Narcolepsy is a malfunction of the sleep/wake regulating
system in the brain which until recently was of unknown
origin. Its most common manifestation is Excessive Daytime
Sleepiness and sleep attacks.
Symptoms of Narcolepsy includes:
a. Temporary paralysis on falling asleep or awakening (sleep
paralysis).
b. Hallucinations - vivid images or sounds - on falling
asleep or awakening (Hypnagogic and hypnopompic
hallucinations respectively).
c. Moments (but sometimes extended periods) of trance-like
behaviour in which routine activities are continued on
"auto-pilot" (Automatic behaviour).
d. Interruption of night-time sleep by frequent waking
periods, marked by quickening of the heart rate, over-
alertness, hot flushes, agitation, and an intense craving
for sweets.
Is there any treatment?
There is no cure for narcolepsy, but the symptoms can
be controlled with behavioral and medical therapy. The
excessive daytime sleepiness may be treated with stimulant
drugs or with the drug modafinil. Cataplexy and
other REM-sleep symptoms may be treated with antidepressant
medications.
Medications will only reduce the symptoms, but will not
alleviate them entirely. Also, many currently
available medications have side effects. Basic lifestyle
adjustments such as regulating sleep schedules, scheduled
daytime naps and avoiding "over-stimulating" situations may
also help to reduce the intrusion of symptoms into daytime
activities.
Drug Therapy
Stimulants are the mainstay of drug therapy for excessive
daytime sleepiness and sleep attacks in narcolepsy patients.
These include methylphenidate (Ritalin®), modafinil,
dextroamphetamine, and pemoline. Dosages of these
medications are determined on a case-by-case basis, and they
are generally taken in the morning and at noon. Other
drugs, such as certain antidepressants and drugs that are
still being tested in the United States, are also used to
treat the predominant symptoms of narcolepsy.
The major side effects of these stimulants are irritability,
anxiety, quickened heart rate, hypertension, substance
abuse, and disturbances of nocturnal sleep. Methylphenidate
and dextroamphetamine are known to cause hypertension. A
common side effect of modafinil is headache, usually related
to dose size, which occurs in up to 5 percent of patients.
Pemoline poses a very low but noticeable risk for liver
complication. None of these stimulants influence the
occurrence of narcolepsy's auxiliary symptoms and usually
are not used to treat them.
Modafinil does not carry the addiction potential that
methylphenidate and dextroamphetamine do. In fact, the
latest development in treatment is a new modafinil drug
called Provigil®, which does not act as a stimulant and so
does not produce side effects like anxiety and irritability.
Provigil's therapeutic effects have been observed in
maintenance of wakefulness test research, where patients
have tripled their wakefulness.
Although there is no cure for narcolepsy, excessive daytime
sleepiness, sudden sleep onset, and cataplexy. Proper sleep
hygiene,which includes a consistent sleep schedule and the
avoidance
of shift work and alcohol, can drastically reduce the ill
impact of narcolepsy.
And often, patients with narcolepsy feel refreshed after a
short nap; therefore, taking short scheduled naps may
greatly benefit patients combatting excessive daytime
sleepiness.
system in the brain which until recently was of unknown
origin. Its most common manifestation is Excessive Daytime
Sleepiness and sleep attacks.
Symptoms of Narcolepsy includes:
a. Temporary paralysis on falling asleep or awakening (sleep
paralysis).
b. Hallucinations - vivid images or sounds - on falling
asleep or awakening (Hypnagogic and hypnopompic
hallucinations respectively).
c. Moments (but sometimes extended periods) of trance-like
behaviour in which routine activities are continued on
"auto-pilot" (Automatic behaviour).
d. Interruption of night-time sleep by frequent waking
periods, marked by quickening of the heart rate, over-
alertness, hot flushes, agitation, and an intense craving
for sweets.
Is there any treatment?
There is no cure for narcolepsy, but the symptoms can
be controlled with behavioral and medical therapy. The
excessive daytime sleepiness may be treated with stimulant
drugs or with the drug modafinil. Cataplexy and
other REM-sleep symptoms may be treated with antidepressant
medications.
Medications will only reduce the symptoms, but will not
alleviate them entirely. Also, many currently
available medications have side effects. Basic lifestyle
adjustments such as regulating sleep schedules, scheduled
daytime naps and avoiding "over-stimulating" situations may
also help to reduce the intrusion of symptoms into daytime
activities.
Drug Therapy
Stimulants are the mainstay of drug therapy for excessive
daytime sleepiness and sleep attacks in narcolepsy patients.
These include methylphenidate (Ritalin®), modafinil,
dextroamphetamine, and pemoline. Dosages of these
medications are determined on a case-by-case basis, and they
are generally taken in the morning and at noon. Other
drugs, such as certain antidepressants and drugs that are
still being tested in the United States, are also used to
treat the predominant symptoms of narcolepsy.
The major side effects of these stimulants are irritability,
anxiety, quickened heart rate, hypertension, substance
abuse, and disturbances of nocturnal sleep. Methylphenidate
and dextroamphetamine are known to cause hypertension. A
common side effect of modafinil is headache, usually related
to dose size, which occurs in up to 5 percent of patients.
Pemoline poses a very low but noticeable risk for liver
complication. None of these stimulants influence the
occurrence of narcolepsy's auxiliary symptoms and usually
are not used to treat them.
Modafinil does not carry the addiction potential that
methylphenidate and dextroamphetamine do. In fact, the
latest development in treatment is a new modafinil drug
called Provigil®, which does not act as a stimulant and so
does not produce side effects like anxiety and irritability.
Provigil's therapeutic effects have been observed in
maintenance of wakefulness test research, where patients
have tripled their wakefulness.
Although there is no cure for narcolepsy, excessive daytime
sleepiness, sudden sleep onset, and cataplexy. Proper sleep
hygiene,which includes a consistent sleep schedule and the
avoidance
of shift work and alcohol, can drastically reduce the ill
impact of narcolepsy.
And often, patients with narcolepsy feel refreshed after a
short nap; therefore, taking short scheduled naps may
greatly benefit patients combatting excessive daytime
sleepiness.
