Michael Baten, MD is The Santa Fe SleepDoctor^™

• The term narcolepsy is used to describe a group of people affected by excessive sleepiness. It also includes features of dreaming that occur while awake. Narcoleptics are often refreshed by short naps. However, after two or three hours, they feel sleepy again. At times, people with narcolepsy can fall asleep suddenly. These “sleep attacks” can happen while eating, walking or driving.
• One type of Narcolepsy is when the leg, arm or face muscles suddenly become weak. It is normally caused by strong emotions. This is what people often experience while laughing or when they are surprised.
• People with narcolepsy may experience:
  • Sleep Paralysis- they are unable to move for a few seconds or minutes as they are falling asleep or waking up.
  • Hallucinations- seeing things that aren’t there. They have a feeling that there is someone in the room with them when falling asleep.
  • Disturbed night time sleep- they wake up frequently and have trouble falling back to sleep.
  • Memory problems- having trouble remembering things that people tell them because they may not be fully awake when conversing
• About one out of every 2,000 people is known to have narcolepsy. There does seem to be a genetic link to it. There are more people in Japan who have it. Fewer people in Israel suffer from it. The chance that you have narcolepsy is higher when a relative also has it. It is very rare for more than two people in the same family to have this sleep disorder. It affects the same number of men and women.
• Narcolepsy can last for your entire life. It usually starts between the ages of 12 and 20. The symptoms do not get better without treatment.

Self Evaluation. If your answer to any of these questions is yes, then you might have narcolepsy.

• Is it almost impossible for you to keep from falling asleep during the day?
• Are you still sleepy even when you have had a full night of sleep?
• Do you soon feel sleepy even after you have had a long nap? Do you tend to fall asleep at unusual times during the day?
• If you are unable to move when you first fall asleep or wake up, then you almost are sure to have narcolepsy.
• Also, your sleep problems may be a result of one of the following: another sleep disorder, a medical condition, medication use, a mental health disorder or substance abuse.

Seeing a Sleep Specialist. Many primary care doctors are not always sure how to figure out if you have narcolepsy. Since it is not a common sleep problem, doctors do not see many patients who have it. Sleep specialists deal with people who have narcolepsy all the time. They have the experience and skill to help you get better. They will need to know your full medical history. They will also be sure to give you a physical exam. Finally, you will need to do two sleep studies. These sleep studies will help them evaluate your problem.

Sleep Diary. You will also want to keep a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This information gives the doctor clues about what is causing your problem and how to correct it.

Testing. To know for sure if you have narcolepsy, you will need to do two sleep studies:

• Overnight Sleep Study also called a polysomnogram, this study records a full night of sleep. This will chart your brain waves, heart beat, and breathing as you sleep. It will also record how your arms and legs move. This will show if there are other problems that are causing your sleep attacks.
• Multiple Sleep Latency Test which is a daytime test that records at least four naps which measures how fast you fall asleep during the day. It will also show what kind of sleep you have when you take a nap. Your doctor may ask that you take a test to screen for drugs before you have the MSLT. There are a number of drugs that can affect the results of the sleep study. The drug screen will help the doctor to know what the MSLT really says about your sleep problem.

Treatment. The most common way to treat narcolepsy is to use a medication. Your doctor will most likely want you to take a stimulant that helps you stay awake during the day. There are a variety of stimulants that can be used. It may take some time for your doctor to find the right medication and dosage for you.

© The Santa Fe SleepDoctor™ 2011 All Rights Reserved