BY DANIEL BABIC 10F1

Narcolepsy is a chronic sleep disorder, found in both humans and dogs, where affected

individuals experience extreme drowsiness throughout the day, and may fall into a random,

uncontrollable deep sleep, at any given time. Narcolepsy is best defined as excessive daytime

sleepiness (EDS), and its most common symptoms, are as followed:

-Sleep paralysis (where a person thinks they are awake, but body is completely paralysed, lasting a few seconds to a couple of minutes)

-Cataplexy (sudden episode of muscular weakness, where a victim’s head may drop uncontrollably, knees buckle, facial muscles sag, or experience slurred speech)

- Hypnagogic hallucination (A vivid dreamlike illusion that occurs as one is falling asleep and or awakening)

- May be brought on by strong emotions, such as laughter, anger, surprise, sadness or fear.

- Automatic behavior (person continues to function as of normal during sleep episodes, but awakens with no recollection of anything that has happened)

- Disturbed night sleep (frequent tossing and turning, nightmares and awakenings)

What happens in narcolepsy?

When an individual is awake, their brain waves show a regular rhythm, and when falling asleep, their brain waves become slower and less regular, given their body is going to rest, and partly shutting down. This sleep state is commonly referred to as non-rapid eye movement (NREM) sleep. After approximately an hour – two hours of NREM sleep, the brain waves then begin to move at a much faster speed, and activities such as one’s heart rate and respiration, become irregular. This type of sleep is known as REM sleep and is associated with dreaming, mild uncontrolled muscle jerks, and rapid eye movements.

In narcolepsy, the order and length of NREM and REM sleep periods are in reverse, with REM sleep taking place at sleep onset, instead of after 1 – 2 hours of NREM sleep.

Due to this, narcolepsy is a sleep disorder in which the sleep cycle is muddled up. Additionally, it’s a disorder where REM sleep’s aspects that usually occur only whilst sleep, such as a lack of muscle tone, sleep paralysis, and vivid dreams, differ in time dramatically for narcoleptics, as a result.

You see, narcolepsy stops the brain passing through the message of the regular stages of dozing and deep sleep, in the sleep cycle, but instead causes REM sleep to occur abnormally in and out.

Because of this, narcoleptics suffer from many consequences, which include:

-A lack of deep sleep, so the brain tries to "catch up" on sleep during the day, hence excessive day time sleepiness (EDS)

- Fall extremely quickly into deep sleep.

- Awake after a short period of time, and are often disoriented when they do

-Have extremely vivid dreams, which in most cases struggle to remember

-May experience dreams instantly after falling asleep, but not longer than a few seconds.

Causes -The most researched and

commonly thought cause of narcolepsy, is genetic mutation. Following the world’s biggest study on narcolepsy in 1999, researchers discovered that particular genes when mutated, render the cells in the hypothalamus (the major part of the brain, in which controls human’s sleep behaviour) and are unable to correspond with other cells suitably. As a result, irregular sleep patterns then develop, causing narcolepsy.

-Through various research and studies conducted in the 90’s, scientists have additionally discovered a strong link between narcolepsy and an autoimmune reaction. You see, in autoimmunity, a person’s immune system protects their body from viruses and infections, through attacking its own cells. It’s also been demonstrated that a narcoleptics immune system attacks the hypothalamus, in which is the cause of narcolepsy, indicating a large connection between autoimmunity and narcolepsy.

-Narcolepsy can also be caused through family history, but is thought to be the most uncommon cause, given studies have shown that the vast majority of narcoleptic sufferers do not have a history of narcolepsy in their family, therefore indicating, this is a rare and uncommon cause of narcolepsy

Diagnosis & Treatment of Narcolepsy

The diagnosis of narcolepsy is relatively easy, as all the symptoms of narcolepsy have been discovered, are relatively obvious, and even self diagnosable. It does however get much more complex if one experiences sleep attacks that are inaccessible, and cataplexy is only very mild or absent

If this is the case, the polysomnogramand the multiple sleep latency tests are taken. These tests are generally performed by a sleep expert or specialist, given the polysomnogramconducts continuous recordings of sleep brain waves and a variety of nerve and muscle functions during night time sleep. When tested, if it is found that people fell asleep extremely quickly, entered REM sleep early, and have disturbed sleep patterns, they are then diagnosed with narcolepsy. The polysomnogram also assists in detection of any other probable sleep disorders that could cause daytime sleepiness, such as insomnia, in which narcoleptics are sometimes even diagnosed with additionally.

As for the multiple sleep latency test, an individual is given an opportunity to only sleep every 2 hours, during normal wake times. Observations are then recorded of the time taken to reach an assortment of stages of sleep. This test helps calculate the quantity of daytime sleepiness a patient may have, in conjunction with detecting how soon the onset of REM sleep begins, given people with narcolepsy fall asleep rapidly, and enter REM sleep early.

Although narcolepsy can now be detected relatively easily through the discovery of modern day tests, there is no known cure for narcolepsy and can only be stabilized and maintained through:

-Stimulant and anti depressant medication

-Lifestyle change through regular exercise

-Attempting to get 8 hours of sleep a night

-Avoiding caffeine, alcohol and nicotine.

Studies supported by the National Institutes of Health (NIH) are currently now trying to increase their understanding on the ability to detect and treat the disease, by examining narcolepsy patients and families in hope of discovering a cure for this uncontrollable sleep disorder.

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Narcolepsy is an autoimmune disorder, Stanford researcher says". EurekAlert. American Association for the Advancement of Science. (2009). http://www.eurekalert.org/pub_releases/sumc-nia042809.php. Retrieved 11/ 10/2010

BBC News article. (2004) http://news.bbc.co.uk/1/hi/health/4081225.stm. Retrieved 16/10/2010