narkolepsi & sleep apnea
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Narcolepsy
Devi Wuysang
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Definition
Narcolepsyis a chronic sleep disorder, or
dyssomnia, characterized by excessive
daytime sleepiness (EDS) in which a
person experiences extreme fatigue and
possibly falls asleep at inappropriate
times, such as while at work, school, or
when talking to your partner.
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Signs & Symptoms
The main characteristic of narcolepsy is excessivedaytime sleepiness(EDS), even after adequatenighttime sleep.
A person with narcolepsy is likely to become drowsy orfall asleep or just be very tired throughout the day, oftenat inappropriate times and places.
Daytime naps may occur with little warning and may bephysically irresistible. These naps can occur severaltimes a day. They are typically refreshing, but only for afew hours.
Drowsiness may persist for prolonged periods of time. Inaddition, nighttime sleep may be fragmented withfrequent awakenings.
http://en.wikipedia.org/wiki/Excessive_daytime_sleepinesshttp://en.wikipedia.org/wiki/Excessive_daytime_sleepinesshttp://en.wikipedia.org/wiki/Excessive_daytime_sleepinesshttp://en.wikipedia.org/wiki/Excessive_daytime_sleepiness -
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Four of the other classic symptoms of the
disorder, often referred to as the "tetrad
of narcolepsy:
1. cataplexy
2. sleep paralysis
3. hypnagogic hallucinations
4. automatic behavior
http://en.wikipedia.org/wiki/Cataplexyhttp://en.wikipedia.org/wiki/Sleep_paralysishttp://en.wikipedia.org/wiki/Hypnagogic_hallucinationhttp://en.wikipedia.org/wiki/Automatic_behaviorhttp://en.wikipedia.org/wiki/Automatic_behaviorhttp://en.wikipedia.org/wiki/Hypnagogic_hallucinationhttp://en.wikipedia.org/wiki/Sleep_paralysishttp://en.wikipedia.org/wiki/Cataplexy -
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These symptoms may not occur in all patients.
Cataplexyis an episodic condition featuring lossof muscle function, ranging from slight weakness(such as limpness at the neck or knees, sagging
facial muscles, or inability to speak clearly) tocomplete body collapse. Episodes may betriggered by sudden emotional reactions such aslaughter, anger, surprise, or fear, and may lastfrom a few seconds to several minutes. Theperson remains conscious throughout theepisode. In some cases, cataplexy mayresemble epileptic seizures.
http://en.wikipedia.org/wiki/Laughterhttp://en.wikipedia.org/wiki/Angerhttp://en.wikipedia.org/wiki/Fearhttp://en.wikipedia.org/wiki/Fearhttp://en.wikipedia.org/wiki/Angerhttp://en.wikipedia.org/wiki/Laughter -
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Sleep paralysisis the temporary inability totalk or move when waking (or less often,when falling asleep). It may last a few
seconds to minutes. This is oftenfrightening but is not dangerous.
Hypnagogic hallucinationsare vivid, oftenfrightening, dreamlike experiences thatoccur while dozing, falling asleep and/orwhile awakening.
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Automatic behaviormeans that a person continues tofunction (talking, putting things away, etc.) during sleepepisodes, but awakens with no memory of performingsuch activities. It is estimated that up to 40 percent of
people with narcolepsy experience automatic behaviorduring sleep episodes.
Sleep paralysis and hypnagogic hallucinations alsooccur in people who do not have narcolepsy, but morefrequently in people who are suffering from extreme lack
of sleep. Cataplexy is generally considered to be uniqueto narcolepsy and is analogous to sleep paralysis in thatthe usually protective paralysis mechanism occurringduring sleep is inappropriately activated.
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Causes
Certain genetic conditionsCertain variations
in the HLA complex were thought to increase the
risk of an auto-immuneresponse to protein-
producing neurons in the brain. The proteinproduced, called hypocretinor orexin, is
responsible for controlling appetite and sleep
patterns.
Individuals with narcolepsy often have reducednumbers of these protein-producing neurons in
their brains.
http://en.wikipedia.org/wiki/Auto-immunehttp://en.wikipedia.org/wiki/Proteinhttp://en.wikipedia.org/wiki/Hypocretinhttp://en.wikipedia.org/wiki/Orexinhttp://en.wikipedia.org/wiki/Orexinhttp://en.wikipedia.org/wiki/Hypocretinhttp://en.wikipedia.org/wiki/Proteinhttp://en.wikipedia.org/wiki/Auto-immunehttp://en.wikipedia.org/wiki/Auto-immunehttp://en.wikipedia.org/wiki/Auto-immune -
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Treatment
The main treatment of excessive daytime
sleepiness in narcolepsy is with CNS
stimulant drugs, such as methylphenidate,
racemic-amphetamine,dextroamphetamine, methamphetamine,
or modafinil (Provigil), etc.
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Sleep Apnea Syndrome
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Sleep apneais a sleep disorder characterisedby having one or more pauses in breathing, orabnormally low breathing, during sleep.
Each pause in breathing, called an apnea, canlast from a few seconds to minutes, and mayoccur 5 to 30 times or more an hour.
Similarly, each abnormally low breathing event
is called a hypopnea. Sleep apnea is diagnosedwith an overnight sleep test called apolysomnogram, or a "sleep study".
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There are three forms of sleep apnea:
1. Central (CSA)
2. Obstructive (OSA)
3. Complex or mixed sleep apnea (i.e., acombination of central and obstructive)constituting 0.4%, 84% and 15% of casesrespectively.
In CSA, breathing is interrupted by a lack of
respiratory effort; in OSA, breathing isinterrupted by a physical block to airflow despiterespiratory effort.
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