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Can Narcolepsy Develop out of Nowhere?
Narcolepsy is a relatively uncommon sleep disorder that causes extreme daytime sleepiness to the point you fall asleep suddenly and without warning. If undiagnosed or left untreated, the disorder can interfere with school, work, and social activities. It can also interfere with psychological, social, and cognitive function and development.
At Sidhu Psychiatric in Palm Harbor, Florida, board-certified psychiatric mental health nurse practitioner Kanwaljit “Kavi” Sidhu and her team diagnose and treat many different sleep disorders, including narcolepsy. Many people feel that their diagnosis comes out of nowhere; is that possible? Here’s what the expert has to say.
What causes narcolepsy?
The causes of narcolepsy depend on the type of narcolepsy you have, but all forms have links to the hypothalamus, an area in your brain that helps regulate sleep and wake times. Symptoms first start appearing between 15-30 years old, mostly in men.
There are two main types:
Type 1 narcolepsy
Previously known as narcolepsy with cataplexy (muscle weakness), type 1 patients either have low levels of the transmitter hormone orexin (hypocretin) in their cerebrospinal fluid, or they report cataplexy. Orexin promotes wakefulness and regulates REM (dream-stage) sleep.
Some 90-95% of type 1 patients have a specific gene mutation, but researchers aren’t certain what this gene does. The condition does, however, tend to run in families.
Type 2 narcolepsy
Previously known as narcolepsy without cataplexy, people with this condition experience excessive daytime sleepiness but usually don’t have muscle weakness associated with it. They usually also have less severe symptoms than type 1 patients and have normal levels of orexin.
Narcolepsy symptoms
There are four main symptoms of narcolepsy, but most people don’t have all four.
1. Excessive daytime sleepiness
Everyone with narcolepsy has this symptom; it’s the defining characteristic of the disorder. These episodes are generally called “sleep attacks.”
2. Sudden muscle weakness (cataplexy)
The weakness may affect one or both sides of your body, and you may experience variations in weakness.
Ordinarily, your brain shuts down most muscle control during REM sleep to prevent you from acting out your dreams. Cataplexy appears as sudden muscle weakness, similar in outcome to the brain’s normal dream action.
A mild case of cataplexy may only affect your face and neck, such as your jaw dropping open, or affect just one side of your body. A severe case can make you fall suddenly to the ground, semi-unconscious, much like some types of epileptic seizures. These events usually last just a few minutes, but you probably won’t be able to move or talk during that time.
Cataplexy is unusual in that certain emotions can cause it to happen. The most likely triggers are positive emotions such as laughing or making jokes. Surprise, anger, and fear don’t appear to trigger the event.
3. Sleep-related hallucinations
You may experience hallucinations just after falling asleep or right before waking up.
4. Sleep paralysis
Your brain has two wake-up centers that have to coordinate their actions to wake you up. Sometimes, though, they don’t coordinate properly, and your mind wakes up, but you can’t move. You can breathe and move your eyes, but you can’t speak or move any other part of your body, no matter how hard you try.
During periods of sleep paralysis, hallucinations are very common, often vivid, and tremendously frightening, making you strain even harder to wake yourself up. After a time, you fall back asleep and then wake up normally, able to move and speak.
Can narcolepsy develop out of nowhere?
The short answer is yes. In almost all cases, narcolepsy happens unpredictably, and because of that, there’s no way to reduce your risk of developing it or prevent its effects.
Narcolepsy isn’t usually dangerous by itself, but suddenly nodding off makes it impossible to drive and creates dangerous situations crossing the road, swimming, and using power tools or heavy machinery, to name just a few of the consequences.
In addition, type 1 narcolepsy, because of its inclusion of cataplexy, creates added risks of injury from falls, especially if it happens on a flight of stairs or stepping off a curb.
Narcolepsy isn’t curable, but it’s treatable, and it’s possible to live a relatively normal life even if you have the disorder. Medications are usually the first-line treatment, and which one is prescribed depends on your unique situation and needs. Good sleep hygiene can also help.
If you’re having trouble staying awake during the day and are prone to nodding off, narcolepsy might be the cause. To learn more, or to schedule a consultation, call Sidhu Psychiatric at 727-761-1526 to schedule a consultation, or contact us online today.