By Clinton Marquardt - Sleep & Fatigue Specialist

March 18, 2008

dreams, fatigue, narcolepsy

“Help me” she moaned as she slumped into the chair.

Narcolepsy is a serious and lifelong sleep disorder. It affects 1 out of every 1000 people (about 27,000 Canadians). Narcolepsy is a physiological sleep disorder that makes people sleepy all the time. People with the disorder may fall asleep uncontrollably, anywhere, and at any time. They can even have sleep attacks in the middle of a meeting, during a lecture, at the dinner table or even behind the wheel of a car. The sleepiness eventually becomes debilitating

A narcoleptic will typically nap throughout the day. The naps are usually 10-20 minutes long and narcoleptics find them refreshing but two to three hours later the narcoleptic feels sleepy again. Often narcoleptics will dream when they nap. This is because narcolepsy is a disorder of REM sleep. REM sleep is the stage when dreaming is most likely to occur. When most people drift off they do not usually reach their first period of REM sleep until about 90 minutes after they have fallen asleep. Narcoleptics however, will often go directly into REM sleep.

Narcolepsy is an under-diagnosed disorder. The disorder tends to develop in the early teenage years and there can be a hereditary component. Genes which play a role in the disorder have been identified. There is no relationship between narcolepsy and gender and although there are some stimulant medications which are helpful, the search for a cure continues.

The first symptom to appear is usually excessive daytime sleepiness followed by repeated episodes of cataplexy which is a sudden loss of muscle tone. Two additional symptoms, sleep paralysis and hypnogogic hallucinations, make up the hallmark Narcoleptic Tetrad. Not all narcoleptics display the tetrad of symptoms. The frequency of cataplexy, sleep paralysis and hypnagogic hallucinations may decrease over time but excessive daytime sleepiness persists.

Narcoleptics can also have memory problems and disturbed sleep. Nocturnal sleep demonstrates frequent awakenings and a resulting disrupted sleep cycle, sleep onset latencies of less than 10 minutes, an increase in stage 1 duration and REM sleep within the first 20 minutes of sleep.

Treatments include behavioural strategies like scheduled napping and often times stimulant medication can be helpful.

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Thanks to L. Orr, BA, RPSGT for her help with this article.

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