Imagine a life that is consistently attacked by sleepiness and drowsiness. It is like a sleeping pill with a sustained release formula which can instantly debilitate a person anytime and anywhere, in the most unexpected situations (during brief conversations, while driving, sitting in a public place, etc.)
It may be a frustrating for narcolepsy patients to always feel helpless to nature's call to sleep during the waking hours, especially considering the fact that they have to live with it for the rest of their lives. The persistence of narcolepsy all throughout life however, does not mean that one cannot do anything but to completely surrender to the sleep attacks. At the very least, one can control its major symptoms like excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations, and automatic behavior.
The process of accurately identifying the problem involves thorough assessment by means of clinical evaluation, accomplishment of questionnaires, sleep logs or diaries, and sleep laboratory tests. Clinical evaluation may include the accomplishment of medical history and physical examination. Accomplishment of various standard questionnaires can help estimate of the degree of daytime sleepiness. Here, activities are enumerated and the patient will be asked to recall and rate the likelihood of him / her falling asleep during such activities. Sleep log or a sleep diary can also be maintained for a more accurate evaluation of disruptions in sleep pattern.
Polysomnogram and the multiple sleep latency test (MSLT) are some test which can confirm the diagnosis of narcolepsy. The polysomnogram is used to record sleep brain waves, the number of nerve functions, as well as muscle functions during nighttime sleep, while the multiple sleep latency test (MSLT) is used to measure the degree of daytime sleepiness.
Most likely, it is narcolepsy if the patients easily fall asleep and in an instant, they enter the REM sleep stage, the 5th and the last sleep stage. Unlike in the case of people with healthy sleep, who pass through stages 1 to 4 first (though there are times when they regress to a lower stage and later on progress to a higher stage), narcoleptics by-pass the initial stages characterized by gradual slowing of brain waves.
All these tests help rule out other sleep disorders which may have similar symptoms like insomnia (as narcoleptics could experience disturbed nighttime sleep) and REM sleep disorder.
Since the combination of symptoms may vary from person to person, treatment is individualized or symptoms-based. Generally, central nervous system stimulants are used to treat excessive daytime sleepiness, a symptom experienced by 100% of narcolepsy patients. Other classes of medications are prescribed for other symptoms.
Non-pharmacologic measures on the otherhand, may involve scheduling of short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness and to help a narcoleptic stay alert throughout the day. Most narcoleptic patient symptoms also improve with a regular 7 1/2 to 8 hours of sleep at night.
As far as the diet is concerned, narcoleptics should avoid large meals and alcohol as it may exacerbate the symptoms. Also known to contribute to daytime sleepiness is the intake of refined sugars.
Activities requiring full attentiveness or alertness, like driving, are prohibited. Regular exercise and the use of bright lights are also proven to be effective in keeping a narcoleptic patient alert. Assistance with documentation for special academic needs, insurance, disability forms, and in attaining a driver's license, may also be needed.
Children diagnosed with narcolepsy should still be encouraged to participate in after-school activities and sports. Similar to adults, a carefully planned exercise program is proven to be beneficial as it can enhance alertness, but if the child appears drowsy, the school personnel should have the child refrain from activities.
Gerrard Mackenzie has taught thousands of the stressed-out, tired and overworked how to overcome their sleeping difficulties.
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