DEAR DR. GOTT:
Will you please address the affliction of narcolepsy in your column? I do okay as long as I am up and about but as soon as I sit down, I cannot hold my eyes open. I fall asleep while trying to read. I’m 83 years old and am not taking any prescription medications.
DEAR READER:
Narcolepsy is a neurological disorder brought on by the brain’s inability to regulate sleep/wake cycles. At various inappropriate times people with the condition experience overwhelming urges to sleep. Day-time sleep periods can last from a few seconds to several minutes, and longer in some instances. A patient with the disorder does not require any more sleep than does an individual without the condition and, in fact might experience episodes of awakening during nighttime sleep. Narcolepsy is estimated to affect about one in every 2,000 Americans. Statistics for this condition vary greatly from one country/nationality to the next. For example, in Israel, it affects about one in every 500,000 while in Japan, one in every 600 is affected. Symptoms often appear between the ages of 10 and 25, but can affect anyone at any age.
There are three characteristics commonly observed in those diagnosed with narcolepsy. The first is the sudden loss of voluntary muscle tone during an episode. The second is hallucinations that occur during the onset of sleep or upon awakening. Third is brief episodes of total paralysis experienced at the beginning and end of sleep patterns.
Researchers believe the condition results from some disease processes that affect the brain’s mechanism to regulate rapid eye movement (REM) sleep patterns. Others feel a number of variant forms of genes located in the region of chromosome 6 known as the HLA complex are strongly associated with narcolepsy. Infection, trauma, hormonal changes, stress, and an immune system dysfunction may be present in individuals prior to the beginning of symptoms.
There are two tests physicians feel are most confirmative for diagnosis. The first is polysomnography (PSG), testing that records continuous measurements while a patient remains asleep. The second is multiple sleep latency testing (MSLT) performed during waking hours that measures an individual’s tendency to fall asleep. It also records whether elements of REM sleep interfere at inappropriate times.
Narcolepsy cannot be cured, but symptoms can be controlled through medication. Central nervous system stimulants or antihistamines have been used for a number of years to lower the incidence of sleeping at inappropriate times. Unfortunately, these drugs carry numerous unpleasant side effects. Two classes of anti-depressant drugs have been found effective and so far don’t appear to carry such severe side effects.
You need to see your primary care physician and, if necessary, request a referral to a specialist for diagnosis. You may have a completely unrelated condition going on and certainly don’t want to subject yourself to medication at your age. Consider taking a brief nap during the day. This simple lifestyle change might be all that you require.
To give you related information, I am sending you a copy of my Health Report “Sleep/Wake Disorders”. Other readers who would like a copy should send a long, self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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