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Narcolepsy: don't just sleep on it.

We wrote last issue about those who never seem to get enough sleep, but for the thousands of Americans who suffer from narcolepsy, "sleeping on" the problem isn't such a good ides. Defined as "excessive daytime sleepiness," nacolepsy is a sleep disorder also characterized by nighttime sleep disturbances. Whereas those with sleep apnea syndrome often wake up in the middle of the night because they cannot breathe, narcoleptics are not known for breathing disturbances. Also, it doesn't seem to matter if narcoleptics are on medication; they seem to fall asleep anywhere anytime-during a conversation, at mealtime, at work, or while standing or walking-for intervals of a few seconds or several minutes (never more than an hour). Once awake, they are refreshed until the next spell comes along, sometimes within a few minutes of the previous one.

"They get so sleepy they literally cannot stay awake," says Dr. Simon Farrow, a Houston-based sleep analyst. Because narcoleptics can spend several hours a day sleeping in advanced cases, it may be difficult for such individuals to hold jobs, drive, go shopping, or even do housework. About three-quarters of narcoleptics also suffer from cataplexy, a muscular disorder that occurs whenever the body undergoes even the slightest emotional or physical shock. Usually the head tilts forward, the eyes close, the speech becomes slurred, and the whole body jerks slightly; unless the patient recognizes the symptoms and can sit or lean against a wall in time, he can just fall to the floor in a dead faint. Thirty seconds later, he will be fine and totally aware of what just went on.

Narcolepsy usually occurs in youths and young adults, although older people have been known to contract it. The disease is presumably due to dysfunction of the brain's diencephalic reticular system. There is no known cure for the disease, although persons with narcolepsy can be prescribed mild doses of a stimulant such as Ritalin, and there are now support groups available in some areas for these persons often misunderstood as lazy or unable to hold down jobs. "People with narcolepsy should be honest about it whenever possible so they can enlist the support of employers," says Dr. Farrow.
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Publication:Medical Update
Date:Jul 1, 1990
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