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What Narcolepsy Is and How to Cope With It

Wednesday, May 20, 2020/ Editor -  

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Abu Dhabi, United Arab Emirates, 20 May 2020:  Narcolepsy is a chronic neurological disorder affecting the part of your brain that regulates sleep. As a result, the patient experience excessive daytime sleepiness and a sudden loss of muscle control (called cataplexy) causing you to fall asleep during normal daytime activities such as working or studying. These episodes are often triggered by strong emotions. Narcolepsy is more common than you probably realize affecting about 1 in 2,000 people—and while there is not yet a cure, there are plenty of ways you can reduce the symptoms.


Dr. Trilok Chand, Specialist - Respiratory Medicine at Burjeel Hospital Abu Dhabi shares recommendation for diagnosing and treating narcolepsy:


What are the causes?


Narcolepsy can be familial and it runs in families that mean it is genetically oriented.  The low level of Hypo cretin (Orexin) in the brain is also a known reason of Narcolepsy. Hypo cretin is a chemical in the brain which helps to promote wakefulness. Other causes of Narcolepsy are infection, hormonal changes of puberty, brain tumor or stroke, toxin and autoimmune disease like Rheumatoid arthritis and Sarcoidosis.


What are its Symptoms?


Four major symptoms of Narcolepsy are:


1) Excessive daytime sleepiness.
2) Muscle weakness (Cataplexy) triggered by emotions, most commonly by hearing or telling a joke.
3) Vivid dreamlike images that occur at sleep onset or sleep-wake transitions.
4) A partial or complete paralysis of the skeletal muscles (Sleep paralysis) that occurs at sleep on set or sleep offset. Narcolepsy can occur without muscle weakness or cataplexy, and you may have one or more symptoms. Narcolepsy patient’s also have secondary symptoms like depression, lack of energy and memory problems.


How prevalent are they in the UAE?


Worldwide narcolepsy is present in about 1/2000 persons. Approximately 60% to 70% of patients with narcolepsy have cataplexy. Men and women are affected equally. The average age of onset in most studies is between 20 and 30 years. Risk of developing narcolepsy in familial narcolepsy is 25-31% in identical twins and 1-2% in first degree relatives.


The exact prevalence data of narcolepsy are not available in the UAE, but it is a rare disorder and it could be similar of worldwide prevalence. In my practice, on an average we encounter less than five cases of narcolepsy per year.


What is the treatment or remedial measures people must take?


There is no cure of Narcolepsy. Life style modification, like good sleep hygiene, a regular sleep schedule, usually 7.5-8 hours of sleep per night, scheduled naps during the day also may help in addition avoiding shift work is essential. Take daytime short rescue naps just before important task and at scheduled times during the day.


Avoid sedating medicines (Anti-allergy drugs) or alcohol.


Stimulant or alerting drugs like Modafinil or Armodafinil indicated if other measures do not work.
Anything else you wish to add about this type of sleep disorder.


People, who have Narcolepsy, must take extra care while driving or operating heavy machineries.

 

Snoring


What are the causes?


The snoring is a noisy breathing while sleeping, and this abnormal sound generated in the upper airways, especially in the throat or nose, due to narrowing secondary to fat deposition or intraluminal tissues like large tonsils, uvula, large tongue and nasal congestion. The snoring is related to anatomy of mount and nose, sedating medications, allergy or cold and obesity.

What are its Symptoms?


The snoring itself a one of the symptom of Obstructive sleep apnea, along with other symptoms like choking or pause in breathing while sleeping and excessive daytime sleepiness or tiredness in the morning. If any person who is snoring and choking at night while sleeping and feels daytime tiredness, fatigue, morning headache and desire to sleep back, is most likely suffering by Obstructive sleep apnea.


How prevalent are they in the UAE?


The snoring is directly related to obesity and weight gain, so the prevalence of snoring is very high in the UAE region. In a recent report, WHO says, 67% of Emirati men and 72% of Emirati women are overweight and around 39.9% of UAE women and 25.6% of men are obese. The prevalence of Obstructive sleep apnea in UAE is around 20%, more in men compare to women.


What is the treatment or remedial measures people must take?


Anyone who suffering by snoring with or without other symptoms like choking and daytime sleepiness, must consult with sleep medicine physician for further evaluation or sleep study. The weight reduction has direct effect on decreased snoring and other symptoms of sleep apnea. If there is any anatomical problem of the face or mouth, it can be corrected by surgery or some devices. The CPAP machine (continuous positive airway pressure device) is the definite therapy for whom suffering with sleep apnea. There is no drug treatment for adult snoring and sleep apnea, except in pediatric snoring or sleep apnea where some anti-allergic medicines or Montelukast can help.


Anything else you wish to add about this type of sleep disorder.
People who suffering with sleep apnea have high risk of future development of hypertension, diabetes, stroke, heart disease, depression, infertility and sexual problems. The road traffic accident is one of the immediate risks of sleep apnea that can endanger the life of others.


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