Narcolepsy
What is Narcolepsy and What are the Types?
Narcolepsy, or as it is popularly known, sleep disease, is a chronic sleep disorder characterized by sleepiness and sudden sleep attacks at abnormal times. Individuals suffering from narcolepsy have difficulty staying awake for long periods of time in their environment and may face great difficulties in daily life.
Narcolepsy is generally defined as two types. In some cases, narcolepsy may be accompanied by cataplexy, a sudden loss of muscle tone that can be triggered by strong emotions. The type of narcolepsy that occurs with cataplexy is called type 1 narcolepsy.
The type of narcolepsy that occurs without cataplexy is known as type 2 narcolepsy.
Narcolepsy typically first appears in individuals between the ages of 10 and 30.
What is the Difference Between Narcolepsy and Normal Sleep Patterns?
The normal process of an individual falling asleep begins with a phase called non-rapid eye movement sleep, or NREM sleep. During this stage, the individual’s brain waves and the level of activity in the brain slow down significantly. After an hour or so of NREM sleep, a change in brain activity is observed and REM sleep, normally fast eye movement sleep, begins. Dreams usually and mostly occur during REM sleep.
In cases of narcolepsy, the individual may suddenly enter REM sleep without experiencing NREM sleep before realizing it, both day and night. Some signs and symptoms of narcolepsy, such as cataplexy, sleep paralysis or hallucinations, are similar to the changes that occur in the brain and body during REM sleep, but occur during wakefulness or drowsiness rather than deep sleep.
Causes
What Causes Narcolepsy?
The cause of narcolepsy is not known for certain by medical experts. However, it has been observed that individuals with Type 1 narcolepsy have low levels of hypocretin. Hypocretin is an important neurochemical in the individual’s brain that helps regulate wakefulness and REM sleep.
Hypocretin levels are particularly low in individuals with cataplexy. It is not known exactly why the hypocretin-producing cells in the brain disappear, but many medical experts suspect that it is due to an immune system response.
Hereditary factors also play a role in the development of narcolepsy. However, the risk of a parent passing the disorder on to their child is only about 1 percent. Family history. However, if narcolepsy runs in an individual’s family, the risk of that individual developing narcolepsy is 20 to 40 times higher.
What are the Complications of Narcolepsy?
Narcolepsy can cause serious problems in people’s professional and personal lives due to public misunderstanding of the condition. People who are unaware of the condition may see the individual as lazy or lethargic. This can affect performance at school or work.
Individuals may tend to shy away from emotional interactions because intense emotions, such as anger or joy, trigger symptoms of narcolepsy such as catalepsy, which can cause difficulty in reciprocal human relationships.
Sleep attacks can cause physical harm and trauma to people with narcolepsy. For example, an episode of narcolepsy while driving can cause a car accident. An attack during food preparation or while working with various tools at work can cause cuts or burns or an occupational accident.
People with narcolepsy are more likely to be overweight because of their low metabolism.
Symptoms
What are the Symptoms of Narcolepsy?
Narcolepsy has multiple symptoms. These signs and symptoms may worsen in the first few years after the condition develops and may continue to affect the individual for life.
The individual may also have problems focusing and sleepiness throughout the day. Excessive daytime sleepiness is often the first symptom of narcolepsy. It makes it difficult for the individual to concentrate and function fully.
Another symptom of narcolepsy is excessive daytime sleepiness. Individuals with narcolepsy can suddenly fall asleep anywhere and at any time. This is not something they can control. The individual may suddenly fall asleep for a few minutes to a few
hours while continuing his/her daily life, working, or talking to others around him/her. When he or she wakes up at the end of this period, he or she may appear to be asleep, but may soon have another sleep attack.
Cataplexy, a sudden loss of muscle tone, is another symptom of narcolepsy. This can cause a range of physical changes, from slurred speech to the complete weakening of many muscles in the body.
Cataplexy is usually triggered by positive emotions such as laughter or excitement, but sometimes by intense emotions such as fear, surprise or anger, and cannot be controlled by the individual. For example, when someone laughs, their head may suddenly droop uncontrollably due to loss of tone in the neck muscles, or their knees may suddenly bend due to loss of tone in the leg muscles.
The incidence of narcolepsy varies from case to case. Some individuals may have only one or two episodes of catalepsy per year, while others may have multiple episodes every day. A person with narcolepsy does not have cataplexy.
Sleep paralysis is another symptom of narcolepsy. People with narcolepsy are often temporarily unable to move or speak when they fall asleep or wake up. In many cases, this lasts only a few seconds or minutes. Even if the individual has no control over themselves, they may be aware of this paralyzed state and may have no difficulty remembering the event afterwards.
Sleep paralysis mimics the type of temporary paralysis that occurs during REM sleep. This temporary immobility that occurs during REM sleep normally prevents the body from performing the movements in a dream. However, not all individuals with sleep paralysis have narcolepsy. Individuals without narcolepsy can also have episodes of sleep paralysis.
Changes in REM sleep are another symptom of narcolepsy. REM sleep is typically the time when most dreams are experienced. In individuals with narcolepsy, REM sleep can start at any time of the day. Individuals with narcolepsy usually enter REM sleep very quickly, usually within 15 minutes of falling asleep.
Narcolepsy can cause the individual to hallucinate. These hallucinations are called hypnagogic hallucinations if they occur after the individual has fallen asleep. Hallucinations that occur after waking up are called hypnopompic hallucinations. These hallucinations can be quite vivid and frightening for the individual, because the individual may not be fully asleep when they start dreaming, and for these reasons their dreams may feel real.
In rarer cases, individuals with narcolepsy may have other sleep disorders, such as obstructive sleep apnea, where breathing starts and stops during the night, restless
legs syndrome and even insomnia, a disorder of sleeplessness.
In some cases, individuals with narcolepsy may begin to automatically repeat certain behaviors, especially during short-term narcolepsy attacks. For example, an individual who falls asleep while writing may continue to write, or an individual who has an episode of narcolepsy while driving may continue to drive, or an individual who is walking may continue to walk. When the individual wakes up, they will not remember what they did and the activity will probably not work well.
Individuals should consult a doctor if they experience excessive sleepiness or drowsiness, especially during the day, to the extent that it interferes with their personal or professional life.
Diagnostic Methods
How is Narcolepsy Diagnosed?
Doctors can normally make a preliminary diagnosis of narcolepsy based on the individual’s excessive daytime sleepiness or sudden loss of muscle tone (cataplexy), if present. After this preliminary diagnosis, the doctor will refer the individual to a sleep specialist for a better and more precise evaluation.
A definitive diagnosis of narcolepsy requires an overnight stay at a sleep center for an in-depth sleep analysis by sleep specialists. Through this narcolepsy test, narcolepsy can be diagnosed and its severity can be determined.
In this process, the doctor will first want to learn about the individual’s sleep history in detail. For this, the Epworth Sleepiness Scale, which consists of a few short questions, will be completed. The questions on this scale include the rate and frequency with which the individual sleeps in certain situations, for example after lunch.
In addition, the doctor may ask the individual to keep a detailed schedule of their sleep patterns for a week or two, so that they can compare sleep patterns with periods of wakefulness to determine the relationship.
In addition, the doctor may ask the individual to use an actigraph. This device, which looks like a wristwatch, measures periods of movement and rest and indirectly measures when and how the individual sleeps.
A polysomnography test can be performed at the sleep center. The polysomnography test measures various signals during sleep through electrodes placed on the scalp. This test measures the electroencephalogram (electrical activity of the brain), the
electrocardiogram (electrical activity of the heart), the electromyogram (electrical activity of the muscles) and the electrooculogram (movement of the eyes). The individual’s respiratory values are also measured.
Another test used to diagnose narcolepsy, the multiple sleep latency test, measures how long it takes an individual to fall asleep during the day. The individual is asked to take four or five naps, each two hours apart. Experts observe the individual’s sleep patterns during this process. People with narcolepsy fall asleep easily and go straight into REM sleep.
These tests can help the individual to rule out other possible causes of excessive daytime sleepiness, such as chronic sleep deprivation, use of sedative medications and sleep apnea.
Treatment Methods
كيف يتم التعامل مع Narcolepsy؟
الخدار هو حالة مزمنة للأسف ليس لها علاج دائم. ومع ذلك، يمكن أن تساعد الأدوية المختلفة وتغيير نمط الحياة الفرد على إدارة الأعراض. في الوقت نفسه، يمكن أن يساعد الدعم من الأقارب من جميع أنحاء الفرد في التعامل مع الخدار.
هناك أنواع مختلفة من الأدوية التي يمكن استخدامها في إدارة عملية narcolepsyprocess. يجب أن تستخدم هذه الأدوية دائما مع نصيحة الطبيب والوصفة الطبية، وتحت إشراف أخصائي طبي. على وجه الخصوص، يجب على الأشخاص الذين يعانون من حالات صحية أخرى، مثل ارتفاع ضغط الدم أو مرض السكري، إخبار طبيبهم عن هذه الحالات والسؤال عن كيفية تفاعل الأدوية التي يتم تناولها لحالات أخرى مع الأدوية التي يتم تناولها لعلاج الخدار.
ومع ذلك، فإن بعض الأدوية التي لا تستلزم وصفة طبية، مثل أدوية الحساسية والبرد، يمكن أن تسبب النعاس الأيضي. قد يوصي الأطباء عادة الأفراد الذين يعانون من ناركولبسيس تجنب تناول هذه الأدوية.
تشمل الطرق الجديدة التي يتم التحقيق فيها لعلاج الخدار الأدوية التي تعمل على النظام الكيميائي للهستامين، واستبدال hypocretin، والعلاج الجيني hypocretin والعلاج المناعي. ومع ذلك، لم يتم تحديد واحد فعال نهائي بعد.
المنشطات، الأدوية التي تحفز الجهاز العصبي المركزي لمساعدة الناس مع narcolepsystay مستيقظا طوال اليوم، هي العلاج الأساسي. يمكن أن تشمل الآثار الجانبية لهذه الأدوية الصداع أو الغثيان أو القلق.
تغيير نمط الحياة والرعاية المنزلية للصلع
تلعب تغييرات نمط الحياة التي يقوم بها الفرد دورا مهما في علاج أعراض الخدار. وفقا لذلك، من المهم الالتزام بجدول النوم. يمكن أن يكون النوم والاستيقاظ في نفس الوقت كل يوم، بما في ذلك عطلات نهاية الأسبوع، فعالا.
يمكن أن تكون القيلولة القصيرة لمدة 20 دقيقة على فترات منتظمة وأوقات استراتيجية على مدار اليوم منشطة للفرد ويمكن أن تقضي على النعاس لمدة ساعة إلى ثلاث ساعات. في بعض الحالات، قد يحتاج الأفراد إلى قيلولة أطول.
يجب على الفرد تجنب النيكوتين والكحول. التدخين، وخاصة في الليل، يمكن أن يؤدي إلى تفاقم العلامات والأعراض.
يمكن أن تساعد التمارين الخفيفة والمنتظمة قبل النوم بأربع إلى خمس ساعات على الأقل الأفراد على الشعور بمزيد من اليقظة خلال النهار والنوم بشكل أفضل في الليل.
يجب على الفرد إعطاء معلومات دقيقة عن حالته لأقاربه أو صاحب العمل أو المعلمين. يجب عليهم أيضا العمل معهم لإيجاد طرق لتلبية احتياجاتهم للتعامل مع الخدار.
ويمكن أن تشمل هذه أخذ وقت للقيلولة خلال النهار، وأخذ فترات راحة متكررة عند القيام بمهام رتيبة، وتسجيل الاجتماعات أو المحاضرات بشكل منفصل، أو الوقوف خلالها، والذهاب للمشي السريع مرة واحدة في حين طوال اليوم.
إذا كان الفرد بحاجة إلى القيادة لمسافات طويلة، فمن الضروري استشارة الطبيب لإنشاء برنامج دواء يسمح للفرد بالبقاء مستيقظا أثناء القيادة. يجب على الفرد التوقف عن القيادة لقيلولة قصيرة بمجرد أن يشعر النوم يقترب، وعدم القيادة على الإطلاق إذا كان يشعر بالنعاس الشديد.
