SLEEP AND NARCOLEPSY

Why Do You Need Sleep?

Sleep is not merely a “time out” from our busy routines; it is essential for good health, mental and emotional functioning and safety. Even occasional sleeping problems can make daily life feel more stressful or cause
you to be less productive-sleep loss has been found to impair the ability to perform tasks involving memory, learning, and logical reasoning. This may contribute to mistakes or unfulfilled potential at school or on the job and strained relationships at home. Insufficient sleep can also be extremely dangerous, leading to serious or even fatal accidents- some of the auto crashes annually are fatigue related.

Sleep stealers:

1. Psychological Factors

Stress is considered by most sleep experts to be the No. 1 cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or marriage problem, and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes. However, if short term sleep problems aren’t managed properly from the beginning, they can persist long after the original stress has passed.

That’s why it’s a good idea to talk to a physician about any sleeping problem that recurs or persists for longer than one week.

Your doctor can help you take steps early to control or prevent poor sleep, as it can also be brought on by depression, evaluation by a healthcare professional is essential.

2.  Lifestyle Stressors

Without realizing it, you may be doing things during the day or night that can work against getting a good night’s sleep. These include drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed.

3.  Shift Work

 shift work forces you to try to sleep when activities around you — and your own "biological rhythms" — signal you to be awake. One study shows that shift workers are two to five times more likely than employees with regular, daytime hours to fall asleep on the job.

4. Jet Lag

Still another sleep stealer is jet lag, an inability to sleep caused when you travel across several time zones and your biological rhythms get "out of sync."

5. Environmental Interferences

A distracting sleep environment such as a room that's too hot or cold, too noisy or too brightly lit can be a barrier to sound sleep. And interruptions from children or other family members can also disrupt sleep. Other influences to pay attention to are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, can't fall or stay asleep, or has other sleep difficulties, it often becomes your problem too!

6. Physical Factors

A number of physical problems can interfere with your ability to fall or stay asleep. For example, arthritis and other conditions that cause pain, backache, or discomfort can make it difficult to sleep well. Sleep apnea, which is recognized by snoring and interrupted breathing, causes brief awakenings (often unnoticed) and excessive daytime sleepiness. If suspected, a person having signs of sleep apnea should see a doctor.

Disorders that cause involuntary limb movements during sleep, such as Restless Legs Syndrome, break up the normal sleep pattern and are also likely to make sleep less refreshing and result in daytime sleepiness.

For women, pregnancy and hormonal shifts including those that cause premenstrual syndrome (PMS) or menopause and its accompanying hot flashes can also intrude on sleep.

Medications

In addition, certain medications such as decongestants, steroids and some medicines for high blood pressure, asthma, or depression can cause sleeping difficulties as a side effect.

What is sleep disorder?

Sleep disorders are problems with sleeping, including trouble falling or staying asleep, falling asleep at the wrong times, too much sleep, or abnormal behaviors during sleep.

Categories

There are more than 100 different sleeping and waking disorders. They can be grouped into four main categories:

• Problems falling and staying asleep (insomnia)
• Problems staying awake (excessive daytime sleepiness)
• Problems sticking to a regular sleep schedule (sleep rhythm problem)
• Unusual behaviors during sleep (sleep-disruptive behaviors)

In this article we shall create awareness on NARCOLEPSY-sleep disorder in the 2^nd category i.e. excessive daytime sleepiness as requested earlier.

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle, as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis -- which explains some of the symptoms of narcolepsy.

What Are the Symptoms of Narcolepsy?

Symptoms of narcolepsy include:

• Excessive daytime sleepiness (EDS): In general, EDS interferes with normal activities on a daily basis, whether or not a person with narcolepsy has sufficient sleep at night. People with EDS report mental cloudiness, a lack of energy and concentration, memory lapses, a depressed mood, and/or extreme exhaustion.
• Cataplexy: This symptom consists of a sudden loss of muscle tone that leads to feelings of weakness and a loss of voluntary muscle control. It can cause symptoms ranging from slurred speech to total body collapse, depending on the muscles involved, and is often triggered by intense emotions such as surprise, laughter, or anger.
• Hallucinations: Usually, these delusional experiences are vivid and frequently frightening. The content is primarily visual, but any of the other senses can be involved. These are called hypnagogic hallucinations when accompanying sleep onset and hypnopompic hallucinations when they occur during awakening.
• Sleep paralysis: This symptom involves the temporary inability to move or speak while falling asleep or waking up. These episodes are generally brief, lasting a few seconds to several minutes. After episodes end, people rapidly recover their full capacity to move and speak

What Causes Narcolepsy?

The cause of narcolepsy is not known; however, scientists have made progress toward identifying genes strongly associated with the disorder. These genes control the production of chemicals in the brain that may signal sleep and awake cycles. Some experts think narcolepsy may be due to a deficiency in the production of a chemical called hypocretin by the brain. In addition, researchers have discovered abnormalities in various parts of the brain involved in regulating REM sleep. These abnormalities apparently contribute to symptom development. According to experts, it is likely narcolepsy involves multiple factors that interact to cause neurological dysfunction and REM sleep disturbances.

How Is Narcolepsy Diagnosed?

A physical exam and exhaustive medical history are essential for proper diagnosis of narcolepsy. However, none of the major symptoms is exclusive to narcolepsy. Two tests that are considered essential in confirming a diagnosis of narcolepsy are the polysomnogram (PSG) and the multiple sleep latency test (MSLT).

How Is Narcolepsy Treated?

Although there is no cure for narcolepsy, the most disabling symptoms of the disorder (Excessive Daytime Sleepiness and symptoms of abnormal REM sleep, such as catalepsy) can be controlled in most people with drug treatment. Sleepiness is treated with amphetamine-like stimulants, while the symptoms of abnormal REM sleep are treated with antidepressant drugs.

Lifestyle adjustments such as avoiding caffeine, alcohol, nicotine, and heavy meals, regulating sleep schedules, scheduling daytime naps (10-15 minutes in length), and establishing a normal exercise and meal schedule may also help to reduce symptoms.