutes, can provide temporary relief and improve alertness.
Lifestyle adjustments
Lifestyle modifications can also play an important role in managing Narcolepsy. Implementing healthy sleep habits and making lifestyle modifications can significantly improve symptoms. This includes maintaining a regular sleep schedule, ensuring a comfortable sleep environment, avoiding caffeine, alcohol and heavy meals close to bedtime, engaging in regular physical exercise and practising good sleep hygiene can help some people in managing this sleep disorder.
Supportive therapies
Certain supportive therapies can complement medical treatments. Psychological counselling and cognitive-behavioural therapy (CBT) may be helpful, although it is important to make sure that your counsellor is familiar with the condition. There are narcolepsy support groups online that can offer emotional support, coping strategies, and guidance for managing the challenges associated with narcolepsy.
Education and lifestyle management
Educating oneself about Narcolepsy and its management is crucial. Learning about triggers, developing effective time management techniques,
and incorporating stress management practices can help individuals better navigate their daily routines and optimise their overall well-being.
Safety measures
Since Narcolepsy can affect alertness and cause sudden sleep attacks, taking safety precautions is vital. This may include avoiding activities that pose a risk, such as driving or operating heavy machinery, during periods of excessive sleepiness. Ensuring a safe environment at home and work is also important to minimise the potential hazards associated with Cataplexy.
Individuals who have been diagnosed with narcolepsy need to report the condition to VicRoads and discuss their fitness to drive with their sleep physician.
What are the risk factors?
While the exact cause of narcolepsy is still not fully understood, certain risk factors have been associated with the development of the condition. These risk factors include:
- Genetic Predisposition: Individuals with certain variations in specific genes have an increased risk of developing narcolepsy. However, having these genetic variations does not guarantee that someone will develop the condition. There are also people without the genetic predisposition that have Narcolepsy.
- Autoimmune Factors: It is believed to involve an autoimmune response in which the immune system mistakenly attacks cells in the brain that produce hypocretin, a neuropeptide involved in regulating wakefulness.
- Age: This often starts during adolescence or young adulthood, although it can develop at any age. The symptoms may gradually appear and worsen over time.If an older person develops narcolepsy symptoms then this can occur as a consequence of stroke or other neurological condition, such as Multiple Sclerosis. In these situations, more extensive neurological problems are usually present.
- Family History: Having a close family member with this kind of sleep disorder increases the likelihood of developing the condition. The risk is higher in first-degree relatives (parents, siblings, and children) compared to the general population.
- Prior Infections or Illnesses: Some studies suggest that certain infections may trigger or contribute to the development of this sleep disorder in individuals who are genetically susceptible.
It’s important to note that while these risk factors can increase the likelihood of developing this sleep disorder, they do not guarantee its occurrence. Many individuals with this condition have no family history of the condition, and not everyone with these risk factors will develop Narcolepsy.
Where can I go for effective narcolepsy treatment?
At Manse Medical, we provide both high quality diagnosis and treatment for sleep disorders such as Narcolepsy. We take a personalised approach that focuses on your medical history and background, in order to provide you with a complete treatment plan that addresses your concerns and helps you effectively manage your symptoms.
Book your appointment online by selecting your preferred clinic and choose from the list of our available specialists.
