Sleeping Beauties

There are real life sleeping beauties out there. But unfortunately, it’s not a happy fairy tale where they meet their true love when they wake up. These sleeping beauties have something called narcolepsy. It is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. It is difficult for narcoleptic people to be awake for long periods of time and it can cause serious disruptions in their life.

Symptoms of narcolepsy include:

• Excessive daytime sleepiness. People with narcolepsy fall asleep anywhere and anytime without warning. When they wake up they feel refreshed, but eventually they will get tired again. Narcoleptic people may also experience decreased alertness and focus throughout the day. This symptom is usually the first to appear. It is also very troublesome, making it difficult for someone to accomplish daily tasks that come easily to a person without narcolepsy.
• Sudden loss of muscle tone. This is a condition called cataplexy. It can cause a number of physical changes, ranging from slurred speech to complete weakness of most muscles, and may last up to a few minutes. Cataplexy is uncontrollable and is triggered by intense emotions. It is usually caused by positive ones like laughter or excitement, but also sometimes fear, surprise, or anger. For example, if someone laughs, their head may droop uncontrollably or their knees may suddenly buckle. Some narcoleptic people only experience one or two episodes of cataplexy a year, while others have numerous episodes daily. Not everybody with narcolepsy experiences this symptom.
• Sleep paralysis. Sleep paralysis is a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief, lasting a few seconds or minutes. However, they can be very terrifying. “This sleep paralysis mimics the type of temporary paralysis that normally occurs during a period of sleep called rapid eye movement (REM) sleep. This temporary immobility during REM sleep may prevent your body from acting out dream activity.” Not everyone with sleep paralysis has narcolepsy. Many people without it have some episodes of sleep paralysis. I do not know if I was actually experiencing sleep paralysis, and it only happened to me once, but I had an experience that I think was similar. I woke up and was completely aware that I was in my bed. However, I could not open my eyes or move even though I wanted to. It’s like my brain was telling my body what to do, but it would not listen. While my eyes were closed, I could still see my dream. Even so, I was conscious of the fact that it was a dream and not real life. I could not control what happened in my dream. It was kind of scary.
• Changes in rapid eye movement (REM) sleep. Typically, most dreaming occurs during REM sleep. REM sleep can happen at any time of the day for people with narcolepsy. They often transition quickly to REM sleep, usually within 15 minutes of falling asleep.
• Hallucinations. There are two types of hallucinations that narcoleptic people can face- hypnagogic and hypnopompic. Hypnagogic hallucinations happen as you fall asleep, while hypnopompic hallucinations occur upon waking. An example of a hallucination is feeling as if there is a stranger in your bedroom. “These hallucinations may be particularly vivid and frightening because you may not be fully asleep when you begin dreaming and you experience your dreams as reality.”

Obstructive sleep apnea, restless legs syndrome, and even insomnia are other sleep disorders that narcoleptic people might have to deal with. Some people will also experience automatic behavior during brief episodes of narcolepsy. Say, they fall asleep while performing a task they normally perform, such as driving, writing, or typing. Even though they are now asleep, they will still continue to perform the task they were previously doing (probably not very well). When they awaken, they can not remember what they did.

There are not many known risk factors for narcolepsy. Among the few, there are age (narcolepsy typically begins in people between 10 and 30 years old) and family history (your risk of narcolepsy is higher if you have a family member who has this disorder).

A normal sleep pattern and narcolepsy share similar sequences. “The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep. During this phase, your brain waves slow considerably. After an hour or so of NREM sleep, your brain activity changes, and REM sleep begins. Most dreaming occurs during REM sleep.” The difference between this and narcolepsy is that narcoleptic people will suddenly enter into REM sleep without first experiencing NREM sleep, both at night and during the day. Some characteristics of narcolepsy such as cataplexy, sleep paralysis, and hallucinations are also similar to changes that occur in REM sleep, but they instead occur during wakefulness and drowsiness.

The exact cause of narcolepsy is unknown. People with type 1 narcolepsy (narcolepsy that occurs with cataplexy) have low levels of the chemical hypocretin. This is an important neurochemical in the brain that helps regulate wakefulness and REM sleep. Although it is still not known what causes the loss of hypocretin-producing cells in the brain, experts suspect it is due to an autoimmune reaction. It is also a strong possibility that genetics play a role in the development of narcolepsy. Still, the risk of a parent passing this disorder to their child is very low at only about 1 percent. Research also suggests a possible association with exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine that’s currently administered in Europe, though it is not yet clear why.

Unfortunately, narcolepsy itself isn’t the only problem that these people face. The sleep disorder causes complications including:

• Public misunderstanding of the condition. Problems arise for them professionally and personally. Others might see them as lethargic or lazy. Their performance at school or work may suffer.
• Interference with intimate relationships. Intense feelings that come naturally when you are interacting with someone can trigger signs of narcolepsy such as cataplexy. This might cause people to withdraw from emotional interactions.
• Physical harm. Sleep attacks may result in physical harm. You are at increased risk of a car accident if you have an attack while driving; your risk of cuts and burns is greater if you fall asleep while preparing food.
• Obesity. People with narcolepsy are more likely to be overweight. The weight gain can be related to a low metabolism.

https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497