bjbj Hello again. My name is Dr Ronald Popper and I am a board certified, sleep medicine
specialist and the Medical Director of the Southern California Pulmonary and Sleep Disorders
Medical Center in Thousand Oaks, CA Today I d like to talk to you about a sleep disorder
called narcolepsy. Narcolepsy is manifest by a symptom complex consisting of excessive
daytime sleepiness, cataplexy, sleep hallucinations and sleep paralysis. All of these symptoms
to not need to be present to make a diagnosis of narcolepsy, but when excessive daytime
sleepiness and cataplexy are present the diagnosis can be made clinically. In the absence of
cataplexy a sleep study and another type of study called a multiple sleep latency test
are required to confirm the diagnosis. So, what is narcolepsy? Let s look at the components
of narcolepsy. Daytime sleepiness can be found in many disorders such as sleep apnea, periodic
limb movements during sleep, shift work, it could be the result of medication or other
medical disorders, so daytime sleepiness by itself is not a sufficient symptom to make
a diagnosis of narcolepsy. So, what is cataplexy? Cataplexy is the sudden and uncontrollable
loss of muscle tone that can occur either out of the blue or in response to some kind
of trigger; the two most common triggers being laughter and anger. But any strong emotion,
be it joy, fear, being startled, getting into an argument, even during climax during sexual
activity any strong emotion can set off this sudden loss in muscle tone. This can be manifest
by the complete dropping to the ground, which is the classic textbook form of cataplexy,
which is rarely seen, to much more subtle manifestations such as the sudden shaking
of a hand while holding a coffee cup, slurring of your speech, a little blurring of your
vision. If you re working on a computer, your fingers might not move quite as well as they
ordinarily move. These symptoms can last, literally, from seconds to as long as 20 to
30 minutes. Patients come out of their cataplectic episodes often feeling drained, but often
they will also be as wide awake as they were just prior to the episode. Sleep hallucinations
or paralysis are just as the names imply. Patients will have a hallucination, seeing
or hearing or smelling an object or a sound or sensation that they know isn t there, as
they are falling asleep or right as they are waking from sleep. More commonly are sleep
paralysis episodes where, again, as the name implies, patients are paralyzed. They re wide
awake after they ve awakened in the morning or just as they re falling asleep. They are
aware of their surroundings but are completely unable to move. These episodes can last for
just a few seconds or even up to 10, maybe 20, minutes and the patient will come right
out of it. These are completely benign but they may be very, very frightening to the
patient. Narcolepsy is not as rare as we once thought it was. Narcolepsy is more common
in males, compared to females. The peak onset of symptoms occurs in the teenage years. We
have seen symptoms occur as young as 5 or 6 year old children, and in patients who are
well into their thirties. Patients who first present with symptoms of narcolepsy after
the age of 40 must rule out other sleep disorders first, before considering a diagnosis of narcolepsy.
And if one takes a very, very thorough history, retrospectively, most patients will demonstrate
symptoms way back into their teenage years or into their twenties. In children who complain
of daytime sleepiness, after ruling out other causes of daytime sleepiness, narcolepsy is
the diagnosis until proven otherwise. In years past, stimulants were the only medications
that were available to treat narcolepsy and they only treated the symptom of excessive
daytime sleepiness. Today we have many choices in the treatment of narcolepsy. To treat the
symptoms of interrupted nighttime sleep and cataplexy, we have a drug known as sodium
oxybate, or Xyrem. To treat the cataplexy, tricyclic antidepressants are also still used
by some physicians. To treat symptoms of daytime sleepiness we will often use drugs known as
provigil, modafinil, nuvigil also known as armodafinil, and older medications such as
dexadrine and ritalin and adderall are also available to treat symptoms of daytime sleepiness
I hope this video has been informative in helping you understand what narcolepsy is
all about. If you have symptoms that are suggestive of narcolepsy, please go to my website to
learn more about narcolepsy and then visit your primary care physician or see a board
certified sleep specialist at an accredited sleep center. Thank you for watching this
video and always remember, sleep well tonight for a better day tomorrow. [Content_Types].xml
u$Nw @8Jb _rels/.rels theme/theme/themeManager.xml sQ}# theme/theme/theme1.xml G$$DA :$BR si-@R
r,[L bX*x KfN1 ,tV@ .EML M .c =<R8 (F{\ O/6K 0i1; P0!Y ?sE/ ?J&l
p)af theme/theme/_rels/themeManager.xml.rels 6?$Q K(M&$R(.1 [Content_Types].xmlPK _rels/.relsPK
theme/theme/themeManager.xmlPK theme/theme/theme1.xmlPK theme/theme/_rels/themeManager.xml.relsPK
<?xml version="1.0" encoding="UTF-8" standalone="yes"?> <a:clrMap xmlns:a="http://schemas.openxmlformats.org/drawingml/2006/main"
bg1="lt1" tx1="dk1" bg2="lt2" tx2="dk2" accent1="accent1" accent2="accent2" accent3="accent3" accent4="accent4"
accent5="accent5" accent6="accent6" hlink="hlink" folHlink="folHlink"/> David Normal.dotm David
Microsoft Macintosh Word Tejasca Web Services, LLC Title Microsoft Word 97-2004 Document
NB6W Word.Document.8