The Two Types of Narcolepsy

According to Villalsa, Lautar, Santos, and Guillerino, (2010) Narcolepsy is a sleeping disorder characterized by excessive daytime sleepiness that is present even if the individual experiences a restful night’s sleep. (p.38) Also, Narcolepsy can be associated with Cataplexy and other sleep abnormalities such as sleep paralysis and hallucinations. The way people are diagnosed to determine if they have narcolepsy is by a video-polysomnography and Multiple Sleep Latency test. Narcolepsy is distinguished into two major groups: narcolepsy with or without cataplexy. (p.65)

Cataplexy is characterized by a sudden drop of muscle tone, triggered by emotional factor, especially if positive, such as laughter or pleasant surprise rarely by stress, fear or physical effort. People with narcolepsy can have both narcolepsy and cataplexy and they can also just have narcolepsy.

In 1880, Gelineau was the first author to describe this syndrome and coined the term narcolepsy to individuate a group of patient with excessive daytime sleepiness, sleep attacks and episodes of muscle weakness triggered by emotions. (p. 66)

Narcolepsy is about .05 percent in the United States. In the most recent hypothesis suggests that narcolepsy could be a neurodegenerative disorder with an autoimmune component triggering the onset of the disease in susceptible individuals. It can also be seen during the course of a neurological disease process. (p. 67)

Narcolepsy is a clinical syndrome defined by four systems: a complaint excessive sleepiness, a sudden bilateral loss of postural muscle tone or a sudden muscle weakness, often subsequent to an intense emotion, sleep paralysis, and hallucinations. (p. 65)

As Villalsa, Lautar, Santos, and Guillermo state (p. 38), individuals with narcolepsy experience extreme fatigue, drowsiness, and a strong urge to nap at inappropriate times throughout the day. Cataplexy, sleep paralysis and hallucinations are related to orexin release in the hypothalamus, and can be managed with stimulants such as amphetamine, methylphenidate or modafinil. The side effects of these medications are irritability and anxiety. Physiological side effects are headaches, gastrointestinal distress and skin irritation. Taking amphetamine and modafinil together result in an effective and well-tolerated wake-promoting agent. Taking antidepressants, antipsychotic or sedatives can help reduce cataplexy, sleep paralysis, and hallucinations. (p.38)

Narcolepsy is typically in children and young adults and most common before the age of twenty-five. According to Sanjeev and Suresh (p. 190), the first symptom is between fifteen and nineteen years of age. Narcolepsy is more common in men then women. (p. 190)

People with narcolepsy have an increasing body-mass then other’s. Some, mainly in children, gain weight after the onset of narcolepsy. Sanjeev and Suresh stated that (p. 195) disrupted nighttime sleep is common and may partially contribute to chronic sleepiness. Sleep terrors and frequent nightmares are symptom. (p. 197) They can also experience eating disorders, irresistible craving for food, binge eating and obesity. Narcoleptics have a high chance of having Periodic Limb Movements (PLM) and Restless Legs Syndrome (RLS). Studies have shown that fifty percent to sixty percent of people with narcolepsy have PLM.

All strained muscles can be affected, but the people with narcolepsy and cataplexy the facial, arms, and legs muscles are more affected. They can experience facial flickering, jaw tremors, head/jaw dropping, dropping of object, or even episodes of dysarthria. They can remain completely conscious during these episodes. People with narcolepsy can also experience syncope, epileptic seizures, and drop attack.

As Villalsa, Lautar, Santos, and Guillermo state, (p. 76 and 77), syncope is a sudden self-termination loss of consciousness with complete and prompt recovery. They can present sudden or complete weakness of the body, sweaty, pale face, cold skin, low heart rate, low blood pressure, and dizziness.

An epileptic seizure is a sudden hypersyncronized discharge of a group of neurons. They can fall to the ground and be asleep. They can experience twitching movements that can be mistaken for the jerking of a seizure.

Drop attack is a sudden bilateral weakness in antigravity muscles, often with out loss of consciousness. In the posterior areas of the brain is what is effective when drop attacks accrue. They might experience a sudden fall down that could last from few to several minutes. (p. 76 and 77)

According to Mary Anne Ott, (1995-2014), massage can improve getting quality sleep. It can improve the quality of nighttime sleep. Massage can also help them relax, loosen their muscles, get a better night sleep, minimize daytime issues and help with better sleep without using medications. She also states, massage therapy exercises and strengthens weak and tight muscles. Improve their muscle tone; lessen the feelings of depression and anxiety. Due to massage the anxiety level drops.

Another great massage technique to use on people with narcolepsy is Light Therapy. They are exposed to bright artificial light for several intervals throughout the day to induce wakefulness. When they feel fatigue or sleepy, they can use another dose of the artificial light to keep them from falling asleep and allowing their body to condition itself to a pattern of sleeping when it’s nighttime.

Narcolepsy is a lifetime disorder and there is no cure. Patients can make normal sleeping schedules and planned naps that help with copping with narcolepsy. Sometimes napping can affect their social and professional life. As Dr. Seiji Nishino states (2007-2008), exercising to avoid obesity, keeping a regular sleep schedule, and having a supportive social environment are also helpful.