Narcolepsy is a malfunction of
sleep/wake regulating system in
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
heart rate, over- alertness, hot flushes, agitation, and an intense craving for sweets.
Is there any treatment?
There is no cure for narcolepsy, but
symptoms can be controlled with behavioral and medical therapy. The excessive daytime sleepiness may be treated with stimulant drugs or with
drug modafinil. Cataplexy and other REM-sleep symptoms may be treated with antidepressant medications.
Medications will only reduce
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
intrusion of symptoms into daytime activities.
Drug Therapy
Stimulants are
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
morning and at noon. Other drugs, such as certain antidepressants and drugs that are still being tested in
United States, are also used to treat
predominant symptoms of narcolepsy.