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September 24, 2022
Living with drowsiness is living under family and social scrutiny. “The symptoms usually cause social, family and work dysfunction, so patients without timely help face an unknown condition on their own,” explains neurologist Frank Villarreal, specialist in Sleep Disorders at Clinica Ricardo Palma. He warns that social isolation increases the risk of suffering from mental and cardiovascular diseases. “In children and young people, it is common to see student failure and behavioral changes, anger and frustration,” he says.
What is narcolepsy and what are its symptoms?
Narcolepsy is a rare disease characterized by the normal interruption of the wake and sleep cycles. It classically manifests with excessive daytime sleepiness accompanied or not by cataplexy (sudden episodes of muscle weakness that cause falls and are usually caused by unexpected emotions).
Its most frequent symptoms are:
In addition to hypnagogic hallucinations (when falling asleep) or hypnopompic (waking up), which are multisensory experiences perceived as “almost real” of generally distressing events. Unrefreshing sleep and sleep attacks (compelling and unavoidable need to take a nap), which are rarely preventable and occur at any time.
This pathology affects from 3 to 67 people per 100,000 inhabitants. It usually manifests itself between the ages of 10 and 20. However, it sometimes begins at younger ages and very rarely at later ages. There is no clear association with sex. Some studies reveal that it shows more prevalence in men than in women (with a ratio of 3 men for every 2 women).
How is it diagnosed?
In the consultation, the specialist looks for the frequent causes of daytime sleepiness in the patient, such as: voluntary sleep deprivation, sleep apnea, periodic movements of the limbs, insomnia, and organic or pharmacological causes.
The next step is to perform an overnight sleep study, followed by a multiple latency test. This test measures how easily a person falls asleep and how long it takes to initiate rapid eye movement (REM) sleep. Additional studies may be performed, according to the clinical suspicion of the attending physician.
Treatment
The treatment is intended to help the patient lead a full and happy life. They are explained what the disease consists of and strategies are designed that allow them to face their work despite the symptoms.
Meanwhile, pharmacological treatment seeks to reduce daytime sleepiness and episodes of cataplexy. There is a need for other multidisciplinary interventions aimed at managing other comorbidities that may appear as mood and mood disorders, insomnia, respiratory sleep disorders, among others.
So far narcolepsy has no definitive cure, however, drug treatments have made significant progress in the last 5 years.
Dr. Frank Villarreal
Neurologist specializing in sleep disorders at Clinica Ricardo Palma