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Feeling Sleepy During Day Time? This Can Be The Underlying Cause

Sometimes it happens that we suddenly start to uncontrollably feel sleepy. Such an urge for an uncontrollable daytime nap may not be just about being bored, or tiredness, or laziness.

Daytime Sleepiness

The underlying cause could be a neurological disorder known as Narcolepsy.

A lot of research has been done and a lot has been written about the most precious physiological phenomenon -  'SLEEP'. 

Sleep is very important to allow the body to regenerate itself emotionally and physically.

On average, a human being spends one-third of their lifespan in sleep. Having said, there are many people who find it difficult to fall asleep or have experienced issues with sleep at some point in their lives.

While sleep issues such as fragmented sleep patterns can lead to fatigue the is also an unpopular condition that results in excessive sleepiness called 'Narcolepsy'. This condition is also mistaken as Hypersomnia which also excessive sleep.

While people with Hypersomnia always complain about not getting enough sleep causing lethargy. Narcolepsy is a more chronic neurological disorder that interferes with the control of sleep and wakefulness.

In people suffering from Narcolepsy, the urge to sleep comes suddenly without any prior sign of falling asleep. They can even fall asleep when they are talking or even when they are driving.

We intend to share awareness of this sleep disorder for improved quality of life.


Causes

The exact cause of Narcolepsy is still unknown. However, it is regarded as an autoimmune disease leading to deficiency of neurochemical called 'Hypocretin'.

Hypocretin regulates the wakefulness signals in the brain.

People affected by Type 1 Narcolepsy have low levels of this Hypocretin hormone in their body.


Symptoms

The most apparent symptom of Narcolepsy is Excessive Daytime Sleepiness (EDS) resulting in regular uncontrollable urges to sleep throughout the day. The uncontrollable urges to sleep are commonly referred to as 'Sleep attacks'.

EDS further causes decreased concentration, poor memory, low energy, fatigue and depression.

In addition, people with Narcolepsy also show symptoms like hypnagogic hallucinations that make imagined sensations seem real, muscle weakness or cataplexy, sleep paralysis and automatic behaviours.

While hallucinations caused due yo this condition can be vivid, they can also be frightening when it leads to sensory hallucinations. It may further involve Rapid Eye Movement (REM) which is common during the state of wakefulness and dreaming.

Sudden Muscle weakness or cataplexy affects the muscles of the face, neck and legs. The muscle weakness can be mild in some people such as causing head or jaw drop, while for some people it can be severe resulting in a fall on the ground. This is usually triggered by strong emotions such as laughter, anger or surprise. 

Sleep paralysis is the temporary inability to move while waking up from sleep. It usually feels like you are not able to move while you suddenly wake up from sleep. This can be extremely terrifying when you also experience hallucinations.

Sleep Paralysis

Automatic behaviours can occur where the person may fall asleep while doing some activity such as walking or driving while the person tends to continue the activity in the subconscious state.


Diagnosis

Physicians usually diagnose by checking the symptoms and asking for detailed sleep history of patients. Patients are also asked to answer a set of questions to determine the degree of sleepiness. The test is referred to as the 'Epworth Sleepiness Scale'.

It is mandatory to keep the sleep records including monitoring and recording sleep patterns at least for a week to ascertain whether the sleep patterns and alertness are related.

In addition to a sleep log, the doctor may advise wearing a wristwatch-like device called an actigraph that measures the period of activity and rest.

Two other tests are also recommended by doctors - Multiple Sleep Latency Test and Polysomnography Test

Multiple Sleep Latency test measures the time a person takes to fall asleep during the day. Doctors observe the sleep pattern. People with Narcolepsy fall asleep very easily and enters REM sleep very quickly.

Polysomnography test makes use of electrodes placed on the scalp of patients to measure a variety of brain signals during sleep. This test is usually at a medical facility where the patient has to stay for one night. In addition, this test also measures the electrical activity of the brain (electroencephalogram), heart (electrocardiogram) and movement of muscles (electromyogram), eyes (electrooculogram) and breathing.


Treatment

There is no permanent cure for Narcolepsy. However, medications and making certain lifestyle changes can help in managing the symptoms.

Treatment involves both pharmacological as well as non-pharmacological components.

While maintaining a proper sleep pattern is important, doctors also recommend exercises and a healthy diet.

Persons affected with Narcolepsy usually improve if they maintain a regular sleep schedule of at least seven to eight hours of sleep per night along with naps during the daytime.

Pharmacological treatment involves the use of Central Nervous System stimulants such as methylphenidate, dextroamphetamine sulphate, modafinil, and solriamfetol to minimize daytime sleepiness and improve symptoms.


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