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Sleep Series: Narcolepsy an Overlooked Clue in a Sleep Disorder

People with narcolepsy have a deficiency in the neurotransmitter hypocretin (also known as orexin), which regulates wakefulness and sleep- Dr. Sourav Sarkar

Parul Soni

Parul Soni of Medbound Times had an interesting conversation with Dr. Sourav Sarkar about Narcolepsy, a neurological sleep disorder.

Dr. Sourav Sarkar is an Anesthesiologist and Sleep Specialist, practicing in Kanpur, Uttar Pradesh, India.

Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness, sudden onset of sleep, and episodes of muscle weakness called cataplexy. It is a relatively rare condition that affects about 1 in 2,000 individuals worldwide.

The cause of narcolepsy is largely unknown, but research suggests that it may be caused by genetic abnormalities, autoimmune factors, or a combination of both. People with narcolepsy have a deficiency in the neurotransmitter Hypocretin (also known as Orexin), which regulates wakefulness and sleep. This deficiency is believed to be due to the destruction of the cells that produce hypocretin in the brain, but scientists are still studying the exact cause of this destruction. Dr. Sourav Sarkar discussed common symptoms of narcolepsy he sees in the clinical setup.

Symptoms of narcolepsy can include:

1. Excessive daytime sleepiness: This is the primary symptom of narcolepsy and is characterized by an irresistible urge to sleep during the day. People with narcolepsy may also experience persistent fatigue, difficulty concentrating, and memory problems.

According to Dr. Sourav Sarkar excessive daytime sleepiness can also happen because of obstructive sleep apnea or insufficient sleep syndrome (very common in Indian population).

2. Cataplexy: This is a sudden loss of muscle tone triggered by strong emotions such as laughter or excitement. The person may feel weak and may have difficulty speaking or moving for a few seconds or minutes. In severe cases, the person may collapse and become fully paralyzed for a brief period.

3. Sleep paralysis: This is a temporary inability to move or speak, which occurs when falling asleep or waking up. It lasts a few seconds or minutes and can be a frightening experience.

Epworth Sleepiness Scale is a good outcome measure to assess excessive daytime sleepiness.
Dr. Sourav Sarkar, MBBS, MD anaesthesia, Sleep medicine specialist

4. Hypnagogic hallucinations: These are vivid and dream-like visual or auditory experiences that occur when falling asleep or waking up.

Other symptoms of narcolepsy can include disturbed nighttime sleep, automatic behaviors, and difficulty in maintaining attention and focus.

According to research, Dr. Sourav Sarkar states that currently there is no solid proven cure for narcolepsy. The treatment options include medications, lifestyle changes and counseling. Medications such as stimulants, anti-depressants, and medications with sodium oxybate can be used to manage excessive daytime sleepiness, cataplexy, and other symptoms. Dr. Sourav Sarkar suggests that no medication is to be taken without a doctors prescription. As the medicines can be dangerous when taken without supervision as well as not available freely. Sleep hygiene practices such as regular sleep and wake times, exercises, and controlling caffeine consumption can also help manage narcolepsy symptoms.

Takeaway points:

1. Narcolepsy is a debilitating neurological disorder that requires proper management and care.

2. Treatment can ensure that individuals can lead productive and fulfilling lives.

3. It is important to seek professional medical care if you suspect that you or someone you know may have narcolepsy.

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