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Narcolepsy Articles & News

The Treatment for Narcolepsy

The good news for those of you who have been falling asleep at the drop of a hat is that there is a treatment! Although this is some positive encouragement, it’s not time to completely celebrate just yet. The modern treatment for Narcolepsy involves mainly the symptoms and it is important to recognize that much about this disorder is still unknown. Both the diagnosis and the treatments still remain somewhat open-ended. There has been continuing research about Narcolepsy, however, and scientists are studying methods for how to support a more accurate diagnosis. Although there are medications to cure the related symptoms such as cataplexy, EDS, hallucinations, and sleep paralysis, scientists still can not come up with a full treatment that will eliminated the disorder as a whole. Instead, we treat the symptoms one at a time and hope for a more complete cure in the near future.

According to many scientific clinical trials since 1999, the drug Modafinil had been used for the treatment of excessive daytime sleepiness or EDS. Antidepressant drugs such as tricyclics and selective serotonin reuptake inhibitors, on the other hand, are effective drugs for cataplexy syndrome. Again, there is no known cure for narcolepsy as a whole because of its unpredictable nature. This doesn’t mean you should give up. There are a lot of great symptomatic treatments that can help you to live a somewhat normal life.

As many people know, Narcolepsy is a chronic neurological disorder where symptoms can be experienced at a very young age and can only be diagnosed after years. Patients have been known to fall asleep almost instantly in the middle of a sentence and this can be quite dangerous considering the many places you need to be during the day. Studies show that in most cases, patients who suffer from narcolepsy had developed infection, immune-system dysfunction, trauma, hormonal changes, traumatic injuries, tumor growth due to exposure to toxins and stress prior to their narcolepsy symptoms attack. This has been a hopeful discovery for the sufferers who are eager to receive a treatment. Aside from this finding, a number of variant forms of genes called Allenes have been pinpointed in a group of human genes. People who are diagnosed to have narcolepsy are those who have only specific variants in the genes but these alone are not sufficient to cause the disorder. There are still clinical studies that show the condition to be more unpredictable by nature. Although the FDA approved the drug xylem or sodium oxybate, also known as GHB (gamma hydroxybutyrate) to treat narcolepsy, its was later restricted due to safety concerns associated with it.

None of the currently available medications are able to help narcolepsy patients have a consistent state of alertness. Many sufferers confess poor work or school performances due to the poor mental alertness. Some would even experience a loss of muscle tone which leads to motor accidents. The symptom cataplexy occurs spontaneously at times and is triggered by sudden or strong emotions such as anger, stress, fear, humor, and excitement.

Narcolepsy cannot yet be cured because of the lack of understanding of its causes but EDS and cataplexy are both the most disabling symptoms of the disorder and can only be controlled by drug treatment. Again, the treatment regimen is only considered to be a symptomatic change and not a symptom elimination.

The National Institutes of Neurological Disorders and Stroke (NINDS) sponsors research on neurological disorders including sleep apnea, restless legs syndrome, and narcolepsy. As part of this responsibility, the NINDS also supports various medical institutions across the country in their respective research. Some of the most helpful scientific studies conducted over the years include “A Safety and Effectiveness Study of a Single Dose of JNJ-17216498 in Patients With Narcolepsy” and “Body Weight Regulation in Patients With Narcolapsy”. Other studies that have proven somewhat enlightening are the “Effectiveness Of The Drug GSK 189254 In Treating Patients With Narcolepsy” and the “Trial of Xyrem (Sodium Oxybate) for the Treatment of Narcolepsy”. All of these have concluded that, while there are available medications to relieve some symptoms of narcolepsy, there is still no complete cure for the condition as a whole.

The Medications for Narcolepsy

Do you want to know more about the most effective and available medications for narcolepsy symptoms? Well, you have come to the right place! There are, in fact, a widely scattered group of medications that can be found on different online sites on the internet but I have summarized some of these below for your reference.

Let’s look at the stimulants first. Stimulants like Modafinil, unlike amphetamines, provide fewer sympathomimetic side effects within dosages ranging from 100-400 mg. Methylphenidate-HCl is a generic drug but it can be purchased branded at 5-60 mg dosages so it can be very useful. This drug has a descriptive short duration of action which is better if combined with stimulant medications and scheduled napping. Destroamphetamine-sulfate and methamphetamine-HCl are widely used in the United States due to their more potent and effective characteristics compared to amphetamine. Those are a great place to start but there is more.

Anticataplectic compounds that aid in the decreased cataphexy symptom include venlafaxine, a new antidepressant with slow release that acts on both the serotoninergic and adrenergic systems. Protriptyline at 5-60 mg dosages is a mild stimulant but is associated with side effects like drying of the mouth, constipation, and blurred vision. The most effective anticataplectic drug is the clomipramine. An antidepressant Riboxetine acts on the adrenergic system of our body and produces very positive results. Sodium oxybate and hypnotic Benzodiazepines are also hypnotic compounds that affect with short period of action and still help eliminate EDS. That is quite a list but it should be a good way for you to get started.

It is important to recognize that this summary is only for general information and it does not intend to replace any valuable medical guidance related to sleep disorders. If you suffer from Nardcolepsy, it is important to see a physician. Scientist have openly admitted the difficulty in determining the accurate factors that cause narcolepsy. This disorder is technically defined as an excessive daytime sleepiness and involves sleep attacks called excessive daytime sleepiness or EDS. They are associated with one or more other symptoms such as cataplexy, hallucination, and sleep paralysis. This tetrad of symptoms occurs only in about 10 percent of cases. The duration and severity of the symptoms vary depending on the patient. Understanding Narcolepsy and cataplexy is a great benefit to the sufferers because it affords them the ability to diagnose and treat themselves better. It also helps them to communicate better with a doctor.

Cataplexy is the most common auxiliary symptom associated with this disorder and afflicting over 70 percent of patients. Sleep paralysis and hypnogogic hallucinations are less common but are very frightening experiences as they can involve not only visual aspects but also other senses of the body. Sleep paralysis, on the other hand, occurs in only 30 percent of cases, and the last, hallucination, is present in only 25 percent.

Narcolepsy is a debilitating disorder that causes uncontrollable sleepiness and muscle weakness. The disorder can interfere with a person’s ability to work. If you are a student, who suffers from Narcolepsy, you may experience lack of mental alertness and poor performance in school. This is the same with those who are working. Their personal interaction is affected by this condition. In cases where narcolepsy is left untreated, worse symptoms can be experienced and are characterized by microsleep and total paralysis. From a simple case of paralysis experienced only by a certain part of our body to the worst cases of untreated narcolepsy, a total muscular collapse and paralysis may be experienced depending on the patient.

The most recent news is extremely hopeful for Narcolepsy patients. Researchers under the leadership of a professor of molecular genetics, Dr. Masashi Yanagisawa at UT Southwestern Medical Center at Dallas, are now claiming to have discovered a new method of treatment for narcolepsy. Just like in movies where mice are used for experiments, the team used some genetically engineered mice with lacking nerve cells in the brain. These nerve cells are responsible for producing the brain chemical Orexin. The method involved introducing this brain chemical to the mice both genetically and by manual injection. It was concluded that without Orexin, the mice exhibited narcoleptic like symptoms including the overpowering sleepiness and cataplexy symptom. With injection of Orexin, the mice returned to full wakefulness. Researchers believe that a lack of the brain chemical Orexin may be the root cause of narcolepsy in humans as well. There is hope on the horizon! With further research it is widely anticipated that a more complete cure for this disorder will soon appear. However, more research and testing will still be necessary before Orexin can be made available to the public.

The Causes of Narcolepsy

What in the world could be causing such a strange disorder as Narcolepsy? Scientists have been asking this same question and have discovered quite a few interesting things. In fact, the National Institute of Neurological Disorders and Stroke (NINDS) has combined its efforts with the National Institute of Health (NIH) to conduct research about narcolepsy and other related sleep disorders. Different studies such as the “Safety and Effectiveness Study of a Single Dose of JNJ-17216498 in Patients With Narcolepsy” and “Body Weight Regulation in Patients With Narcolepsy”, many conclusions have been made. Other studies such as the “Effectiveness Of The Drug GSK 189254 In Treating Patients With Narcolepsy” and “Trial of Xyrem (Sodium Oxybate) for the Treatment of Narcolepsy” have helped to conclude that, while there are available medications to relieve some symptoms of narcolepsy, there is still no cure for the condition as a whole.

Thanks to some of the friendly doctors on the job, we are provided with some simple explanations about the causes of a very complex disorder. To make things more understandable to the average layman, it had been explained that narcolepsy is a chronic neurological condition caused by the inability of the brain to exercise normal and regular sleep and wake cycles. The underlying causes of this neurological condition are too complex for many people to understand, but there are four major symptoms that are associated with this condition. First, patients experience excessive daytime sleepiness or EDS. Second, they experience cataplexy or the sudden loss of muscle tone. Third, they experience vivid hallucinations during sleep or upon awakening and lastly they have brief periods of total paralysis. People with this condition do not have the luxury to exercise a regular sleep cycle from non-rapid eye movement to rapid eye movement. Instead, they must seek serious medical treatment.

One of the most common questions still remains for many people. “What causes narcolepsy?” If we are willing to stretch our minds a bit, a more complex explanation can be given for this strange disorder. First, there are some simple things that can be said to trigger the symptoms of this disorder. According to researchers, studies show that patients who suffer from narcolepsy had developed infection, immune-system dysfunction, trauma, hormonal changes, traumatic injuries, tumor growth due to exposure to toxins and stress prior to their narcolepsy symptoms attack. Although these are not considered definite causes for the disorder, they can be readily associated with its onset.

In addition to this, a more complicated explanation involves the fact that a number of variant forms of genes called Allenes affect the condition and are located in a region of chromosome 6 known as the HLA complex of the human gene. I told you this was going to be complicated! Anyway, Allenes have also been discovered to be an essential factor associated with narcolepsy. The HLA complex makes up the majority of interrelated genes that regulate vital roles in the immune system function. People who are diagnosed to have this condition have been shown to have only specific variants in certain HLA genes. These alone, however, are not sufficient to cause the disorder because there are clinical studies that prove the condition to be more unpredictable by nature. Many other genes, aside from those which make up the HLA complex may significantly contribute to the occurrence of narcolepsy. By considering the group of neurons in the brainstem and in the central brain which interact with each other to control sleep, there are large numbers of genes which are supposed to disrupt the brain’s neurotransmitters. These neurotransmitters keep us awake when we need to be awake and individuals who lack these transmitters are found to develop many symptoms of narcolepsy. Now you see how complicated it all is! The good news is that you don’t have to be a genius to see the symptoms or to seek medical advice if you think you may be suffering from this condition.

As part of treatment and good management of this condition, medical practitioners strongly suggest that patients must adhere to certain behavioral strategies such as avoidance of alcohol, caffeine, and nicotine before bedtime. These behaviors, accompanied by proper medication to establish a regular sleep every night, are the best solutions known to help combat this strange disorder known as Narcolepsy.

The Symptoms of Narcolepsy

How do you know if you are suffering from Narcolepsy? Actually, Narcolepsy is not a very common condition. Most sufferers of narcolepsy are diagnosed with the condition only after 10-15 years of suffering the first symptoms. This long lag-time is attributed to many factors including its rarity as a condition, subtle and varying symptoms plus the lack of familiarity that the public has with this condition. Still, there are symptoms that will develop and, even if you would not normally recognize them, you can become familiar with them now and thereby recognize this in someone who suffers from this distinct neurological disorder.

According to medical researchers, diagnosis and treatment of narcolepsy can be determined from a clinical examination and exhaustive medical history of the patient. Although excessive daytime sleepiness or EDS is the most common narcoleptic symptom, it can also be diagnosed as a symptom of other sleep related disorder such as sleep apnea, a virus, a bacterial infection, depression, congestive heart failure and rheumatoid arthritis. Consumption of caffeine, alcohol, and nicotine can also lead to EDS so it is not likely to be Narcolepsy in most cases. This lack of specificity in the narcolepsy symptoms increases the difficulty to arrive at an accurate diagnosis. Thus, a battery of specialized tests is usually required before a near-accurate diagnosis can be established.

People with narcolepsy experience excessive daytime sleepiness (EDS) which is usually the most common among all other symptoms. Generally, EDS is experienced to interfere in any normal activities on a daily basis. Patients describe EDS as a persistent mental cloudiness and a depressed mood. Many confess that they have great difficulty concentrating while at school or at work. They also experience memory lapses and some find it impossible to remain alert in passive situations such as watching television. As much as 40 percent of narcolepsy patients are prone to automatic behavior called “microsleeps”. From the word itself, micro meaning very small, refers to the sudden automatic sleeping of the patient. It can happen while performing any task whatsoever.

Another very frightening symptom is called cataplexy, which is characterized by a sudden loss of muscle tone which leads to feeling weak. It is associated with the loss of voluntary muscle control. In 10 percent of all reported narcolepsy cases, this symptom is noted to be one of the first few symptoms to appear. It is oftentimes misdiagnosed as a manifestation of another type of disorder which is not narcolepsy. The attack of cataplexy among patients varies in the duration and severity of the condition. The loss of muscle control by a limited number of muscles, such as drooping of the eyelids, results from a somewhat mild case. A complete loss of muscle control is also possible and in those cases a total physical collapse makes it impossible for the patient to move, keep their eyes open or speak. This is the result of severe symptomatic attacks.

Sleep paralysis is associated with a temporary inability to move or speak while you are falling asleep or even after you have awakened. This is usually unnoticeable because it occurs only while you are asleep and entering the rapid eye movement stage (REM). Experiencing sleep paralysis, again, is like going through a cataleptic attack which affects the whole body. Cataplexy and sleep paralysis are both frightening experiences especially when first experienced. It is understandable to fear these symptoms. In fact, many patients fear that they may become permanently paralyzed. This, however, is only part of the initial reaction. People who seek medical attention have always been able to attain a rapid recovery.

Lastly, the symptom commonly referred to as hypnagogic hallucinations are delusional experiences and are also very frightening. Most of the time, the content of these hallucinations are purely visual but any of the other senses may be involved. If you suffer from these same symptoms, seek medical advice right away! Do not let yourself be frightened by these unusual symptoms as that may lead you to having an unhealthy and inactive lifestyle. All of us must be extra cautious about this disorder as it develops early in life, but we should not allow ourselves to become paralyzed by them. An ounce of prevention will go a long way.

What is Narcolepsy?

Believe it or not, thousands of people suffer from a strange condition in which they are prone to suddenly fall asleep in the middle of a sentence. They will be talking one minute and the next minute they are passed out on the floor! Narcolepsy is a chronic neurological disorder that can attack sporadically and is caused by the brain’s inability to normally regulate the sleep and wake cycles. People who suffer from this will actually fall asleep at the drop of a hat. Narcolepsy is a sporadic disorder affecting a region of the central nervous system that regulates sleep and wakefulness. It interrupts daytime wakefulness such that excessive daytime sleepiness is often the first sign. It slowly develops over several months or years especially if not treated immediately.

It really is true that one minute you might be wide awake and the next minute fast asleep. Throughout the day, if you are suffering from narcolepsy, you will experience excessive daytime sleepiness or EDS as a primary symptom. When this sleeping urge becomes too strong, you will instantly fall asleep for periods lasting from a few seconds to several minutes. If you are unfortunate enough to suffer from this rare disorder, you could remain asleep for up to an hour or longer. If the boss catches you like this at work, you won’t be likely to hold onto your job too long! It is true, however, that if you have experienced falling asleep while working, cooking, or even driving, you may have narcolepsy and may need to seek out a physician. Although it is rare, this condition has been found to be the third highest primary diagnosed sleep disorder among many sleep clinics.

For most adults, it has been clinically proven that 8 hours of normal sleep is composed of 4-6 separate sleep cycles. A sleep cycle is defined as beginning with a non-rapid eye movement (NREM) and followed by the rapid eye movement (REM). This sequence of transition from NREM to REM is due to the interactions of the nerve cells in the brain. When these cycles aren’t functioning correctly, the person begins to experience excessive daytime sleepiness.

Aside from the excessive daytime sleepiness (EDS), there are other major symptoms which characterize narcolepsy. One of these is called cataplexy which is marked by a sudden loss of voluntary muscle tone. The person may just go weak and fall over. These attacks are sometimes so sudden that they can even surprise and scare the patient. They can be brought about by strong emotions like anger, depression, laughter, fright, or surprise. One minute they are laughing and the next minute they are snoring! Vivid hallucinations right after falling asleep or even upon awakening are also common with this disorder. They are referred to as hypnagogic hallucinations. These delusional experiences can be very frightening and can be accompanied by episodes of sleep paralysis at the beginning or end of the sleep cycle.

Narcolepsy is a chronic disorder affecting a region of the central nervous system that regulates sleep and wakefulness. As the dreaming stage of sleep (REM sleep) interrupts daytime wakefulness, a series of symptoms commonly appear. The National Institutes of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) have conducted research about narcolepsy but, still, there was found to be no cure for it.

It has been concluded that, while there are available medications to relieve some symptoms of narcolepsy, there is still no accurate cure for the condition as a whole. In 1999, however, after a series of clinical trial results, the FDA approved the drug Modafinil for the treatment of EDS symptoms. The two classes of antidepressant drugs, tricyclics which include Imipramine, Desipramine, Clomipramine, and Protriptyline, and selective serotonin reuptake inhibitors which include Fluoxetine and Sertraline have proven effective in controlling cataplexy in many patients. These drugs, however, should be supplemented with behavioral strategies. Living a healthier lifestyle by eliminating alcohol, nicotine and caffeine intake may still be the best way to maintain a balanced lifestyle and decrease the symptoms of narcolepsy.

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