Narcolepsy is a malfunction of the sleep/wake regulating system in the brain which until recently was of unknown origin. Its most common manifestation is Excessive Daytime Sleepiness and sleep attacks.

Symptoms of Narcolepsy includes:

a. Temporary paralysis on falling asleep or awakening (sleep paralysis).

b. Hallucinations - vivid images or sounds - on falling asleep or awakening (Hypnagogic and hypnopompic hallucinations respectively).

c. Moments (but sometimes extended periods) of trance-like behaviour in which routine activities are continued on "auto-pilot" (Automatic behaviour).

d. Interruption of night-time sleep by frequent waking periods, marked by quickening of the heart rate, over- alertness, hot flushes, agitation, and an intense craving for sweets.

Is there any treatment?

There is no cure for narcolepsy, but the symptoms can be controlled with behavioral and medical therapy. The excessive daytime sleepiness may be treated with stimulant drugs or with the drug modafinil. Cataplexy and other REM-sleep symptoms may be treated with antidepressant medications.

Medications will only reduce the symptoms, but will not alleviate them entirely. Also, many currently available medications have side effects. Basic lifestyle adjustments such as regulating sleep schedules, scheduled daytime naps and avoiding "over-stimulating" situations may also help to reduce the intrusion of symptoms into daytime activities.

Drug Therapy

Stimulants are the mainstay of drug therapy for excessive daytime sleepiness and sleep attacks in narcolepsy patients. These include methylphenidate (Ritalin), modafinil, dextroamphetamine, and pemoline. Dosages of these medications are determined on a case-by-case basis, and they are generally taken in the morning and at noon. Other drugs, such as certain antidepressants and drugs that are still being tested in the United States, are also used to treat the predominant symptoms of narcolepsy.

The major side effects of these stimulants are irritability, anxiety, quickened heart rate, hypertension, substance abuse, and disturbances of nocturnal sleep. Methylphenidate and dextroamphetamine are known to cause hypertension. A common side effect of modafinil is headache, usually related to dose size, which occurs in up to 5 percent of patients. Pemoline poses a very low but noticeable risk for liver complication. None of these stimulants influence the occurrence of narcolepsy's auxiliary symptoms and usually are not used to treat them.

Modafinil does not carry the addiction potential that methylphenidate and dextroamphetamine do. In fact, the latest development in treatment is a new modafinil drug called Provigil, which does not act as a stimulant and so does not produce side effects like anxiety and irritability. Provigil's therapeutic effects have been observed in maintenance of wakefulness test research, where patients have tripled their wakefulness.

Although there is no cure for narcolepsy, excessive daytime sleepiness, sudden sleep onset, and cataplexy. Proper sleep hygiene,which includes a consistent sleep schedule and the avoidance of shift work and alcohol, can drastically reduce the ill impact of narcolepsy.

And often, patients with narcolepsy feel refreshed after a short nap; therefore, taking short scheduled naps may greatly benefit patients combatting excessive daytime sleepiness.