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.

Do you have any non-medical strategies for relief? Across the years I have sometimes taken 25 mg of diphenhydramine for allergies and have noticed some assistance with sleeping. I would only be willing to take medication as a last resort. Please give me a quick, easy fix. Thank you.

DEAR READER:
Diphenhydramine (Benadryl) is an antihistamine that is sometimes recommended as a non-habit forming sleep aid because it has sedative properties. This is why you experience some relief when taking the product. It is also sold under the trademark, Simply Sleep for those who do not take it for allergies.

Most adults require seven to nine hours of sleep a day. There is no evidence to support the belief that older individuals require less.

There are many reasons for sleep deprivation. Perhaps family concerns, employment issues, health, some medications, fears, or financial obligations can cause stress that may keep us from getting to sleep. Often we will awaken in the middle of the night with a solution to a complex issue, only to have difficulties falling back to sleep.

Melatonin is a hormone produced by the pineal gland in the brain. It is stimulated by darkness and suppressed by light. Levels of this hormone are highest just prior to bedtime. Often night lights in a bedroom, a light intentionally left on in a child’s room, or a window with a street light shining in will suppress the production of melatonin and cause wakefulness. Take the necessary steps to sleep in a quiet, comfortable, darkened room. Perhaps this simply means moving the furniture to another wall to avoid light seeping in. Don’t sleep with a television on. The light from the screen is counter-productive in this instance and the sound could add to the problem.

Other suggestions include eating lighter meals in the evening. Don’t go to bed after eating a large meal. Discontinue or substantially reduce smoking and alcohol and caffeine consumption. If you routinely enjoy coffee with or after dinner, switch to a decaffeinated form. Remember that soda and chocolate contain caffeine and should be avoided later in the evening, as well. Exercise as much as possible during the day and go to bed when tired, not necessarily at a specific time of the evening. Some medications have a tendency to cause insomnia. Speak with your physician about any drugs you might be on with this unwanted side effect. He or she can switch you to another product in the same drug class. Synthetic melatonin is an over-the-counter sleep aid that is safe when used according to package directions. Speak with your doctor first, but he will probably recommend a trial basis of this harmless substance to get you back on track.

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.

DEAR READER:
Let’s consider the big picture here. You are on a host of medications and supplements for your Parkinson’s, hypothyroidism, depression, anxiety, hypercholesterolemia, and osteoporosis.

I would like to clarify the dosage of Levoxyl you are taking for hypothyroidism. While I left out the dosages of the medications you are on, you stated you take 50 mg daily. This amount is beyond comprehension. Could you have meant to say 50 micrograms (mcg)? Levoxyl should be taken in the morning on an empty stomach and at least four hours apart from other drugs taken that are known to interfere with its absorption. At what time of day are you taking this drug and how often do you follow-up with your other medications?

Side effects include anxiety, nervousness, insomnia, weight loss, heat intolerance, headache, hyperactivity, diarrhea, hair loss, and more. A consequence of over-or-under treatment for women with long-term use includes a decrease in bone mineral density. You don’t indicate whether you are male or female. Could your insomnia and osteoporosis be a consequence of the Levoxyl?

How often do you have blood drawn to test for your hypothyroidism? One consideration you should speak with your physician about is that drugs that have worked well for years can become ineffective for no apparent reason. We anticipate things will not change. Unfortunately, our bodies respond in different ways and what worked in the past simply might not work that way permanently.

Now on to your question of insomnia. Serotonin and melatonin are essentially the same. Serotonin kicks in when light is present and is a naturally-occurring chemical found in the brain and intestines that controls wakefulness and mood. It converts to melatonin when darkness occurs and is a hormone released into the bloodstream by the pineal gland in the brain. Many individuals with depression have low serotonin levels, leading to low melatonin levels and an inability to sleep. In many instances, light is present in the room a person sleeps in — either from a night light or television.

Synthetic melatonin is often used as a sleep aid. It is available in most pharmacies and is one of the safest options offered. Before you consider trying it for your insomnia, ask your physician if one of your medications might be the culprit. Perhaps we can get you sleeping and stop any advancement of the osteoporosis, simply by keeping tighter control on your hypothyroidism.

To give you related information, I am sending you copies of my Health Reports “Parkinson’s Disease” and “Sleep/Wake Disorders”. Other readers who would like copies should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

DEAR READER:
Yes, they are. Dreams occur during rapid eye movement (REM) sleep stages. A sequence of dreams in a progressive pattern often appears to resolve emotional issues by working through them in a step by step manner and by comparing them to successful challenges from the past. A dreamer is likely to awaken in an uplifted mood after such an evening of dreams. In an opposite manner, sequences of dreams that present in a repetitive pattern throughout the night fail to resolve emotional problems and the dreamer often awakens in a bad mood.

It is often said that people problem-solve when they dream. They might awaken abruptly from a sound sleep with those thoughts still fresh in their minds. A resolution is apparent and restful sleep follows.

Then there is the individual who cannot remember a single facet of a dream once awakening in the middle of the night. It’s difficult to analyze whether this is good or a sign of something else.

There are several circumstances that appear to prevent dreams from occurring. Numerous over-the-counter and prescription medications (particularly anti-depressants) and alcohol hold back the normal dreaming process. Researchers now know there is a positive connection between the loss of dreaming and serious illness.

Philosophers, inventors, writers and people from every walk of life have attributed dreams to inspiration for painting masterpieces, completing poetry, writing prize-winning novels and more. So to say the least, most dreams are good.

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 self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

After months of barely sleeping, I was exhausted. One night I feel asleep on the couch in a sitting position and found that I slept like a rock. I woke up in the morning feeling fine. Since then I start out trying to sleep in bed but inevitably wind up back on the couch sleeping in a sitting position. I always feel fine in the morning but worry that this might do my body some harm down the road should it continue.

DEAR READER:
To the best of my knowledge there is no harm in sleeping on the couch in a sitting position. I would imagine that this could cause some muscle stiffness upon waking but if you are not experiencing any problems, I don’t see any reason to stop.

There are some other safe options for insomnia. Some individuals experience remarkable results with the oldest home remedy, warm milk. I don’t know why this works but suspect it has some ties to infancy (most babies fall asleep shortly after mealtimes).

One of the best remedies I have come across is melatonin. This is a naturally occurring chemical in the brain that stimulates sleep. During daylight hours the brain produces serotonin which aids in wakefulness. At night, however, the serotonin is switched to melatonin. The only catch to this remedy is that it must be dark. In today’s society most people have televisions or computers in their bedrooms and do not provide themselves with a dark, quiet, relaxing sleeping environment. Removing these devices from the room and taking a melatonin supplement one hour before bedtime may make a huge difference. Simply follow the instructions on the bottle (which can be purchased in most pharmacies, the vitamin/supplement aisle in grocery stores or health food stores). It is non-habit forming and safe for long-term use (as it is a naturally occurring chemical within the body).

If your insomnia persists I recommend you see your physician or a sleep specialist because you may have a physical reason for your sleep problems such as sleep apnea (periods in which you stop breathing while sleeping) or restless legs syndrome.

You may wish to try prescription sleep aids such as Ambien or Lunesta. These, however, can be addictive, are only recommended for short-term use and may be expensive. There has also been huge media coverage of possible side effects including sleep walking, driving and eating with associated amnesia of the event, aggressive behavior and so forth. That being said, these drugs work for thousands of people without side effects. Inappropriate use (long-term or excessive amounts) increase the risk for side effects. Ask your doctor about this option.

To give you related information, I am sending you a copy of my newly updated Health Report “Sleep/Wake Disorders”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My problem is that I am constantly tired. About one and a half hours after lunch I fall asleep. I cannot control it. This has been happening for quite a while. I get plenty of sleep at night (eight to nine hours). Getting more than that does not seem to help.

I was wondering if I could be diabetic or hypoglycemic. Could these conditions possibly be the culprit and if so, how could I easily tell? I don’t know what else it could be. Please help me. My school work is suffering because of it.

DEAR READER:
You need a thorough examination and testing by your family physician. In particular, you should have blood work to check for anemia, thyroid disorders and abnormal blood sugar levels.

If the testing is normal, the next step, in my opinion, is for you to see a neurologist. This specialist can test you for several disorders. I would be most interested in the outcome of testing for narcolepsy. This is an unusual brain condition that results in an uncontrollable desire to sleep or sudden attacks of falling asleep at intervals. It is often associated with a condition known as cataplexy which is sudden attacks of muscle weakness.

Your uncontrollable sleeping in the afternoon is not normal. A diagnosis needs to be made; however, because of the strange nature of your symptoms, this may not be an easy process. I urge you to speak to your parents about it, seek medical help and be persistent until someone can tell you what is happening.

To give you related information, I am sending you copies of my Health Reports “Sleep/Wake Disorders” and “Medical Specialists”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

I started having them about five years ago and it got to be that I was having them almost every night. Some nights I would have several. Mine weren’t as severe as others I had seen on TV but they were bad enough that to make me jump out of bed and practically leave the room to escape the spiders on the bed, the collapsing ceiling or whatever I believed was about to take my life. I lived with this for a while, thinking I was just losing my mind. I didn’t know what else to do. Even my primary care physician couldn’t suggest anything.

Then, I discovered melatonin. I started taking 1 mg before bed and soon the night terrors started to diminish. It’s been a few years now and I have had to increase the dosage to 3 mg a night. As long as I continue to take the melatonin, I don’t have any terrors.

A few months ago, I ran out and didn’t buy more for a couple of days. The night terrors came back. Now I am careful not to run out. It is safe and inexpensive. I thought you might find this interesting and possibly would recommend it to those with this very frustrating affliction.

DEAR READER:
I am glad to hear that you have resolved your problem in an easy, inexpensive and safe way. I am passing your experience on to my readers.

Night terrors are a form of nightmare which causes the sufferer to cry out in fright and awake in panic. They are more common in male children ages three to five but can occur in anyone of any age. The major differences between a nightmare and a night terror are the time and stage of sleep in which it occurs. Nightmares generally happen during the REM (rapid eye movement) period of sleep and in the early morning hours. Night terrors occurs during stage 3 (deep sleep) and stage 4 (deepest sleep). They also generally occur within the first 60 minutes of falling asleep.

Symptoms of a night terror include sudden awakening from sleep, sweating, confusion, rapid heart rate (usually between 160-170 beats per minute), screaming, persistent fear that occurs at night, difficult to comfort, and an inability to wake up fully (but eyes may be open). One of the most characteristic symptoms is not remembering the night terror. Some individuals remember parts of the “dream”; some may even be able to remember the whole thing, but in general there is no recollection. Once the night terror occurs, the person may sit up and appear to be awake; however, this is not always the case. The sufferer may still be in the midst of the terror, be unable to explain what is happening and usually is difficult to comfort. Physical contact occasionally worsens the experience.

Often times the night terrors are about people or animals. Most sufferers, who can remember the terrors, describe the person or animal as dark, shadowy and threatening. They feel that it is going to cause them harm.

Night terrors can be troublesome in the least. There is no test for diagnosis and medical treatment is not generally used or recommended. For severe cases, therapy and counseling may be helpful. Minimizing risk factors, such as stress, and obtaining appropriate amounts of sleep can reduce the frequency, diminish severity and may cause the night terrors to stop.

For my readers who are interested in this subject or believe they may suffer from these episodes, I recommend the website www.NightTerrors.org. This website was created by a gentleman who suffers night terrors and started researching the subject. I should mention that he is not (to my knowledge) a physician or scientific researcher. He, however, has done fairly extensive research using well-known medical publications such as the Journal of American Medicine and the British Medical Journal. I also recommend that you speak to your primary care physician, a psychiatrist or psychologist or ask for a sleep study if you have the episodes nightly; continue the melatonin therapy.

Readers, if you suffer from night terrors, please let me know if melatonin is successful or not for you.

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 self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Your husband, like the reader above, would probably benefit from the use of melatonin. It is safe, inexpensive and non-habit forming. It is available over-the-counter in the vitamin and supplement section. Good luck.

DEAR READER:
Adjusting to time changes can be a challenging problem because it requires a re-setting of our biological clocks. There are some solutions but one of the most common is used by many pilots who fly internationally.

Melatonin is a naturally occurring compound. It is manufactured in our brains when it is dark, which causes us to feel sleepy and, therefore, go to bed. However, for this to be effective, it must be completely dark because once our eyes, even if they’re closed, are exposed to light, the melatonin production stops, causing us to wake up. Be sure to speak to your physician before taking melatonin so he or she is aware of your sleep problems and can then be prepared should you decide the melatonin is not for you.
Simply take the melatonin one hour before you plan to go to bed. Be sure not to expose yourself to unnecessary light during this one hour period. One hour later, go to bed in your dark bedroom. You should have no problem falling asleep. If you do, try taking a slightly higher dose until you find the one that is right for you but do not exceed the package’s direction unless your physician has told you its okay.

Melatonin, unlike sleeping aids, is safe, inexpensive and non-habit forming.

As far as changing Day Light Savings time, I don’t know what could be done other than moving to Arizona which, to the best of my knowledge, does not observe it.

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 self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.