Is narcolepsy with cataplexy a disability?

Narcolepsy symptoms in adults

Narcolepsy is a condition in which the brain loses control of being in a state of sleep or wakefulness. People suffering from this condition may sleep during the day and experience other symptoms as well. However, the condition seems to be disruptive, but can be easily dealt with through treatment. With proper medication like Smartfinil 200 and care it is easy to manage this situation and cope with its effects. 

This disorder always makes you feel sleepy at any time of day. And the urge is so strong that you cannot even resist. Although it is not commonly seen in people, it’s popular for its symptoms. 

5 signs of narcolepsy

Narcolepsy can be detected with the help of its five commonly known symptoms. These symptoms are: 

• Feeling sleepy during daytime: It is the most common symptom among people suffering from narcolepsy. As per experts they call it sleep attacks. People start falling asleep randomly with this symptom. 

• Weakness in muscle: It can also be described as cataplexy. In this you will have sudden and mild weakness in the one side of your body. 

• Hallucinations: These symptoms can occur in patients with narcolepsy. It might happen while sleeping or waking up. Also it can even be frightening or vivid. 

• Disturbed nighttime sleep: People with this problem might face problems in falling asleep. Hence disturbed dreams along with frequent waking up could be a symptom. 

• Sleep paralysis: It is one of the common symptoms of narcolepsy. Hence it leads to temporary incapacity to move or speak while you are asleep. 

Narcolepsy with cataplexy

Narcolepsy type 1 is a combination of narcolepsy with cataplexy which is a sleep disorder caused due to neurological problems. One can identify this disease through characteristics like excessive sleeping during daytime and sudden pain in muscles developed due to muscle weakness that happens due to emotions. 

Hence this cataplexy can be a distinguishing feature of Type 1 Narcolepsy from Type-2. This type Type-2 Narcolepsy is the one without Cataplexy. The feature of this narcolepsy is: 

• Having sudden uncontrollable sleep attacks with overwhelming sleepiness 
• Many individuals might have sleep paralysis and hallucinations. 
• Sudden pain in muscles that is triggered due to strong emotions. 
• This type 1 Narcolepsy is associated with deficiency in neurotransmitter hypocretin that regulates sleep. 
• People with a family history of this disorder have 10% chances of having it. 

This type of narcolepsy affects about 0.02% of people worldwide. And these symptoms begin at teenage or early in adulthood. 

Difference between Narcolepsy with and Without Cataplexy

The main difference between Narcolepsy with or without Cataplexy is evident in the name itself. If Narcolepsy is with Cataplexy it is known as Type 1 and if it’s absent it can be called Type-2. The type-2 is characterized by absence of cataplexy hence, the patient will not feel a sudden loss of muscle tone, which happens due to high emotions. 

Type 1 is generally due to low oxerin, which is a neurotransmitter, but this is not the case with type 2. All type 2 patients will have a normal level of this hormone. Here’s a detailed breakdown of the differences. 

Narcolepsy type 1 (with Cataplexy) 

• Cataplexy: A Feeling of muscle weakness that could be mild or complete. One could also face loss of muscle control. All of this is triggered due to emotions. 
• Orexin levels: In these types of patients, the level of the orexin neurotransmitter is low. Hence, it affects the sleep cycle. 
• Daytime sleepiness: One of the most common symptoms observed in all patients is feeling excessively sleepy during the day. 
• Other symptoms might include sleep paralysis and hallucinations. 

Narcolepsy type 2  (without cataplexy)

• No cataplexy: The patients with type 2 will not experience any kind of sudden muscle weakness. 
• Orexin levels: The orexin levels will be normal in these type 2 patients. 
• Daytime sleepiness: These symptoms will remain the same for both types of Narcolepsy  
• Additionally, other symptoms like hallucinations and sleep paralysis will also be seen. 

Hence, both of these narcoleptics will have excessive daytime sleepiness; the only difference is in the presence of Cataplexy and orexin levels.

Diagnosis for narcolepsy

Narcolepsy can be easily diagnosed with a series of clinical steps, studies on sleep, and certain tests. Here’s a list of tests that can be conducted to detect Narcolepsy: 

• Clinical evaluation and sleep history 

Evaluating sleep history in detail, which includes sleep patterns, the level of sleepiness you feel, and other symptoms like cataplexy. One might also face hallucinations or sleep paralysis. For this, the Epworth Sleepiness Scale is generally used. 

• Sleep studies

At first, your doctors might want to study your overnight sleep patterns through polysomnography. It can help analyze disorders and sleeping stages. 

The muscle sleep latency test has to be conducted one day after PSG. It can test the time at which a person can fall asleep if they get an opportunity. 

• Biomarker testing:

The first test is evaluating the levels of Oxerin. For type 1 patients, the level of this neurotransmitter is very low. For this, a lumbar puncture has to be done. 

Another test called HLA has to be performed to determine the presence of human leukocyte antigen. Although it is not only an indication of Narcolepsy, it can be helpful. 

• Other tests 

Actigraphy is a test that assesses sleep-wake patterns for determining narcolepsy. Know that there are certain conditions that can cause excessive daytime sleepiness. Hence, keep this in mind before checking for narcolepsy.

Narcolepsy with cataplexy treatment‌

If you are looking to manage narcolepsy with cataplexy together. It can only be possible when you adjust your lifestyle with medications. Two FDA-approved treatments for this type 1 Narcolepsy are sodium oxybate and oxybate salts. Additionally, if you have to manage cataplexy, you can go for antidepressants that inhibit serotonin or norepinephrine. 

Remember that you can consume these medications only after advice from a physician. Other options for its treatment are: 

• Pitolisant
• Modvigil 200
• Armodafinil
• Methylphenidate

There are several lifestyle changes that can be more helpful in dealing with type 1 Narcolepsy. You must create a fixed bedtime along with a cozy sleep environment. Additionally, you can manage daytime sleepiness through scheduled daytime naps. 

You must also be careful in avoiding emotions that could lead to cataplexy. Considering physical activities daily can lessen the chances of cataplexy or sleepiness. 

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