The term narcolepsy comes from narco (somnolence) and leprosy (attack / crisis). Describes a condition characterized by short-term sleep episodes, which occur in small time intervals. It is a syndrome of unknown origin and implies a REM sleep dysfunction, due to the fact that this important phase of sleep appears at the inappropriate time, either at the beginning or after a night awakening.
Narcolepsy occurs in 2 to 7 people in 10,000, affecting more men than women. The age of onset varies, and can manifest from preadolescence to 50-60 years. Usually, most patients develop their first symptoms before age 35 .
It is a chronic pathology , that is to say, the patient will suffer it all the life, but of which the causes are not known. There are recent studies that claim to have a neurochemical basis, involving the monoaminergic system. However, the absence of symptoms over time may lead to confusion in the diagnosis. Thus, when cataplexy attacks occur during the sleep crisis, the diagnosis by the specialist in Clinical Neurophysiology and Sleep Medicine is easy but sometimes it can take more than 10 years without an adequate diagnosis. This happens because the symptoms do not appear at the same time: the crisis of the dream usually presents first and, years later, the cataplejía.
Yes that is remarkable the fact that in approximately half of the cases, there is some situation of stress or changes in the schedule and lack of sleep that triggers the symptoms. There is also a predisposing genetic factor in half of the patients. In the other half of patients, however, there will be no history.
There are a number of symptoms that alert the patient to narcolepsy. Among the basic symptoms are excessive daytime drowsiness and cataplexy. Sleep paralysis and hypnagonic hallucinations are also considered auxiliary symptoms.
- Excessive daytime drowsiness : Unexpectedly, and unable to control it, patients feel the need to sleep for a short time. When it occurs in pre-teens parents often notice delayed learning, lack of attention and little interest in the environment. However, when it occurs in adults, they fall asleep at family gatherings, at work or even driving. The problem is that these patients notice a family misunderstanding, as they reproach them for the fact that they are always so sleepy. At first, patients often attribute it to being more tired, but they are more distressed because, however much they want, they are unable to master sleep. These episodes can last from minutes to an hour, depending on the position of the patient. So if you are lying down you will fall asleep quickly. If, on the other hand, you try not to fall asleep (because you can not do so at that moment), the drowsiness will persist until you can sleep a few minutes. After this brief dream the patient feels comforted and active.
- Cataplejia : It is the abrupt loss of muscle tone when the patient is awake, triggered by something emotional (joy, fear, surprise ...). It can affect the whole musculature or only a part and have a duration of between seconds or even half an hour. If cataplexy is partial, it usually affects the cervical and facial muscles, accompanied by irregular breathing. This prevents them from speaking for a few seconds, but may go unnoticed. However, cataplexy can also affect muscles in the trunk and arms, preventing accurate movements. This creates great frustration in narcoleptic patients. If the involvement of the muscles is total, the person can even fall to the ground and suffer fractures and blows, sometimes confused with epileptic seizures. Cataplexy may manifest daily or be spaced out over time, although when it occurs it usually has a stable periodicity for some time. Usually episodes that last for seconds without loss of consciousness. It is the second symptom presented by patients and usually appears at 3-4 years from the first sleep attack.
- Sleep paralysis : It is a phenomenon not pleasant for the patient. Occurs when sleep begins or ends. It consists of the inability to move the body, talk and even breathe deeply, despite being awake. There is the sensation of total immobility even if it tries with all the forces. It usually lasts a few seconds or minutes and disappears abruptly, so that the patient may even fall out of bed, when the force uncontrollably reappears. The episodes frighten the patient a lot, creating anxiety and fear. If a person sees patients from outside, they seem to sleep. The problem is that he / she can not warn the rest of the people in any way, to help stop the paralysis. When doing a study of the dream it is seen that the patient wakes up from a REM stage and the brain is fully awake but his muscular strength still endures in the REM phase (with atony). It is a phenomenon that affects non-narcoleptic narcoleptic patients, especially adolescents and young adults.
- Hypnagogic hallucinations : These are dreams that occur at the time of sleeping, but can also occur upon awakening (then they are called hypnapompicas). Dreams are often intense visual components and disproportionate to reality, without consistency. Some patients say they are "seen from the outside" and can even incorporate sensory, olfactory and auditory components.
*Translated with Google translator. We apologize for any imperfection