Narcolepsy has been heavily oversimplified in its depiction by the media, reduced to a comedic stereotype where people collapse into a dead sleep at inopportune moments. In reality, narcolepsy produces diverse and often debilitating symptoms, all of which affect the sufferer’s waking life tremendously, such as:
- Excessive exhaustion and impaired cognitive functioning. This goes far beyond the feeling of “being tired” that is associated with not getting a good sleep for a night or two; rather, this sort of exhaustion is the cumulative effect of never having truly restful, restorative sleep—something which is unimaginable to most people who do not have a sleep disorder (though if you have ever stayed awake for 48 hours straight or more, you may have an idea of what it’s like for a narcoleptic).
One of the most tragic misconceptions about narcoleptics is that they suffer from an overabundance of sleep, when in fact they are invariably severely sleep deprived owing to the fact that their bodies “skip” the critical stages of NREM sleep that they require to remain healthy. This accumulates a significant sleep debt, one which mounts each day that the narcoleptic is alive, making even small tasks feel like a Herculean challenge.
Narcoleptics therefore struggle with all of the ills and difficulties that come with chronic sleep deprivation, such as impaired concentration, short term memory loss, “brain fog”, poor motor reflexes, blurred vision, headaches, and being at elevated risk for many serious illnesses.
- “Autopilot” type automatic behaviour. If you have ever seen someone sleepwalking (or been a sleepwalker yourself), you’re no doubt aware that it’s possible to get up, get dressed, even leave the house while actually sound asleep—a phenomenon many find decided scary when it happens to them. Now, imagine that you may end up driving, doing your work, or caring for your children in such a state; this is a fear, and reality, for many people struggling with narcolepsy.
What’s worse, this can be quite undetectable to outside observers, meaning that no one comes to the rescue to shake the narcoleptic out of it; numerous sleep tests and brain scans have proven that people may look, feel, and function as though they are awake when their brains are in fact sound asleep. If not properly managed (either through medication or the narcoleptic developing an uncanny awareness of when he or she is about to enter a sleep state) this symptom of narcolepsy can easily become life-threatening.
- Uncontrollable daytime sleeping. This, of course, is the most well-known symptom of narcolepsy: the complete inability to stop the body from falling into a sleep state. This symptom is, however, less abrupt than it is frequently portrayed by the media; often it comes on with poorly-managed managed narcolepsy, as a result of the sufferer pushing his or her body beyond its limit. Usually the sufferer will experience warning signs of extreme tiredness, then start to take “micro naps” of a few minutes at a time, often not being aware that he or she is doing so, rather than simply dropping off entirely. Once the narcoleptic has learned how to treat and manage his or her narcolepsy, this involuntary sleeping can often be curtailed.
- Excessive, vivid dreaming.
Those with narcolepsy have highly disrupted sleep cycles, ones which seldom enter the deep stages of sleep, and as such, they dream vividly and often, tending to enter a dream state immediately upon falling to sleep (whereas non-narcoleptics usually take about 90 minutes to begin dreaming). This makes narcoleptics more susceptible to nightmares, night terrors, and sleep paralysis. This can often be managed by the development of lucid dreaming skills, through which the narcoleptic may (upon sensing the signs that sleep is imminent) use positive emotions and conscious awareness to manipulate the content of his or her dreams. This skill usually takes a good deal of time to master, however, as narcoleptics often have particularly vivid and life-like dreams, full of deep emotion which they find it easy to get caught up in.
Due to this frequent, vivid dreaming intruding into daily life, many narcoleptics experience “false memories”, where they confuse dreamed events for real ones. Often these events are quite mundane in nature (such as dreaming one has taken out the garbage, when one hasn’t), so are easily overlooked as something potentially the product of a dream.
- Fragmented / broken sleep. Narcoleptics are plagued by the inability to sleep deeply and restfully, despite sleeping frequently. Many narcoleptics, while they drop off quickly, find it very hard to actually stay asleep; they may wake anywhere from 6 to 20 times a night, or even more in extreme cases.
- Hallucinations (in conjunction with sleep paralysis). As mentioned prior, narcoleptics are susceptible to sleep paralysis (being unable to move upon waking), as they often wake up directly from REM sleep, whereupon the brain may still be dreaming but the body awake, or vice versa. This pattern also makes the sufferer prone to hallucinations, which are often disturbing in nature as they play upon the sufferer’s conscious fears.
- Body temperature irregularities. While this symptom has not been deeply explored by the medical community, many narcoleptics report waking up feeling unusually freezing cold, and having to swath themselves in layers of clothing and blankets to get warm again… Only to wake up some time later feeling far too hot, having to peel off many layers, and starting the cycle all over again. This symptom may be related to depleted oxerin levels, as the hypothalamus is also responsible for body temperature regulation.
- Increased appetite / sugar cravings.Increases in appetite are normal for anyone who is sleep deprived—after all, the body is depleted of energy, so it looks for sources of energy in the immediate environment to keep itself fuelled—but sleep and appetite are more closely linked than many people realize. Narcoleptics often suffer from additional digestive issues, such as intense, sudden hunger pangs even after eating well, which may lead to the onset of nausea at any time, day or night.
Sleep deprived people are also most likely to crave simple carbohydrates (i.e. sugary treats, white bread), and narcoleptics are particularly susceptible to becoming entrenched in vicious cycles of sugar-related highs and lows, as they easily come to rely on the sudden bursts of energy sugar provides.
Studies also suggest a link between altered orexin levels within the hypothalamus and more frequent and intense cravings for glucose, with orexin levels being further affected by this consumption of glucose, which may also explain the predisposition of narcoleptics toward “sugar cycles”.
- Other sleep conditions. Research has revealed that those with narcolepsy also have a higher chance of suffering from other sleep conditions in tandem with narcolepsy, such as Restless Leg Syndrome and Sleep Apnea.
- Mood swings. Naturally, anyone with a chronic debilitating condition like narcolepsy suffers from anger, frustration, sadness, confusion, and a host of other negative emotions, and justifiably so. Narcoleptics may be at particular risk for depression, however, owing to the influence the hypothalamus upon mood, specifically the condition of chronic depression.
- Cataplexy often, but not always, goes hand in hand with narcolepsy, though they are frequently treated as separate conditions. Episodes of cataplexy are often triggered by intense emotions, including happy emotions (laughter in particular is a notorious trigger), and bring on muscle weakness so intense the narcoleptic may end up collapsing. This symptom is most likely what gives rise to the stereotypical image of the narcoleptic suddenly collapsing onto the floor; however, during cataplexy the narcoleptic is actually usually completely aware, making this symptom particularly frightening and disempowering.
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