Narcolepsy is the troublesome disorder of the human nervous system. The sufferer has to rely on the alternative ways to mitigate the problem.
What is Narcolepsy?
Hope you are doing well.
Let we talk about another sleep disorder…Narcolepsy. This sleep disorder can disturb our sleep-wake cycle. Occasionally it makes us accident prone.
Definition of Narcolepsy:
Narcolepsy happens when we lose control over our sleeping. The narcoleptic person suffers from excessive daytime sleepiness. In fact, he falls asleep within a short while. The uncontrolled episodes of sleep usually stand for a brief period. Sometimes even for few seconds. In other words, the narcoleptic individual suffers from sleep attacks.
It is important to realize, such sleep attacks may happen while performing daytime activities. Just imagine the risk they carry….!!!
Overall 0.02% of the worldwide population is affected with this sleep disorder. Around 25% narcoleptic individuals suffer from the disability. Mostly, the narcoleptic individuals suffer from chronic sleepiness.
What causes Narcolepsy?
An actual cause of Narcolepsy is unknown yet. It is believed that the deficiency of Hypocretin causes it. Hypocretin is a brain chemical. Certain brain neurons produce Hypocretin or Orexin. Its deficiency conversely impacts regulation of sleep-wake cycles. In the final analysis, average sleep duration for narcoleptic individual and normal person nearly equals. However, the former suffers from a bad quality of sleep. Not to mention, this sleep disorder brings all ills of poor sleep quality.
Is Narcolepsy genetic?
Although this may be true that around 10% cases of Narcolepsy were found to have the family history. They have certain variations of HLA complex. These complexes were considered to be lowering Hypocretin. Hence initially it was thought to have a genetic cause.
Provided that narcoleptic individual has abnormal immune system involved, initial belief is shifting now.
In fact, certain autoimmune disorders lower neurotransmitter Hypocretin. That, in turn, leads to Narcolepsy. Hence the family history of Narcolepsy would be a risk factor. Lowering of Hypocretin is also associated with brain trauma. Additionally, history of infection and diet may impact its production. Also, certain brain tumors or stroke conditions may lower the Hypocretin.
Narcolepsy may begin with childhood. Gender doesn’t matter in its occurrence.
Does trauma cause Narcolepsy?
The relation between excessive daytime sleepiness and brain trauma is being researched. In fact, symptoms of sleep disorders often observed in patients with the history of a brain trauma. Neurons situated in the lateral part of the hypothalamus in our brain play the pivotal role in sleep-wake cycle regulation. Loss of these neurons due to brain trauma conversely lowers Hypocretin. The Hypocretin promotes wakefulness while regulating the sleep cycle. Hence patients with brain injury often suffer from daytime sleepiness.
Out of billions, only 1-2 lakh brain neurons could produce Hypocretin. Loss of several brain neurons causes Narcolepsy with Cataplexy. In Cataplexy, sudden and transient muscle weakness occurs. Just to mention here the difference between Cataplexy and Catalepsy. Catalepsy is kind of seizure. In Catalepsy the person becomes unconscious and rigid. On the contrary, during Cataplexy muscles give up their tone. Mostly, Cataplexy is associated with narcolepsy.
How can infections cause excessive daytime sleepiness?
As discussed above, Narcolepsy happens due to lowering of Hypocretin. Conditions that kill such brain neurons consequently cause this sleep disorder. Unfortunately, sometimes our immune defense acts against us killing these vital neurons. Growing evidence states autoimmune cause in lowering of Hypocretin leading to Narcolepsy.
Which kinds of infection are likely to cause Narcolepsy?
Whenever infection occurs our body defense mechanism becomes activated. As we know, infection specific antibodies fight against pathogens. However, in some individuals, such antibodies target their own vital parts. The phenomenon of infections and autoimmune disorders is well known. Pathogens like bacteria, viruses or parasites may cause an autoimmune inflammation of the variety of organs. Such self-destructive autoimmunity can impact major organs like heart, bowel, as well as the Central and the peripheral nervous systems.
Evolving evidence suggests an association between Narcolepsy and Streptococcal infections. In fact, the number of narcoleptic individuals tells past history of Streptococcal infection during diagnosis. Looking at the proportion, Narcolepsy can be thought of post-streptococcal complication. Streptococcal infection may trigger an autoimmune response that initiates destruction of neurons that produce Hypocretin.
Compelling evidence suggests a linkage between H1N1 infection and Narcolepsy. Few children, who have been vaccinated for H1N1, developed this daytime sleeping disorder within a period of 1-2 months. It is equally important to say, many of them had inherent HLA complex. Hence they were genetically prone to Narcolepsy. The recent surge in Narcolepsy patients after H1N1 infection highlights this linkage.
In all, exposure to streptococcal pyrogens, Influenza A infections, and selected H1N1 vaccine preparations can be associated with this sleep disorder.
Sleep Pattern in Narcolepsy
Dear friend, I have mentioned NREM and REM sleep in the previous article. Comparatively duration of total sleep in narcoleptic individual and normal person nearly equals. However, Narcolepsy significantly affects sleep quality. The NREM stage i.e. Non-rapid eye movement stage begins as soon as the normal person falls asleep. In this stage, the brain waves slow down. The REM stage i.e. Rapid eye movement stage follows NREM stage after an hour. Dreaming occurs at REM stage.
In fact, in this sleep disorder, the individual directly enters in REM stage. This happens even though he sleeps during the daytime. Hence some phenomenon’s of REM sleep such as cataplexy or sleep paralysis happen at this stage. The Narcoleptic individual lacks benefits of NREM sleep.
Not to mention, the sleep of narcoleptic individual is not refreshing or healthier one.
Is Narcolepsy fatal disorder?
Don’t be afraid with above question. As discussed earlier, this sleep disorder causes excessive daytime sleepiness. In its severe form, it may cause Cataplexy, sleep paralysis or hallucinations.
Hence this sleep disorder is fatal only if it makes you accident prone.
Yes… In few individuals, episodes of Cataplexy may occur during activity. Unfortunately, if such instance ends in the fatal accident then this disorder would turn fatal for such individual. Hence it is advisable for the Narcoleptic individual to take extra care and avoid unnecessary ventures that may meet an accident.
I hope you would have well introduced with this disorder now. We will discuss each sign and symptom in detail in my next letter article.