Tag Archives: Narcolepsy

Narcolepsy

Definition:
Narcolepsy is chronic sleep disorder, or dyssomnia. The condition is characterized by excessive daytime sleepiness (EDS) in which a person experiences extreme fatigue and possibly falls asleep at inappropriate times, such as whilst at work or at school. A narcoleptic will most probably experience disturbed nocturnal sleep and also abnormal daytime sleep pattern, which is often confused with insomnia. When a person with narcolepsy falls asleep or goes to bed they will generally experience the 4th stage of sleep REM (rapid eye movement/dreaming state), within 10 minutes; whereas for most people, this shouldn’t occur until generally 30 minutes of slumber.
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Cataplexy, a sudden muscular weakness brought on by strong emotions (in most cases, there are many people who will experience cataplexy without having a emotional trigger), is known to be one of the other problems that some narcoleptics will experience. Often manifesting as muscular weaknesses ranging from a barely perceptible slackening of the facial muscles to the dropping of the jaw or head, weakness at the knees, or a total collapse. Usually only speech is slurred, vision is impaired (double vision, inability to focus), but hearing and awareness remain normal. In some rare cases, an individual’s body becomes paralyzed and muscles will become stiff.

The term narcolepsy derives from the French word narcolepsie created by the French physician Jean-Baptiste-Édouard Gélineau by combining the Greek narke numbness, stupor and lepsis attack, seizure.

Symptoms
The main characteristic of narcolepsy is excessive daytime sleepiness (EDS), even after adequate night time sleep. A person with narcolepsy is likely to become drowsy or fall asleep, often at inappropriate times and places. Daytime naps may occur with little warning and may be physically irresistible. These naps can occur several times a day. They are typically refreshing, but only for a few hours. Drowsiness may persist for prolonged periods of time. In addition, night time sleep may be fragmented with frequent awakenings.

Four other classic symptoms of the disorder, often referred to as the “tetrad of narcolepsy,” are cataplexy, sleep paralysis, hypnagogic hallucinations, and automatic behavior. These symptoms may not occur in all patients. Cataplexy is an episodic condition featuring loss of muscle function, ranging from slight weakness (such as limpness at the neck or knees, sagging facial muscles, or inability to speak clearly) to complete body collapse. Episodes may be triggered by sudden emotional reactions such as laughter, anger, surprise, or fear, and may last from a few seconds to several minutes. The person remains conscious throughout the episode. In some cases, cataplexy may resemble epileptic seizures. Sleep paralysis is the temporary inability to talk or move when waking (or less often, falling asleep). It may last a few seconds to minutes. This is often frightening but is not dangerous. Hypnagogic hallucinations are vivid, often frightening, dreamlike experiences that occur while dozing, falling asleep and/or while awakening.

Automatic behavior means that a person continues to function (talking, putting things away, etc.) during sleep episodes, but awakens with no memory of performing such activities. It is estimated that up to 40 percent of people with narcolepsy experience automatic behavior during sleep episodes. Sleep paralysis and hypnagogic hallucinations also occur in people who do not have narcolepsy, but more frequently in people who are suffering from extreme lack of sleep. Cataplexy is generally considered to be unique to narcolepsy and is analogous to sleep paralysis in that the usually protective paralysis mechanism occurring during sleep is inappropriately activated. The opposite of this situation (failure to activate this protective paralysis) occurs in rapid eye movement behavior disorder.

In most cases, the first symptom of narcolepsy to appear is excessive and overwhelming daytime sleepiness. The other symptoms may begin alone or in combination months or years after the onset of the daytime naps. There are wide variations in the development, severity, and order of appearance of cataplexy, sleep paralysis, and hypnagogic hallucinations in individuals. Only about 20 to 25 percent of people with narcolepsy experience all four symptoms. The excessive daytime sleepiness generally persists throughout life, but sleep paralysis and hypnagogic hallucinations may not.

Although these are the common symptoms of narcolepsy, many people with narcolepsy also suffer from insomnia for extended periods of time. The symptoms of narcolepsy, especially the excessive daytime sleepiness and cataplexy, often become severe enough to cause serious problems in a person’s social, personal, and professional life. Normally, when an individual is awake, brain waves show a regular rhythm. When a person first falls asleep, the brain waves become slower and less regular. This sleep state is called non-rapid eye movement (NREM) sleep. After about an hour and a half of NREM sleep, the brain waves begin to show a more active pattern again. This sleep state, called REM sleep (rapid eye movement sleep), is when most remembered dreaming occurs. Associated with the EEG-observed waves during REM sleep, muscle atonia is present (called REM atonia).

In narcolepsy, the order and length of NREM and REM sleep periods are disturbed, with REM sleep occurring at sleep onset instead of after a period of NREM sleep. Thus, narcolepsy is a disorder in which REM sleep appears at an abnormal time. Also, some of the aspects of REM sleep that normally occur only during sleep — lack of muscular control, sleep paralysis, and vivid dreams — occur at other times in people with narcolepsy. For example, the lack of muscular control can occur during wakefulness in a cataplexy episode; it is said that there is intrusion of REM atonia during wakefulness. Sleep paralysis and vivid dreams can occur while falling asleep or waking up. Simply put, the brain does not pass through the normal stages of dozing and deep sleep but goes directly into (and out of) rapid eye movement (REM) sleep.

This has several consequences. Night time sleep does not include as much deep sleep, so the brain tries to “catch up” during the day, hence EDS. People with narcolepsy may visibly fall asleep at unpredicted moments (such motions as head bobbing are common). People with narcolepsy fall quickly into what appears to be very deep sleep, and they wake up suddenly and can be disoriented when they do (dizziness is a common occurrence). They have very vivid dreams, which they often remember in great detail. People with narcolepsy may dream even when they only fall asleep for a few seconds.

Causes
Although the cause of narcolepsy was not determined for many years after its discovery, scientists had discovered conditions that seemed to be associated with an increase in an individual’s risk of having the disorder. Specifically, there appeared to be a strong link between narcoleptic individuals and certain genetic conditions. One factor that seemed to predispose an individual to narcolepsy involved an area of Chromosome 6 known as the HLA complex. There appeared to be a correlation between narcoleptic individuals and certain variations in HLA genes, although it was not required for the condition to occur. Certain variations in the HLA complex were thought to increase the risk of an auto-immune response to protein-producing neurons in the brain. The protein produced, called hypocretin or orexin, is responsible for controlling appetite and sleep patterns. Individuals with narcolepsy often have reduced numbers of these protein-producing neurons in their brains. In 2009 the autoimmune hypothesis was supported by research carried out at Stanford University School of Medicine.

The neural control of normal sleep states and the relationship to narcolepsy are only partially understood. In humans, narcoleptic sleep is characterized by a tendency to go abruptly from a waking state to REM sleep with little or no intervening non-REM sleep. The changes in the motor and proprioceptive systems during REM sleep have been studied in both human and animal models. During normal REM sleep, spinal and brainstem alpha motor neuron depolarization produces almost complete atonia of skeletal muscles via an inhibitory descending reticulospinal pathway. Acetylcholine may be one of the neurotransmitters involved in this pathway. In narcolepsy, the reflex inhibition of the motor system seen in cataplexy is believed identical to that seen in normal REM sleep.

In 2004 researchers in Australia induced narcolepsy-like symptoms in mice by injecting them with antibodies from narcoleptic humans. The research has been published in the Lancet providing strong evidence suggesting that some cases of narcolepsy might be caused by autoimmune disease. Narcolepsy is strongly associated with HLA-DQB1*0602 genotype. There is also an association with HLA-DR2 and HLA-DQ1. This may represent linkage disequilibrium. Despite the experimental evidence in human narcolepsy that there may be an inherited basis for at least some forms of narcolepsy, the mode of inheritance remains unknown. Some cases are associated with genetic diseases such as Niemann-Pick disease or Prader-Willi syndrome.

How common is narcolepsy
The prevalence of narcolepsy is similar to that of Parkinson’s disease and multiple sclerosis. In the United States, the National Institute of Neurological Disorders and Stroke estimates narcolepsy affects one in every 2,000 people. However, in some countries (for example, Israel), the prevalence of narcolepsy is much lower (one per 500,000) while in other countries (for example, Japan), it is much higher (one per 600). The American Sleep Association estimates that approximately 125,000 to 200,000 Americans suffer from narcolepsy, but only fewer than 50,000 are properly diagnosed.

Narcolepsy often remains undiagnosed or misdiagnosed for several years. This may occur because physicians do not consider the diagnosis of narcolepsy frequently enough. They may think of narcolepsy only in people who have the main symptom of excessive daytime sleepiness. Narcolepsy may not be considered in the evaluation of patients who come to doctors complaining of fatigue, tiredness, or problems with concentration, attention, memory, and performance, and other illnesses (seizures, mental illness, etc.).
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Narcolepsy has its typical onset in adolescence and young adulthood. There is an average 15-year delay between onset and correct diagnosis which may contribute substantially to the disabling features of the disorder. Cognitive, educational, occupational, and psychosocial problems associated with the excessive daytime sleepiness of narcolepsy have been documented. For these to occur in the crucial teen years when education, development of self-image, and development of occupational choice are taking place is especially damaging. While cognitive impairment does occur, it may only be a reflection of the excessive daytime somnolence.

The prevalence of narcolepsy is about 1 per 2,000 persons. It is a reason for patient visits to sleep disorder centers, and with its onset in adolescence, it is also a major cause of learning difficulty and absenteeism from school. Normal teenagers often already experience excessive daytime sleepiness because of a maturational increase in physiological sleep tendency accentuated by multiple educational and social pressures; this may be disabling with the addition of narcolepsy symptoms in susceptible teenagers. In clinical practice, the differentiation between narcolepsy and other conditions characterized by excessive somnolence may be difficult. Treatment options are currently limited. There is a paucity in the literature of controlled double-blind studies of possible effective drugs or other forms of therapy. Mechanisms of action of some of the few available therapeutic agents have been explored but detailed studies of mechanisms of action are needed before new classes of therapeutic agents can be developed. Narcolepsy is an underdiagnosed condition in the general population. This is partly because its severity varies from obvious to barely noticeable. Some people with narcolepsy do not suffer from loss of muscle control. Others may only feel sleepy in the evenings.

Diagnosis
Diagnosis is relatively easy when all the symptoms of narcolepsy are present, but if the sleep attacks are isolated and cataplexy is mild or absent, diagnosis is more difficult. It is also possible for cataplexy to occur in isolation. Two tests that are commonly used in diagnosing narcolepsy are the polysomnogram and the multiple sleep latency test (MSLT). These tests are usually performed by a sleep specialist. The polysomnogram involves continuous recording of sleep brain waves and a number of nerve and muscle functions during nighttime sleep. When tested, people with narcolepsy fall asleep rapidly, enter REM sleep early, and may awaken often during the night. The polysomnogram also helps to detect other possible sleep disorders that could cause daytime sleepiness.

For the multiple sleep latency test, a person is given a chance to sleep every 2 hours during normal wake times. Observations are made of the time taken to reach various stages of sleep (sleep onset latency). This test measures the degree of daytime sleepiness and also detects how soon REM sleep begins. Again, people with narcolepsy fall asleep rapidly and enter REM sleep early.
You may click to learn more     http://www.medicinenet.com/narcolepsy/page4.htm

Treatment
Treatment is tailored to the individual, based on symptoms and therapeutic response. The time required to achieve optimal control of symptoms is highly variable, and may take several months or longer. Medication adjustments are also frequently necessary, and complete control of symptoms is seldom possible. While oral medications are the mainstay of formal narcolepsy treatment, lifestyle changes are also important.

The main treatment of excessive daytime sleepiness in narcolepsy is with a group of drugs called central nervous system stimulants such as methylphenidate, racemic – amphetamine, dextroamphetamine, and methamphetamine, or modafinil, a new stimulant with a different pharmacologic mechanism. In Fall 2007 an alert for severe adverse skin reactions to modafinil was issued by the FDA.  Other medications used are codeine and selegiline. Another drug that is used is atomoxetine (Strattera), a non-stimulant and Norepinephrine reuptake inhibitor (NRI), that has little or no abuse potential. In many cases, planned regular short naps can reduce the need for pharmacological treatment of the EDS to a low or non-existent level.

Cataplexy and other REM-sleep symptoms are frequently treated with tricyclic antidepressants such as clomipramine, imipramine, or protriptyline, as well as other drugs that suppress REM sleep. Venlafaxine, a newer antidepressant which blocks the reuptake of serotonin and norepinephrine, has shown usefulness in managing symptoms of cataplexy[citation needed]. Gamma-hydroxybutyrate (GHB), a medication recently approved by the FDA, is the only medication specifically indicated for cataplexy. Gamma-hydroxybutyrate has also been shown to reduce symptoms of EDS associated with narcolepsy. While the exact mechanism of action is unknown, GHB is thought to improve the quality of nocturnal sleep.

In addition to drug therapy, an important part of treatment is scheduling short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness and help the person stay as alert as possible. Daytime naps are not a replacement for nighttime sleep. Ongoing communication between the health care provider, patient, and the patient’s family members is important for optimal management of narcolepsy. Finally, a recent study reported that transplantation of hypocretin neurons into the pontine reticular formation in rats is feasible, indicating the development of alternative therapeutic strategies in addition to pharmacological interventions.

Learning as much about narcolepsy as possible and developing a support system or finding a support group may help patients and families deal with the practical and emotional effects of the disorder, possible occupational limitations, and situations that might cause injury. Individuals with narcolepsy should avoid jobs that require driving long distances or handling hazardous equipment or that require alertness for lengthy periods. They may find it helps to take a nap before driving if possible or have a scheduled nap break during a long driving trip.
Click to learn more-> 1.Medication 2.Non Medication treatment

The National Sleep Foundation, University at Buffalo, and Mayo Clinic suggest it may help sufferers if they alert their employers, co-workers and friends in the hope that others will accommodate their condition and help when needed. The foundation say it may help if the sufferer breaks up larger tasks into small pieces and focuses on one small thing at a time, and if they carry a tape recorder, if possible, to record important conversations and meetings. The clinics say taking several short walks during the day may help sufferers.

What’s in the future for narcolepsy?

The discovery that a lack of hypocretins in the cerebrospinal fluid (CSF) may be related to the cause of narcolepsy could lead to the development of tests to determine the level of hypocretins in the CSF. Such tests could help in the diagnosis of narcolepsy. The expectation is that these tests will be simple (drawing blood), and will reflect the level of hypocretins in the CSF. In addition, the discovery of the role of hypocretins in the development of narcolepsy may lead to the development of new drugs for the treatment of narcolepsy.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


Resources:

http://en.wikipedia.org/wiki/Narcolepsy
http://www.medicinenet.com/narcolepsy/article.htm

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Narcolepsy

Definition:
Narcolepsy is a chronic neurological disorder caused by the brain’s inability to regulate sleep-wake cycles normally. At various times throughout the day, people with narcolepsy experience fleeting urges to sleep. If the urge becomes overwhelming, patients fall asleep for periods lasting from a few seconds to several minutes. In rare cases, some people may remain asleep for an hour or longer.

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Narcoleptic sleep episodes can occur at any time, and thus frequently prove profoundly disabling. People may involuntarily fall asleep while at work or at school, when having a conversation, playing a game, eating a meal, or, most dangerously, when driving an automobile or operating other types of potentially hazardous machinery. In addition to daytime sleepiness, three other major symptoms frequently characterize narcolepsy: cataplexy, or the sudden loss of voluntary muscle tone; vivid hallucinations during sleep onset or upon awakening; and brief episodes of total paralysis at the beginning or end of sleep.

Contrary to common beliefs, people with narcolepsy do not spend a substantially greater proportion of their time asleep during a 24-hour period than do normal sleepers. In addition to daytime drowsiness and involuntary sleep episodes, most patients also experience frequent awakenings during nighttime sleep. For these reasons, narcolepsy is considered to be a disorder of the normal boundaries between the sleeping and waking states.

For most adults, a normal night’s sleep lasts about 8 hours and is composed of four to six separate sleep cycles. A sleep cycle is defined by a segment of non-rapid eye movement (NREM) sleep followed by a period of rapid eye movement (REM) sleep. The NREM segment can be further divided into stages according to the size and frequency of brain waves. REM sleep, in contrast, is accompanied by bursts of rapid eye movement (hence the acronym REM sleep) along with sharply heightened brain activity and temporary paralysis of the muscles that control posture and body movement. When subjects are awakened from sleep, they report that they were “having a dream” more often if they had been in REM sleep than if they had been in NREM sleep. Transitions from NREM to REM sleep are governed by interactions among groups of neurons (nerve cells) in certain parts of the brain.

Scientists now believe that narcolepsy results from disease processes affecting brain mechanisms that regulate REM sleep. For normal sleepers a typical sleep cycle is about 100 – 110 minutes long, beginning with NREM sleep and transitioning to REM sleep after 80 – 100 minutes. But, people with narcolepsy frequently enter REM sleep within a few minutes of falling asleep.

Who Gets Narcolepsy?
Narcolepsy is not rare, but it is an underrecognized and underdiagnosed condition. The disorder is estimated to affect about one in every 2,000 Americans. But the exact prevalence rate remains uncerntain, and the disorder may affect a larger segment of the population.

Narcolepsy appears throughout the world in every racial and ethnic group, affecting males and females equally. But prevalence rates vary among populations. Compared to the U.S. population, for example, the prevalence rate is substantially lower in Israel (about one per 500,000) and considerably higher in Japan (about one per 600).

Most cases of narcolepsy are sporadic-that is, the disorder occurs independently in individuals without strong evidence of being inherited. But familial clusters are known to occur. Up to 10 percent of patients diagnosed with narcolepsy with cataplexy report having a close relative with the same symptoms. Genetic factors alone are not sufficient to cause narcolepsy. Other factors-such as infection, immune-system dysfunction, trauma, hormonal changes, stress-may also be present before the disease develops. Thus, while close relatives of people with narcolepsy have a statistically higher risk of developing the disorder than do members of the general population, that risk remains low in comparison to diseases that are purely genetic in origin.

* Obstructive sleep apnea is a temporary cessation of breathing that occurs repeatedly during sleep and is caused by a narrowing of the airway. Restless legs syndrome is a neurological disorder characterized by unpleasant sensations-burning, creeping, tugging-in the legs and an uncontrollable urge to move when at rest


Symptoms:

The main characteristic of narcolepsy is excessive daytime sleepiness (EDS), even after adequate night time sleep. A person with narcolepsy is likely to become drowsy or to fall asleep, often at inappropriate times and places. Daytime naps may occur without warning and may be physically irresistible. These naps can occur several times a day. They are typically refreshing, but only for a few hours. Drowsiness may persist for prolonged periods of time. In addition, night time sleep may be fragmented with frequent awakenings.

Four other “classic” symptoms of narcolepsy, which may not occur in all patients, are cataplexy, sleep paralysis, hypnogogic hallucinations, and automatic behavior. Cataplexy is an episodic condition featuring loss of muscle function, ranging from slight weakness (such as limpness at the neck or knees, sagging facial muscles, or inability to speak clearly) to complete body collapse. Episodes may be triggered by sudden emotional reactions such as laughter, anger, surprise, or fear, and may last from a few seconds to several minutes. The person remains conscious throughout the episode. Sleep paralysis is the temporary inability to talk or move when waking (or less often, falling asleep). It may last a few seconds to minutes. This is often frightening but is not dangerous. Hypnagogic hallucinations are vivid, often frightening, dreamlike experiences that occur while dozing, falling asleep and/or while awakening. Automatic behavior means that a person continues to function (talking, putting things away, etc.) during sleep episodes, but awakens with no memory of performing such activities. It is estimated that up to 40 percent of people with narcolepsy experience automatic behavior during sleep episodes. , sleep paralysis, and hypnagogic hallucinations also occur in people who do not have narcolepsy, more frequently in people who are suffering from extreme lack of sleep. Cataplexy is generally considered to be unique to narcolepsy and is analogous to sleep paralysis in that the usually protective paralysis mechanism occurring during sleep is inappropriately activated. The opposite of this situation (failure to activate this protective paralysis) occurs in rapid eye movement behavior disorder.

In most cases, the first symptom of narcolepsy to appear is excessive and overwhelming daytime sleepiness. The other symptoms may begin alone or in combination months or years after the onset of the daytime naps. There are wide variations in the development, severity, and order of appearance of cataplexy, sleep paralysis, and hypnagogic hallucinations in individuals. Only about 20 to 25 percent of people with narcolepsy experience all four symptoms. The excessive daytime sleepiness generally persists throughout life, but sleep paralysis and hypnagogic hallucinations may not.

Although these are the common symptoms of narcolepsy, many (although less than 40% of people with narcolepsy)[citation needed] also suffer from insomnia for extended periods of time.

The symptoms of narcolepsy, especially the excessive daytime sleepiness and cataplexy, often become severe enough to cause serious problems in a person’s social, personal, and professional life.

Normally, when an individual is awake, brain waves show a regular rhythm. When a person first falls asleep, the brain waves become slower and less regular. This sleep state is called non-rapid eye movement (NREM) sleep. After about an hour and a half of NREM sleep, the brain waves begin to show a more active pattern again. This sleep state, called REM sleep (rapid eye movement sleep), is when most remembered dreaming occurs. Associated with the EEG-observed waves during REM sleep, muscle atonia is present (called REM atonia).

In narcolepsy, the order and length of NREM and REM sleep periods are disturbed, with REM sleep occurring at sleep onset instead of after a period of NREM sleep. Thus, narcolepsy is a disorder in which REM sleep appears at an abnormal time. Also, some of the aspects of REM sleep that normally occur only during sleep — lack of muscular control, sleep paralysis, and vivid dreams — occur at other times in people with narcolepsy. For example, the lack of muscular control can occur during wakefulness in a cataplexy episode; it is said that there is intrusion of REM atonia during wakefulness. Sleep paralysis and vivid dreams can occur while falling asleep or waking up. Simply put, the brain does not pass through the normal stages of dozing and deep sleep but goes directly into (and out of) rapid eye movement (REM) sleep. This has several consequences:

*Night time sleep does not include as much deep sleep, so the brain tries to “catch up” during the day, hence EDS.
*People with narcolepsy may visibly fall asleep at unpredicted moments (such motions as head bobbing are common).
*People with narcolepsy fall quickly into what appears to be very deep sleep.
*They wake up suddenly and can be disoriented when they do (dizziness is a common occurrence).
*They have very vivid dreams, which they often remember in great detail.
*People with narcolepsy may dream even when they only fall asleep for a few seconds.

Causes:
While the cause of narcolepsy has not yet been determined, scientists have discovered conditions that may increase an individual’s risk of having the disorder. Specifically, there appears to be a strong link between narcoleptic individuals and certain genetic conditions. One factor that may predispose an individual to narcolepsy involves an area of Chromosome 6 known as the HLA complex. There appears to be a correlation between narcoleptic individuals and certain variations in HLA genes, although it is not required for the condition to occur.

Certain variations in the HLA complex are thought to increase the risk of an auto-immune response to protein-producing neurons in the brain. The protein produced, called hypocretin or orexin, is responsible for controlling appetite and sleep patterns. Individuals with narcolepsy often have reduced numbers of these protein-producing neurons in their brains.

The neural control of normal sleep states and the relationship to narcolepsy are only partially understood. In humans, narcoleptic sleep is characterized by a tendency to go abruptly from a waking state to REM sleep with little or no intervening non-REM sleep. The changes in the motor and proprioceptive systems during REM sleep have been studied in both human and animal models. During normal REM sleep, spinal and brainstem alpha motor neuron depolarization produces almost complete atonia of skeletal muscles via an inhibitory descending reticulospinal pathway. Acetylcholine may be one of the neurotransmitters involved in this pathway. In narcolepsy, the reflex inhibition of the motor system seen in cataplexy is believed identical to that seen in normal REM sleep.

In 2004 researchers in Australia induced narcolepsy-like symptoms in mice by injecting them with antibodies from narcoleptic humans. The research has been published in the Lancet providing strong evidence suggesting that some cases of narcolepsy might be caused by autoimmune disease.

Narcolepsy is strongly associated with HLA DQB1*0602 genotype. There is also an association with HLA DR2 and HLA DQ1. This may represent linkage disequilibrium.

Despite the experimental evidence in human narcolepsy that there may be an inherited basis for at least some forms of narcolepsy, the mode of inheritance remains unknown.

Some cases are associated with genetic diseases such as Niemann-Pick disease or Prader-Willi syndrome.

Diagnosis:

Narcolepsy is not definitively diagnosed in most patients until 10 to 15 years after the first symptoms appear. This unusually long lag-time is due to several factors, including the disorder’s subtle onset and the variability of symptoms. As important, however, is the fact that the public is largely unfamiliar with the disorder, as are many health professionals. When symptoms initially develop, people often do not recognize that they are experiencing the onset of a distinct neurological disorder and thus fail to seek medical treatment.

A clinical examination and exhaustive medical history are essential for diagnosis and treatment. However, none of the major symptoms is exclusive to narcolepsy. EDS-the most common of all narcoleptic symptoms-can result from a wide range of medical conditions, including other sleep disorders such as sleep apnea, various viral or bacterial infections, mood disorders such as depression, and painful chronic illnesses such as congestive heart failure and rheumatoid arthritis that disrupt normal sleep patterns. Various medications can also lead to EDS, as can consumption of caffeine, alcohol, and nicotine. Finally, sleep deprivation has become one of the most common causes of EDS among Americans.

This lack of specificity greatly increases the difficulty of arriving at an accurate diagnosis based on a consideration of symptoms alone. Thus, a battery of specialized tests, which can be performed in a sleep disorders clinic, is usually required before a diagnosis can be established.

Two tests in particular are considered essential in confirming a diagnosis of narcolepsy: the polysomnogram (PSG) and the multiple sleep latency test (MSLT). The PSG is an overnight test that takes continuous multiple measurements while a patient is asleep to document abnormalities in the sleep cycle. It records heart and respiratory rates, electrical activity in the brain through electroencephalography (EEG), and nerve activity in muscles through electromyography (EMG). A PSG can help reveal whether REM sleep occurs at abnormal times in the sleep cycle and can eliminate the possibility that an individual’s symptoms result from another condition.

The MSLT is performed during the day to measure a person’s tendency to fall asleep and to determine whether isolated elements of REM sleep intrude at inappropriate times during the waking hours. As part of the test, an individual is asked to take four or five short naps usually scheduled 2 hours apart over the course of a day. As the name suggests, the sleep latency test measures the amount of time it takes for a person to fall asleep. Because sleep latency periods are normally 10 minutes or longer, a latency period of 5 minutes or less is considered suggestive of narcolepsy. The MSLT also measures heart and respiratory rates, records nerve activity in muscles, and pinpoints the occurrence of abnormally timed REM episodes through EEG recordings. If a person enters REM sleep either at the beginning or within a few minutes of sleep onset during at least two of the scheduled naps, this is also considered a positive indication of narcolepsy.

Treatment:
The drowsiness is normally treated using amphetamine-like stimulants such as methylphenidate, racemic amphetamine, dextroamphetamine, and methamphetamine, or modafinil, a new stimulant with a different pharmacologic mechanism. In Fall 2007 an alert for severe adverse reactions to modafinil was issued by the FDA .

Other medications used are codeine and selegiline. Another drug that is used is atomoxetine (Strattera), a non-stimulant and Norepinephrine reuptake inhibitor (NRI), that has little or no abuse potential. In many cases, planned regular short naps can reduce the need for pharmacological treatment of the EDS to a low or non-existent level. Cataplexy is frequently treated with tricyclic antidepressants such as clomipramine, imipramine, or protriptyline. Venlafaxine, a newer antidepressant which blocks the reuptake of serotonin and norepinephrine, has shown usefulness in managing symptoms of cataplexy. Gamma-hydroxybutyrate (GHB), a medication recently approved by the US Food and Drug Administration, is the only medication specifically indicated for cataplexy. Gamma-hydroxybutyrate has also been shown to reduce symptoms of EDS associated with narcolepsy. While the exact mechanism of action is unknown, GHB is thought to improve the quality of nocturnal sleep.

Treatment is tailored to the individual based on symptoms and therapeutic response. The time required to achieve optimal control of symptoms is highly variable, and may take several months or longer. Medication adjustments are also frequently necessary, and complete control of symptoms is seldom possible. While oral medications are the mainstay of formal narcolepsy treatment, lifestyle changes are also important. The main treatment of excessive daytime sleepiness in narcolepsy is with a group of drugs called central nervous system stimulants. For cataplexy and other REM-sleep symptoms, antidepressant medications and other drugs that suppress REM sleep are prescribed.

In addition to drug therapy, an important part of treatment is scheduling short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness and help the person stay as alert as possible. Daytime naps are not a replacement for nighttime sleep.

Ongoing communication between the health care provider, patient, and the patient’s family members is important for optimal management of narcolepsy.

Finally, a recent study reported that transplantation of hypocretin neurons into the pontine reticular formation in rats is feasible, indicating the development of alternative therapeutic strategies in addition to pharmacological interventions.

Click & see the Alternative Treatments for narcolepsy  :-

Herbal Remedies for Narcolepsy

Natural herbal & homeopathic remedies for narcolepsy

11 Natural cures for Narcolepsy

 Herbal Remedies For Narcolepsy
Lifestyle and home remedies for Narcolepsy

Coping with narcolepsy:
Learning as much about narcolepsy as possible and finding a support system can help patients and families deal with the practical and emotional effects of the disorder, possible occupational limitations, and situations that might cause injury. A variety of educational and other materials are available from sleep medicine or narcolepsy organizations.

Support groups exist to help persons with narcolepsy and their families.

To imagine what a person with narcolepsy copes with daily, keep in mind that while many are not sleep-deprived (in the classical sense), a major symptom of narcolepsy is akin to sleep deprivation in a normal person; as a normal person, imagine going years functioning off just 3-4 hours of sleep per night. While lifestyle changes and drug therapy can help largely mitigate many symptoms of narcolepsy, there currently exists no complete and permanent solution, therefore patience, empathy and self-education are excellent coping tools.

Individuals with narcolepsy, their families, friends, and potential employers should know that:

Narcolepsy is a life-long condition that may require continuous medication.
Although there is no cure for narcolepsy at present, several medications can help reduce its symptoms.
People with narcolepsy can lead productive lives with proper medical care and lifestyle changes.
A major physiological and physical effect of narcolepsy is roughly akin to the effects of sleep deprivation; such effects can often be controlled and minimized through a combination of lifestyle changes and drug therapy.
Individuals with narcolepsy should avoid jobs that require driving long distances or handling hazardous equipment or that require alertness for lengthy periods (especially where the consequences of falling asleep are dangerous to themselves or others).
Parents, teachers, spouses, and employers should be aware of the symptoms of narcolepsy. This will help them avoid the mistake of confusing the person’s behavior with laziness, hostility, rejection, or lack of interest and motivation. It will also help them provide essential support and cooperation.
Employers can promote better working opportunities for individuals with narcolepsy by permitting special work schedules and nap breaks.
Doctors generally agree that lifestyle changes can be very helpful to those suffering with narcolepsy. Suggested self-care tips, from the National Sleep Foundation, University at Buffalo, and Mayo Clinic, include:

Take several short daily naps (10-15 minutes) to combat excessive sleepiness and sleep attacks.
Develop a routine sleep schedule – try to go to sleep and awaken at the same time every day.
Alert your employers, co-workers and friends in the hope that others will accommodate your condition and help when needed.
Do not drive or operate dangerous equipment if you are sleepy. Take a nap before driving if possible. Consider taking a break for a nap during a long driving trip.
Join a support group.
Break up larger tasks into small pieces and focusing on one small thing at a time.
Take several short walks during the day.
Carry a tape recorder, if possible, to record important conversations and meetings.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

What Research is Being Done?
Within the Federal government, the National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health (NIH), has primary responsibility for sponsoring research on neurological disorders. As part of its mission, the NINDS supports research on narcolepsy and other sleep disorders with a neurological basis through grants to major medical institutions across the country.

Within the National Heart, Lung, and Blood Institute, also a component of the NIH, the National Center on Sleep Disorders Research (NCSDR) coordinates Federal government sleep research activities and shares information with private and nonprofit groups. NCSDR staff also promote doctoral and postdoctoral training programs, and educates the public and health care professional about sleep disorders. For more information, go to the NCSDR website at http://www.nhlbi.nih.gov/about/ncsdr/index.htm.

NINDS-sponsored researchers are conducting studies devoted to further clarifying the wide range of genetic factors-both HLA genes and non-HLA genes-that may cause narcolepsy. Other scientists are conducting investigations using animal models to identify neurotransmitters other than the hypocretins that may contribute to disease development. A greater understanding of the complex genetic and biochemical bases of narcolepsy will eventually lead to the formulation of new therapies to control symptoms and may lead to a cure. Researchers are also investigating the modes of action of wake-promoting compounds to widen the range of available therapeutic options.

Scientists have long suspected that abnormal immunological processes may be an important element in the cause of narcolepsy, but until recently clear evidence supporting this suspicion has been lacking. NINDS-sponsored scientists have recently uncovered evidence demonstrating the presence of unusual, possibly pathological, forms of immunological activity in narcoleptic dogs. These researchers are now investigating whether drugs that suppress immunological processes may interrupt the development of narcolepsy in this animal model.

Recently there has been a growing awareness that narcolepsy can develop during childhood and may contribute to the development of behavior disorders. A group of NINDS-sponsored scientists is now conducting a large epidemiological study to determine the prevalence of narcolepsy in children aged 2 to 14 years who have been diagnosed with attention-deficit hyperactivity disorder.

Finally, the NINDS continues to support investigations into the basic biology of sleep, including the brain mechanisms involved in generating and regulating REM sleep. Scientists are now examining physiological processes occurring in a portion of the hindbrain called the amygdala in order to uncover novel biochemical processes underlying REM sleep. A more comprehensive understanding of the complex biology of sleep will undoubtedly further clarify the pathological processes that underlie narcolepsy and other sleep disorders.

How Can you Help Research?
The NINDS contributes to the support of the Human Brain and Spinal Fluid Resource Center in Los Angeles. This bank supplies investigators around the world with tissue from patients with neurological and other disorders. Tissue from individuals with narcolepsy is needed to enable scientists to study this disorder more intensely. Prospective donors may contact:

Human Brain and Spinal Fluid Resource Center
Neurology Research (127A)
W. Los Angeles Healthcare Center
11301 Wilshire Blvd. Bldg. 212
Los Angeles, CA 90073
310-268-3536
24-hour pager: 310-636-5199
Email: RMNbbank@ucla.edu
http://www.loni.ucla.edu/~nnrsb/NNRSB

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Where you can get more information?

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
http://www.ninds.nih.gov

Information also is available from the following organizations:

Narcolepsy Network, Inc.
79 Main Street
North Kingstown, RI 02852
narnet@narcolepsynetwork.org

Home NEW


Tel: 888-292-6522 401-667-2523
Fax: 401-633-6567

National Sleep Foundation
1522 K Street NW
Suite 500
Washington, DC 20005
nsf@sleepfoundation.org
http://www.sleepfoundation.org
Tel: 202-347-3472
Fax: 202-347-3472

National Heart, Lung, and Blood Institute (NHBLI)
National Institutes of Health, DHHS
31 Center Drive, Rm. 4A21 MSC 2480
Bethesda, MD 20892-2480
http://www.nhlbi.nih.gov
Tel: 301-592-8573/240-629-3255 (TTY) Recorded Info: 800-575-WELL (-9355)

Resources:
http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm#109043201
http://en.wikipedia.org/wiki/Narcolepsy

Sleep Disorders

Definition :
Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep.

.Click to  see the pictures

Sleep disorders are a group of conditions characterized by disturbance in the amount, quality, or timing of a person’s sleep. They also include emotional and other problems that may be related to sleep. There are about seventy different sleep disorders. Short-term, temporary changes in a person’s sleep pattern are not included in sleep disorders.

Description:

Sleep disorders are divided into two major categories. One category consists of disorders in which a person has trouble falling asleep or staying asleep. This category also includes disorders in which a person may fall asleep at inappropriate times. Conditions of these kinds are called dyssomnias. A second category of sleep disorders includes those in which people experience physical events while they are sleeping. Nightmares and sleepwalking are examples of these disorders. Conditions of this type are called parasomnias.

The following are some examples of each type of sleep disorder:

Dyssomnias

  • Insomnia. Insomnia (see insomnia entry) is perhaps the most common of all sleep disorders. About 35 percent of all adults in the United States experience insomnia during any given year. People with insomnia have trouble falling asleep. Often people with this disorder worry or become anxious about not being able to sleep, which can make the problem even worse. Insomnia may begin at any time in a person’s life. It tends to be most common in young adulthood and middle age.
  • Hypersomnia. Hypersomnia is a condition in which a person is excessively sleepy during normal waking hours. The person may often fall asleep for lengthy periods during the day, even if he or she has had a good night’s sleep. In some cases, patients have difficulty waking up in the morning. They may seem confused or angry when they awaken. About 5 to 10 percent of people who seek help for sleep disorders have hypersomnia. The condition is most common in young adults between the ages of fifteen to thirty.
  • Narcolepsy. Narcolepsy is characterized by sleep attacks over which patients have no control. They may fall asleep suddenly with no warning. The sleep attack may last a few minutes or a few hours. The number of attacks patients experience can vary. People with narcolepsy usually feel refreshed after awakening from a sleep attack but they may become sleepy again a few hours later and experience another attack.

Three other conditions are often associated with narcolepsy: cataplexy, hallucinations, and sleep paralysis. Cataplexy is the sudden collapse of a person’s muscles. The person may become completely limp and fall to the ground. A person may also experience hallucinations. Hallucinations are sounds and sights that a person experiences that do not exist in the real world. Sleep paralysis occurs when a person is just falling asleep or just waking up. The person may want to move, but is unable to do so for a few moments.

  • Sleep apnea. Sleep apnea (pronounced AP-nee-uh) is a condition in which a person actually stops breathing for ten seconds or more. The most common symptom of sleep apnea is very loud snoring. Patients with this condition alternate between periods of snoring or gasping and periods of silence.
  • Circadian rhythm sleep disorders. The term circadian (pronounced sir-CAYD-ee-uhn) rhythm refers to the usual cycle of activities, such as waking and sleeping that is common to any form of life. Most people are accustomed to falling asleep after it gets dark out and waking up when it gets light. In certain conditions, this pattern can be disrupted. A person may fall asleep as the sun comes up and wake up as the sun goes down. An example of a circadian sleep disorder is jet lag. People who fly suddenly across many time zones may have their sleep patterns disrupted. It may take a few days before those patterns return to normal.

Sleep Disorders: Words to Know

Apnea:
A temporary pause in one’s breathing pattern. Sleep apnea consists of repeated episodes of temporary pauses in breathing during sleep.
Brainstem:
Portion of the brain that connects the spinal cord to the forebrain and the cerebrum.
Cataplexy:
A sudden loss of muscular control that may cause a person to collapse.
Circadian rhythm:
Any body pattern that follows a twenty-four-hour cycle, such as waking and sleeping.
Insomnia:
Difficulty in falling asleep or in remaining asleep.
Jet lag:
A temporary disruption of the body’s sleep/wake rhythm caused by high-speed air travel through different time zones.
Narcolepsy:
A sleep disorder characterized by sudden sleep attacks during the day and often accompanied by other symptoms, such as cataplexy, temporary paralysis, and hallucinations.
Polysomnograph:
An instrument used to measure a patient’s body processes during sleep.
Restless leg syndrome:
A condition in which a patient experiences aching or other unpleasant sensations in the calves of the legs.
Sedative:
A substance that calms a person. Sedatives can also cause a person to feel drowsy.
Stimulant:
A substance that makes a person feel more energetic or awake. A stimulant may increase organ activity in the body.
Somnambulism:
Also called sleepwalking, it refers to a range of activities a patient performs while sleeping, from walking to carrying on a conversation.

Parasomnias

  • Nightmare disorder. Nightmare disorder is a condition in which a person is awakened from sleep by frightening dreams. Upon awakening, the person is usually fully awake. About 10 to 50 percent of children between the ages of three and five have nightmares. The condition is most likely to occur in children and adults who are under severe stress.
  • Sleep terror disorder. Sleep terror disorder occurs when a patient awakens suddenly crying or screaming. The patient may display other symptoms, such as sweating and shaking. Upon awakening, the patient may be confused or disoriented for several minutes. He or she may not remember the dream that caused the event. Sleep may return in a matter of minutes. Sleep terror disorder is common in children four to twelve years of age. The condition tends to disappear as one grows older. Less than one percent of adults have the disorder.
  • Sleepwalking disorder. Sleepwalking disorder is also called somnambulism (pronounced suhm-NAHM-byoo-LIHZ-uhm). The condition is characterized by a variety of behaviors, of which walking is only one. Sleepwalkers may also eat, use the bathroom, unlock doors, and carry on conversations. If awakened, sleepwalkers may be disoriented. They may have no memory of their sleepwalking experience. About 10 to 30 percent of children have at least one sleepwalking experience. The occurrence among adults is much lower, amounting to about 1 to 5 percent of all adults.

A few sleep disorders are related to some physical or mental disorder. The three conditions that fall into his category include:

  • Sleep disorders related to mental disorders. Many types of mental illness can cause sleep disorders. People who have severe mental illness, for example, may develop chronic (long-lasting) insomnia.
  • Sleep disorders due to physical conditions. Physical illnesses such as Parkinson’s disease (see Parkinson’s disease entry), encephalitis (see encephalitis entry), brain disease, and hyperthyroidism may cause sleep disorders.
  • Substance-induced sleep disorders. The use of certain types of drugs can lead to sleep disorders. The most common of these drugs are alcohol and caffeine. Certain types of medications can also cause sleep disorders. Antihistamines, steroids, and medicines used to treat asthma are examples.

Causes:

More than 100 different disorders of sleeping and waking have been identified. They can be grouped in four main categories:

  • Problems with falling and staying asleep
  • Problems with staying awake
  • Problems with adhering to a regular sleep schedule
  • Sleep-disruptive behaviors

In many cases, the cause of a sleep disorder is not known. In other cases, researchers know at least part of the reason the disorder occurs. Some examples include:

  • Insomnia. Insomnia may be caused by emotional experiences or concerns such as marital problems, problems at work, feelings of guilt, or concerns about health. A person may become so distraught that sleep is impossible. Insomnia often becomes worse when patients worry about the condition. In such cases, the worry itself becomes another cause for the disorder.
  • Hypersomnia. One possible cause of hypersomnia is restless legs syndrome. Restless legs syndrome is the name given to cramps and twitches a person may experience in the calves of the legs during sleep. These sensations may keep a person awake and lead to sleep episodes during the day.
  • Narcolepsy. The cause of narcolepsy is currently not known.
  • Sleep apnea. The most common cause of sleep apnea is blockage of the airways. The condition occurs most commonly in people who are over-weight. The snoring and gasping that are typical of apnea are caused by the person’s trying to catch his or her breath. Less commonly, sleep apnea is caused by damage to the brainstem.
  • Circadian rhythm sleep disorders. Circadian rhythm sleep disorders are caused when people are forced to adjust to new dark/light patterns. An example is a worker whose assignment is changed from the day shift to the night shift. The worker must learn how to sleep when it’s light out and to work when it’s dark out.

The causes of most parasomnias are not well understood. In some cases, severe stress may be responsible for the condition. In other cases, it is not clear what the cause for the disorder is.

Symptoms:

The symptoms of most sleep disorders are obvious from the descriptions above. A person with insomnia, for example, tends to be very tired during the day. A person with nightmare disorder displays the disturbed behavior typical of a person who has been awakened from sleep by a bad dream.

  • Awakening in the night
  • Difficulty falling asleep
  • Excessive daytime drowsiness
  • Loud snoring
  • Episodes of stopped breathing
  • Sleep attacks during the day
  • Daytime fatigue
  • Depressed mood
  • Anxiety
  • Difficulty concentrating
  • Apathy
  • Irritability
  • Loss of memory (or complaints of decreased memory)
  • Lower leg movements during sleep

The symptoms may vary with the particular disorder.
Diagnosis:
A beginning point in diagnosing sleep disorders is an interview with the patient and his or her family. From this interview may come a list of symptoms that suggests one or another form of sleep disorder. For example, very loud snoring may be an indication that the patient has sleep apnea. Sleepwalking is, itself, enough of a symptom to permit diagnosis of the condition.

Doctors use a number of other tools to diagnose the exact type of sleep disorder a patient has experienced. Some of these tools include:

*Sleep logs. Patients are asked to record everything about their sleep experiences they can remember. The log might include symptoms, time of appearance, severity, and frequency. Events in the person’s life may also be recorded as possible clues to the cause of the disorder.

*Psychological testing. Some sleep disorders are caused by emotional problems in a person’s life. Those problems may be identified by means of certain tests. Examples of these tests are the Minnesota Multiphasic Personality Inventory (MMPI), the Beck Depression Inventory, and the Zung Depression Scale.

*Laboratory tests. Techniques have now been developed to observe and record a patient’s behavior during sleep. The most common device used is called a polysomnograph. this device measures a person’s breathing, heart rate, brain waves, and other physical functions during sleep. Various types of sleep disorder can be identified based on these measurements.
Exams and Tests :

*Polysomnography (recording brain activity, muscle activity and breathing during sleep)

……….….click & see

The most common device to use to test for sleeping disorders is called a polysomnograph. This device measures a person’s breathing, heart rate, brain waves, and other physical functions during sleep. (Photograph by Russell D. Curtis. Reproduced by permission of the National Audubon Society Collection/Photo Researchers, Inc.)

*Multiple sleep latency test — a daytime test that uses polysomnography during multiple brief nap periods

Treatment:
The choice of treatment for a sleep disorder depends on the cause of the disorder, if it is known. For example, some people develop insomnia because they have become depressed. The solution to this problem is not to treat the insomnia, but to treat the depression (see depression entry). The patient may be given antidepressants or counseling to improve his or her emotional outlook. If this treatment is successful, the insomnia usually disappears on its own.

In many cases, however, the sleep disorder itself may be treated directly. The five forms of treatment that can be used are medications, psychotherapy, sleep education, lifestyle changes, and surgery.

Medications:
One might expect that insomnia should be treated with a sedative (a substance that helps a person relax and fall asleep). But sedatives provide only temporary relief from insomnia. They do not cure the underlying cause for the disorder. In addition, some sedatives may be habit-forming or may interact with other drugs to cause serious medical problems.

Stimulants (substances that cause a person to feel more energetic or awake) are often effective in treating narcolepsy. The drug known as clonazepam is used to treat restless legs syndrome. Benzodiazepines are used for children with sleep terror disorder or sleepwalking because they help the child sleep more soundly.

Psychotherapy

Psychotherapy is used when sleep disorders are caused by emotional problems. Patients are helped to understand the nature of their problems and to find ways to solve or to live with those problems. To the extent this treatment is successful, the patient’s sleep disorders may be relieved.

Sleep Education

Researchers now know a great deal about the sleep process. By learning about that process, and changing their behavior patterns, patients may overcome some forms of sleep disorder. Some general guidelines that can help people sleep better include the following:

  • Wait until you are sleepy before going to bed.
  • Avoid using the bedroom for work, reading, or watching television.
  • Get up at the same time every morning, no matter how much or how little you have slept.
  • Get at least some physical exercise every day.
  • Avoid smoking and avoid drinking liquids that contain caffeine.
  • Limit fluid intake after dinner.
  • Learn to meditate or practice relaxation techniques.
  • Do not stay in bed if you can’t fall asleep. Get up and listen to relaxing music or read.

Lifestyle Changes

Some types of sleep disorders can be relieved by changing one’s lifestyle. For example, people with sleep apnea should stop smoking if they smoke, avoid alcohol and drugs, and lose weight to improve the function of their airways. People who experience circadian rhythm sleep disorders should try to adjust their travel or work patterns to allow time to adjust to new day/night patterns. Children with nightmare disorder should not watch frightening movies or television programs.

Surgery

Surgery is the treatment of last resort for sleep apnea, perhaps the only type of sleep disorder that is life-threatening. Combined with other factors, such as obesity, it can cause death. In such cases, surgery may be required to open up the patient’s airways and make breathing easier.

Alternative Treatment

Stress may be responsible for a number of forms of sleep disorder. Alternative treatments that teach people how to reduce stress in their lives can be very helpful. These treatments may include acupuncture, meditation, breathing exercises, yoga, and hypnotherapy. Homeopathic practitioners recommend a variety of substances to treat insomnia caused by various factors. They suggest Nux vomica for insomnia caused by alcohol or drugs, Ignatia for insomnia caused by grief, Arsenicum for insomnia caused by fear or anxiety, and Passiflora for insomnia related to mental stress.

Practitioners of Chinese medicine also have a range of herbs for the treatment of sleep disorder. The substance recommended depends on the particular type of disorder. For example, the magnetic mineral known as magnetite is recommended for insomnia caused by fear or anxiety.

Dietary changes may also help relieve some sleep disorders. Patients should avoid any food that contains caffeine or other stimulants. Such foods include coffee, tea, cola drinks, and chocolate. Some botanical remedies that may help a person relax and get a good night’s sleep include valerian, passionflower, and skullcap.

Prognosis:
Prognosis depends on the specific type of sleep disorder. In most cases, children outgrow sleep disorders such as nightmares and sleep terror disorder. Other conditions tend to be chronic. Narcolepsy, for example, is a life-long condition. Relatively few forms of sleep disorder represent life-threatening medical conditions. Sleep apnea is one of the few examples.

Possible Complications:
A complication is dependence upon sedatives or other medications prescribed for sleep disorders.

Prevention:
Maintaining regular sleep habits and a quiet sleep environment may prevent some sleep disorders.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000800.htm
http://www.faqs.org/health/Sick-V4/Sleep-Disorders.html

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Researchers find key to treating insomnia

: Researchers studying a disease that causes people to suddenly drop off to sleep are trying to turn what they have learnt into a new way to help insomniacs get some shut-eye…...click & see

They found that blocking brain receptors for orexin, a blood peptide, promoted sleep in rats, dogs and people, according to a paper in Sunday’s online issue of the journal Nature Medicine.

Orexin, also known as hypocretin, is important in maintaining wakefulness. It is absent in the brains of people who suffer from narcolepsy, a chronic disorder in which people cannot regulate sleep-wake cycles normally.

It is estimated to affect more than 135,000 people in the United States, according to the National Institutes of Health.

The research team, led by Francois Jenck of the Swiss drug company Actelion Pharmaceuticals, reasoned that they might be able to induce sleep if they could block orexin.

They developed a drug that can block the receptors in the brain that respond to orexin-hypocretin. The researchers reported successful testing in rodents, dogs and men.

The first tests were proof of the concept and the drug is now being evaluated to establish the correct dosage, said Roland Haefeli, an Actelion spokesman.

Researchers hope to decide this year whether to conduct a phase-three study, a detailed assessment of the drug that would be the final step before seeking US government approval for its use. Such studies can take a few years.

Narcolepsy victims often also experience cataplexy, a condition in which they lose control of muscle tone for a few seconds to minutes. Jenck said in a telephone interview that the drug tests did not prompt indications of cataplexy.

Thomas Scammell, an assistant professor of neurology at Harvard University, said the work was “promising, with a certain amount of caution”.

“I think it may be the beginning of something quite exciting,” said Scammell, who was not part of the research team.

Source:The Times Of India