- Excessive Daytime Sleepiness (EDS)
- Loss of Muscle Tone (Cataplexy)
- Distorted Perceptions
- Sleep Paralysis
- Disturbed Sleep
- Automatic Behaviour
Narcolepsy normally remains undiagnosed for many years. The physicians ignore other symptoms such as fatigue, tiredness, or problems with concentration, attention, memory, and performance etc., in the absence of the main symptom, EDS Excessive Daytime Sleepiness.
Excessive Daytime sleepiness (EDS):-
The main symptom of Narcolepsy, EDS, Excessive Daytime Sleepiness will cause the patients to doze off or fall to sleep during day time. Even while watching Television, reading books, driving vehicles, attending classes or meetings or talking with somebody. Even if they have sufficient and normal sleep in the night they will feel sleepy or fall asleep during daytime. The EDS symptom may be understood and expressed by the patients as feeling tired, fatiqued, sleepy, lazy or feeling as if lost energy. Even though the patient will try to avoid falling asleep, they will doze off for a short duration, being unable to control their sleepiness.
Loss of Muscle Tone or Cataplexy:-
Loss of Muscle Tone or Cataplexy is a sudden and temporary reversible loss of muscle tone is another symptom of Narcolepsy. An attack of cataplexy usually is triggered by emotional stimuli such as laughter, excitement, surprise, or anger. Physical fatigue, stress, and sleepiness. dropping head, sagging jaw, slurred speech, buckling of the knees, or weakness in the arms will be associated with Cataplexy. During Cataplexy though the patients will be conscious, usually they will be unable to speak. Normally Cataplexy will be mild and if it is severe possibility of falling down cannot be ruled out. The Cataplexy attack will last for a duration ranging from some seconds to some minutes.
For patients of Narcolepsy, Cataplexy may develop after a year or so, EDS being the first symptom, and in the initial stages only EDS will be present and the absence of Cataplexy may not lead to conclude absence of the disease. It has been found that abnormalities in the structure and function of a particular group of nerve cells in the brain called hypocretin neurons are the factors in the development of narcolepsy.
The diagnosis of narcolepsy is based on:-
- clinical evaluation
- specific questionnaires
- sleep logs or diaries
- the results of sleep laboratory tests (polysomnography and multiple sleep latency test)
- behavioral modification therapies
- disease-specific education of the patient and family members
- The Doctor
- The Patient and
- The member of the family of the patient
Behavioral modification therapies include:-
- Establishing a structured sleep-wake cycle and planned naps
- Diet, exercise, occupational, marriage, and family counseling