GOLDESSAYS

Narcolepsy

Abstract

A dream is a natural, regular, and necessary condition of any living being. The phenomenon of sleep violations is of the particular interest in the study of human psychology. Narcolepsy is a kind of sleep disorders that causes the person’s inability to control the processes of sleeping. The relevance of the problem is dictated by the following fact. Sleeping is a restorative process for the brain and the body as a whole. Since the attacks of narcolepsy may occur at any time, there is a limitation of activities that a person can perform. Moreover, this issue causes the greatest harm to the child development as it affects school performance, causes activity limitation, changes in behavior and personality. Thus, narcolepsy can negatively impact life quality. The purpose of the paper is to identify the specificity of narcolepsy, its symptoms, diagnosis, treatment, and its influence on human beings.

Keywords: sleep, neurological disorder, narcolepsy, treatment

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Narcolepsy

Narcolepsy is such a neurological disorder, the effects of which influence the person’s ability to control the own condition of wakefulness and sleep. This disease is especially dangerous in the childhood since it can lead to negative lifelong consequences. The symptomatic treatment of narcolepsy can contribute to avoiding negative results that can be caused by the complications. This disorder, the symptoms of which co-occur with unregulated sleep attacks, is a dangerous disease, since an unexpected onset of sleepiness can happen at any time and in the performance of any activity. Since narcolepsy is a serious sleep issue, which hinders the child’s development and adult’s life due to immense sleepiness. Therefore, there is a crucial need to use symptomatic treatment.

General Description

Narcolepsy is a disorder that affects the ability to monitor sleep and wakefulness. It is a neurological issue of sleep that is not associated with a mental illness or psychological problems. In a normal sleep cycle, firstly, there is a superficial hibernation, then a stage of deep dream, and, eventually, a person enters a phase of sleep with a rapid eye movement (fast sleep). In people with narcolepsy, the phase of rapid dreaming begins almost instantly after falling asleep and occasionally during awakening hours (Leschziner, 2014, p. 324). It is during this period that a person sees dreams and experiences muscle immobility, which gives an explanation of the symptoms of narcolepsy.

Generally, this disorder occurs in young people (15-25 years old), mostly in men. However, its development is possible at any other age (Zeman et al., 2004, p. 725). According to Aran et al. (2010), narcolepsy affects “0,02 % to 0,05% of the population in the United States” (p. 1457). As a key presumed factor that contributes to the development of this issue, heredity aspects are taken into consideration. They are combined with the influence of particular external factors. The seizure of falling asleep during the disease is characterized by unexpectedness and immediate loss of muscle tone. Narcolepsy is accompanied by continuous tiredness and somnolence. These conditions preserve relevance regardless of the complete lasting of hibernation of the patient. The disease can become a severe obstacle, which affects the quality of life.

Causes

At the moment, there are no accurate reasons for giving an explanation of the nature of the problem. The causes of narcolepsy can be found in the identification of genes that are closely associated with the sleep disorder. Due to them, the control over the formation of signals in the brain, which are associated with falling asleep and wakening, is provided (Campion & Scammell, 2015, p. 2657). In addition, there can be some abnormalities of various areas of the brain, due to which the involvement in the regulation of fast sleep phases is guaranteed. They act as the key affecting element in the development of signs that are applicable to this disorder. At the combination of factors that accompany the personal life of patients with the aspect of gene disorders, this disease can grow. There may be the connection between the development of narcolepsy and some disorders in the immune system, which can be considered as the factor accompanying this disease. Thus, the main attending aspects include brain trauma, infectious brain lesions, pregnancy, unstable emotional state, diabetes, excessive fatigue, and genetic predisposition.

Narcolepsy is the pathology of sleep. In the human body, the brain is responsible for sleeping. Therefore, the cause of the disease is related to something there. It is known that in narcolepsy, the structure of sleep, that is the relationship between the phases of slow and fast sleeps, is disturbed. The period of fast sleep becomes excessive and comes faster than normal. The decrease in the activity of the brain activating system contributes to the occurrence of periods of fast sleep even during wakefulness. It is manifested by the clinical symptoms of falling asleep at the wrong place and at the wrong time. It is necessary to understand that all these are just assumptions since an exact mechanism of the disorder development is still beyond the understanding of scientists.

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Symptoms

The symptoms of narcolepsy include excessive drowsiness during the day. Due to excessive somnolence within the daytime, the problems that are associated with conducting regular activities throughout the day are determined (Zeman et al., 2004, p. 724). It can happen at any time, but by the evening usually drowsiness is less than during the day. The person wants to sleep so much that almost no action can stop the desire to hibernate. Washing a face with cold water, active movements, tingling, smoking, and other similar actions can only delay the beginning of dreaming a little. Sleeping occurs at any condition. Certainly, it is more conducive to monotonous work, reading a book, watching TV, and listening to boring lectures. However, an important conversation at work, as well as participating in a quarrel and in similar situations does not conflict with the onset of sleep. At the same time, as already claimed, drowsiness is a factor that accompanies the general state of the patient, manifested regardless of how long it takes for them to sleep at night. Thus, narcolepsy is not a condition that is instigated by a deficiency of a night sleeping (Campion & Scammell, 2015, p. 2654). The patient can sleep any amount of time. Nevsimalova (2014) argues that “sleep attacks in children are, as a rule, of longer duration than in adults” (p. 470). The manifestations of narcolepsy are not connected with this condition. Moreover, the patients complain of blurred vision, difficulty of concentrating, and lack of energy. In addition, they suffer from depressive conditions and exhaustion of the general state.

The development of cataplexy is another symptom of narcolepsy. This signal is more common in adults than in children (Nevsimalova, 2014, p. 470). This condition means the state, in which there is the unexpected loss of muscle tone. As a result, sudden exhaustion develops and results in the loss of control over the body. Consciousness with cataplexy is not violated. The person understands that he or she is falling down or cannot perform some action, but is powerless to do anything about it. Against the background of this condition, the entire complex of manifestations develops, which can occur in the form of speech indistinctness and the state of complete exhaustion of the organism.

The symptoms of narcolepsy include the occurrence of hallucinations. Predominantly, it involves illusory experiences. They are quite realistic and vivid, even frightening in their character. Hallucinations can manifest themselves in certain variants of their own species, being hypnagogic and hypnopompic. Hypnagogic hallucination is appearing immediately before falling asleep, while hypnopompic hallucinations accompany the awakening state of the sick person in its own origin. According to Nevsimalova (2014), the adults experience frightening hallucinations, while children have more simple forms (images of people or animals) (p. 470).Thus, during these states, unusual phenomena occur and unusual sounds are heard. In common, hallucinations may lead to the development of anxiety in patients due to the specificities of their manifestation.

Another symptom is the development of sleep paralysis. This signal occurs with the development of nonpermanent disability, that is the absence of ability to move or speak caused by the sleep of patients or, vice versa, their arousal (Nevsimalova, 2014, p. 471). The duration time of manifestation of these incidents is short. As a rule, the disappearance of signs of paralysis occurs when the sick person is touched. The end of the attack is accompanied by the recovery of the ability to produce speech and move. Generally, the picture of the manifestation of the disorder can be supplemented by the fact that the symptoms of narcolepsy can reveal themselves as instantly in full. Moreover, they may be accompanied by their gradual development and aggravation.

Complications

General Complications

In narcolepsy, chronic sleep disorders, depressive conditions, and the decreased sexual desire may occur. Attacks of falling asleep can cause a physical harm to the patient. For example, if at this time, the individual is dealing with dangerous tools, then a sharp fall asleep can lead to unpredictable consequences. Road traffic accidents may happen if a bout of narcolepsy begins while driving. The person can hit one’s head or other parts of the body during an attack of narcolepsy that is followed by a fall. Narcolepsy can cause the loss of social and work contacts. The attacks of the disease during work, which, obviously, is performed with less efficiency, and in the process of the social activity lead to the marginalization of the subject.

Therefore, people, who suffer from narcolepsy, should not drive a car, work at a height or with moving machinery, as they can cause harm not only to themselves, but also to those ones surrounding them in case of falling asleep. Patients with this pathology should not despair. It is necessary to reconsider some moments of one's life, slightly change the way of living, and adapt to existing problems. The disease itself does not endanger life, if the one excludes situations, in which falling asleep can be risky.

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Complication in Children

In children, narcolepsy can become a reason for the poor school performance, limitation of activities, as well as behavioral and personal changes. Preschool kids and school youngsters  may show emotional liability, inattentiveness, and hyperactive behavior (Nevsimalova, 2014, p. 469). It influences the further development of the child. The poor educational achievement decreases life opportunities.

Diagnosis and Treatment

Diagnosis of narcolepsy is accompanied by the evaluation of the general condition of the patient at the doctor's assumption. Due to it, other diseases that are characterized by narcolepsy-like symptomatic manifestation can be excluded or, conversely, confirmed. In the circumstances of a somnological laboratory, a specialist investigates the general medical history of the sick person, which is also accompanied by the physical examination of the complex scale. However, the symptoms in childhood can differ from the signs of the disease in the adulthood that can cause misdiagnosis (Nevsimalova, 2014, p. 469). Predominantly, two basic testing options (MSLT test and polysomnography) are used in the evaluation (Nevsimalova, 2014, p. 472). Polysomnography means conducting the study, in which the individual remains in a separate room; and small electrodes are affixed to  skin. Their fixation is provided by a sticky iron substance. The affixed electrodes register a number of parameters, such as the heart rate, intracerebral waves, the features of muscle activity, and eye motion. On the basis of the results of this test, one can define whether other disorders that accompany narcolepsy are relevant. It allows getting a better presentation of the definite features of the course of the disease in each specific case. As for the MSLT test, it is performed the next day after polysomnography. The patient has to fall asleep, when the electrodes are fixed on the body (Leschziner, 2014, p. 327). Based on the above two tests, it becomes clear whether the symptomatology, which disturbs persons, is triggered by narcolepsy or there is another pathology accompanied by the listed symptoms.

The treatment of narcolepsy is symptomatic. The manifestations of the disease can be facilitated or controlled to some extent. Nonetheless, it is not possible to treat it. Due to some possible effects, narcolepsy can be reduced, which, in turn, supposes the probability of the normal life. To treat sleepiness, various types of stimulants (analogs of amphetamine) may be used. To exclude the symptoms, which accompany the anomalies of the phase of the onset of fast sleep, certain antidepressants are used (Zeman et al., 2004, p. 727). The facilitation of the signals following narcolepsy can also be reached by changing the way of life. Particularly, it involves the necessity for the withdrawal from alcohol and nicotine, the exception of caffeine and the consumption of heavy food. Moreover, it is significant to keep the day regime and night sleep. The duration of night sleep should be long, while the time of day hibernation should be reduced. When symptoms that indicate the relevance of narcolepsy appear, it is necessary to consult a neurologist. Nevsimalova (2014) emphasizes that there is a need to start treatment in school-age children to avoid the issues of poor achievements (p. 473). Kids and their parents should be informed about the necessity of long-term treating and nature of the disease.

Conclusion

Narcolepsy is a disease of the central nervous system, which causes sleep disorder. It is characterized by daytime bouts of insuperable drowsiness and sudden falling asleep during normal waking hours, as well as attacks of cataplexy. It means the sudden loss of muscle tone with clear consciousness, sleeplessness, and sleep disturbances, falling asleep, and awakening hallucinations. Narcolepsy has negative outcomes and complications, especially in the childhood. Therefore, it is of particular importance to make the correct diagnosis and start the treatment as soon as possible to avoid long-term effects of the disease. Both of them should be carried out under the strict supervision of a neuropathologist.

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