Narcolepsy: What We All Should Know
Published in The Huffington Post
Narcolepsy. Though many recognize the word, relatively few of us know what it really means. And why should we? As far as sleep disorders go, it’s not nearly as common as insomnia or apnea. And let’s face it, it doesn’t sound very sexy either. (As one patient put it, “Combining ‘narc,’ and ‘olepsy,’ sounds like an epileptic narcotics agent to me.”) Actually, the term literally refers to sleep attacks. But it’s so much more complex and interesting than that.
Why should we all know more about narcolepsy? First, many if not most persons with narcolepsy (PWN) remain undiagnosed and, therefore, are not receiving the treatment and support they need. The majority of PWN that I’ve seen in my practice had initially been misdiagnosed with conditions like chronic fatigue syndrome or depression. Narcolepsy can be terribly challenging, and it’s critical that both the public and professionals become better informed about its signs and symptoms. Still another compelling reason for all of us to get more informed about narcolepsy is that it can teach us so much about sleep and dreams and even life itself.
So, what is narcolepsy? In short, it’s a condition in which the boundary that ordinarily segregates waking consciousness from the world of sleep and dreams becomes exceptionally permeable. For most of us, sleep is largely walled off during the day. In narcolepsy, sleep readily slips into and out of waking consciousness.
Normally, sleepiness accrues gradually through the waking day, reaches its peak at night, and is then discharged with sleep. It’s a bit like urine accumulating in a bladder and then reaching a threshold where it insists on being emptied. Metaphorically speaking, PWN have a small “sleepiness bladder.” They can’t hold accumulating sleepiness for long stretches without nodding out for short periods. Just as a small bladder might require one to get up and urinate frequently at night, a small “sleepiness bladder” can force one to get down and sleep repetitively by day.