Dear Doctor Dara... The sleep disorder narcolepsy

This week's question for Dr Dara is about the brain’s ability to control the sleep/wake cycle

Greetings everyone, and thanks for sending in all your questions. As the nights get longer, the weather gets chillier, and we start cozying up in front the fire, maybe for a little snooze, Oliver from Oldcastle had a question about narcolepsy, which is a disorder that affects sleep.

Oliver asked: Can you explain a bit about what narcolepsy is, and why people who have it can’t help just falling asleep at any time?

Certainly Oliver, I’ll try to do a summary piece - Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control the sleep/wake cycle. Generally sufferers feel excessive sleepiness during the day, despite having had a restful night’s sleep. They also often have regularly interrupted sleep during the night. They can at times fall asleep in the middle of a conversation, when driving, or eating, through no fault of their own.

At times they can also have sudden muscle weakness (cataplexy), even total paralysis just before falling asleep, or just after waking up. Occasionally hallucinations also. If it is undiagnosed or untreated, it can affect a person’s cognitive function, also affecting their work, studies, or social activities. It may occur following an infection, or major stress.

It typically affects men as much as women, usually starting in kids or teenagers, and can be tricky to diagnose, as it can be mistaken for emotional disorders. Luckily, although it is lifelong, it doesn’t tend to worsen over time. It can be primary, which can be hormonal (low levels of a natural chemical caused hypocretin), immune linked, or secondary, with normal hormone levels, which can be due to a brain injury in an area called the hypothalamus. The cause is often unknown, except that almost all people with narcolepsy have factors that cause low levels of hypocretin, or it can be inherited, or can be due to a head injury/brain tumour/MS.

Lifestyle changes

I think the key is that if you think you might have narcolepsy, to talk to your GP in order to rule out other neurological disorders, and refer for further investigations as appropriate, including sleep studies in a sleep disorder clinic. Although there is no cure as such, there are medications that can help, also lifestyle changes such as taking short naps, having a routine, avoiding caffeine/alcohol/large meal before bed. As with all conditions/issues listed in this column, my advise is always is: ‘If in doubt, check it out!’.

We all love our sleep. It’s when we recharge our batteries as it were - when we heal and repair the cells all throughout our body. A good sleep is linked to lower body weight, greater concentration and focus, and maximising our performance mentally and physically. Poor sleepers have a higher risk of heart disease and stroke, also obesity and diabetes.

The key to a good night’s sleep is a combination of factors, including regular exercise, particularly in the morning; keeping your bed for sleep - no phones / TV; having your bedroom at a moderate temperature, quiet, and dark. Also having a sleep routine of going to bed tired, at the same time every night, with perhaps a warm bath, warm milk, or soothing music to lull you to sleep. Going to bed hungry, or too full is not advised. Avoid caffeine, alcohol, and acidic foods. I also advise sitting down for 10-15 mins before bed, working through your day, perhaps doing a to-do list, so you can go to bed destressed and ready for a good nights sleep.

Well, I don’t know about you, but ...Yawn... all this talk about sleep is making me tired ! Sweet dreams everyone. And until next time, stay safe out there and look after each other.


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