Causative & risk factors
The exact cause of narcolepsy is not known, however it has a genetic basis. Narcolepsy probably has a multifactorial etiology.
Clinical presentation
A narcoleptic person experiences excessive daytime sleepiness, in spite of sufficient sleep at night. He may experience confusion, fatigue, depression and problems with memory. He may develop cataplexy in which there is sudden loss of muscle tone. Cataplexy is usually triggered by intense emotions. Hallucinations may be experienced during sleep or wakefulness. He may also experience brief episodes of sleep paralysis.
Investigations
For every patient suspected with narcolepsy, 2 tests are advised: Polysomnography and MSLT.
Polysomnography is essentially a sleep study in which various electrodes and sensors are attached to the patient’s body while he sleeps throughout the night. Several measurements are taken throughout the night including ECG (electrocrdiography), EEG (electroencephalography), chest movements etc.
A multiple sleep latency test (MSLT) is performed in the daytime. The patient is asked to take frequent naps through the day and his sleep pattern is analysed.
Treatment
Narcolepsy cannot be cured, yet the symptoms can be managed with medications. Medications include antidepressant and amphetamine-like stimulants. The patient must avoid activities which can contribute to daytime sleepiness such as heavy meals, alcohol, caffeine etc.
Recent updates
A new medication known as Xyrem has recently been discovered to help patients with narcolepsy.
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