Narcolepsy and Hypersomnia

Written by Administrator

Narcolepsy is a genetically determined, neurological sleep disorder that usually appears in young adulthood. It is marked by recurring episodes of daytime sleeping, and regular disruptions of nocturnal sleep.   Narcoleptics also experience cataplexy -- sudden attacks of muscle weakness all over the body during moments of strong emotion, which cause them to lose control of themselves and fall down -- and sleep paralysis -- moments of disconnection between brain and body, when they are unable to move for a few minutes at a time while they are falling asleep or waking up.

Also characteristic of narcolepsy are frequent hypnagogic hallucinations, or wakeful dreaming -- frightening but imaginary noises, images and smells that fill the mind in the moments just before falling asleep. Although about half of all people may experience sleep paralysis and wakeful dreaming once or twice in their lives, narcoleptics live with these conditions on a regular basis.

Most people sleep in predictable stages; lightly at the beginning of the cycle, then more deeply, and finally, after about 90 minutes, rapid eye movement (REM) sleeps.   Narcoleptics, on the other hand, move immediately into REM sleep after dozing off, skipping the intervening stages. They also seem to fall into moments of REM sleep during their waking hours; the chronic dreamlike episodes and muscle paralysis they experience are characteristic of the REM phase of the sleep cycle.

Although narcolepsy emerges in most patients between the ages of 15 and 25, it can strike at any age. Many cases are undiagnosed and, therefore, not treated, which may explain the cases where narcolepsy appears in later life.   The genes most closely associated with the disease control the production of brain chemicals such as orexin, a neuropeptide that may signal sleep and awake cycles. Some experts like Dr. Masashi Yanagisawa, a Howard Hughes investigator at UT Southwestern, believe that narcolepsy may be the result of deficiencies in the brain's production of a chemical called hypocretin. Researchers who study the brains of people with narcolepsy have also discovered several abnormalities in the areas of their subjects’ brains that are involved in regulating REM sleep.    The consensus in the field today is that narcolepsy probably involves multiple factors that interact to cause malfunctions in the neurons and disturbances in REM sleep, but these factors have not yet been identified precisely.

Narcolepsy itself cannot be cured, but its worst symptoms are controllable. EDS (excessive daytime sleepiness) can be treated with amphetamine-like stimulants such as Ritalin or dextroamphetamine, which help patients become more alert during the day. Provigil (modafinil) is a new, less powerful type of stimulant, which appears to be effective at keeping people awake and is less addictive than other stimulants. Cataplexy can be tamed with traditional antidepressant medications. However, the most logical choice for many people with narcolepsy may be Xyrem, a new drug designed specifically for the disease. Xyrem is a central nervous system depressant which can reduce both daytime sleepiness and cataplexy attacks.

A website named Native Remedies proposes natural alternatives to the use of synthetic antidepressants and stimulants, claiming that "although these medications can help to control the symptoms [of narcolepsy] to varying degrees, they do not address the underlying cause and may cause unwanted side effects."

According to Native Remedies, natural treatments can be both a companion and an alternative to conventional medicine. Herbs and vitamins such as Hypericum perforatum, Schizandra chinesis, Calcium lactate, Magnesium lactate and Vitamin B6 "can provide relief for narcoleptics" by helping them "maintain regular sleeping patterns." The website also proposes natural therapies such as counseling and psychotherapy, homeopathy, acupuncture, aromatherapy and spiritual therapy, and reminds its readers that healthy diets and regular excercise can improve both the quality of sleep and the quality of life.   It concludes by suggesting that research into treatments for narcolepsy should include stem cell therapy and a synthetic form of hypocretin.

According to the experts at Natural Health Reference.com, an online natural health information service, "gotu kola and St. John’s Wort" are good natural remedies for narcolepsy, because they "boost energy levels and possess antioxidant properties." An herb called "Gingko Biloba" protects cells because of its anti oxidant properties and its ability to improve the circulation of blood to the brain. The website also proposes specific dietary changes to treat narcolepsy; these include the frequent consumption of :

leafy greens, sea vegetables, brewers' yeast, brown rice and other foods high in Vitamin B,
protein, in the form of meat, poultry, cheese, nuts, seeds and soy products, and (3) complex carbohydrates such as fruits, vegetables, legumes, natural whole grains, and whole wheat pastas.
Foods rich in tyrosine, such as eggs, oats, poultry and wheat germ. Proteins, complex cards, tyrosine and Vitamin B all help to increase alertness. Simple carbohydrates can calm you down and make you sleepy, and are therefore not a good dietary choice for chronically tired people with narcolepsy.

WebMD agrees with Native Remedies and Natural Health Reference.com that lifestyle changes can help patients keep symptoms under control, but the natural remedies it proposes are not unique to narcolepsy. Instead they are similar to the natural treatments for most sleep disorders --

sleep hygiene, in the form of scheduled 10-15 minute daytime naps that can help relieve the sleepiness of narcolepsy;
the avoidance of caffeine, alcohol, nicotine, and heavy meals, and
regular exercise and meal schedules.

Narcolepsy is a relatively rare disorder, and its neurological dimension makes it difficult to cure but fascinating to study. Newer, more effective treatments are surely on the way, but in the meantime, the best choice for people with narcolepsy is to take the appropriate combination of stimulants and antidepressants, embrace natural treatments, and hope for the best.