Narcolepsy and Sleep Apnea as Main Sleeping Conditions

As the world turns, change becomes a consistency. Other consistencies in life involve your body’s rest and performance cycles. Rest often determines the productivity rate of an individual.It has been stated by several physicians that the average person should aim for 7-8 hours of adequate sleep. Athletes May perform better the next Day day if well rested the night before. Newborns and small Infants can be said to be a little cranky when sleep deprived not to mention the five year old that haven’t had their nap all day. Every situation previously stated is ideal in reference to how humans seek rest. However, under different circumstances is individuals that suffer to get enough sleep, have varied sleep rates in a 24hour period, Experience lack of oxygen while sleeping or may not be able to sleep at all. Sleep disorders are real and is becoming more frequent amongst individuals. In this literary review we are exploring the various sleeping disorders, their origins, signs, symptoms and suggested treatments. Sleep Apnea is one of the most prevalent diseases in the U.S. Sleep Apnea literally means “without breath”. Sleep Apnea is categorized by the involuntary stoppage of breathing followed by a randomized restart. With about ¼ of the American population having Sleep Apnea about 75% of that same population isn't even aware of their alarming condition (vitalrecord.tamhsc.edu). Sleep apnea is further broken into two main categories: Obstructive sleep apnea and Central Sleep Apnea. Obstructive Sleep Apnea commonly referred to as OSA is an Apnea where throat muscles relax and block the airway during sleep as a result no air enters the lungs upon expansion of chest.

A result of obstructive Apnea includes snoring. Sleep Apnea can be treated in several ways. The go-to treatment method is called Positive Airway Pressure Device or PAP machine. The machine is used for moderate or severe sleep apnea and eliminate snoring and OSA. Studies show that with being consistent individuals who use this type of therapy feel better, and have leesend effects of the disease. Oral Appliances are growing in popularity as treatment options for Sleep Apnea. The difference between the two therapies is that the PAP machine is constant across the board and the Oral Appliances vary having over 100 different types that are approved for treatment. The function of the oral device is to hold the lower jaw forward to keep airways clear and stop the tongue from collapsing, ultimately stopping the rate of cessation of breath. While OSA is influenced by blockage of the airways Central Sleep Apnea is a result of your brain failing to tell your muscles to breathe ultimately resulting you to not breath.

The timing in between the breathing varies by age. Newborns can have a maximum of 20 seconds of paused breathing whereas adults are up to eight(SleepHealth CD1). CSA can also be linked with severe lower brain stem illness. The lower brainstem is the main control of breathing and communication with brain. Treatment for CSA is through Continuous Positive Airway Pressure or CPAP. The CPAP machine covers the mouth and nose connected to a motor that blows air into the tubing. The CPAP is used in newborns with poorly developed lungs. In addition to lack of oxygen in sleep is the varied sleeping patterns within a 24 hours. Narcolepsy is a disorder characterized by uncontrollable brief episodes of sleep, frequent hypnagogic hallucinations and sleep paralysis(The Gale Encyclopedia of Neurological Disorders.) Narcolepsy is idiopathic meaning that there isn't a direct cause. Studies in the Early 2000’s expressed that narcolepsy is due to a neurotransmitter imbalances. Patients that have been diagnosed with narcolepsy have a below average amount of the neurotransmitters referred to as hypocretin. Hypocretin is also responsible for daytime sleepiness and hallucinogenic behavior that is linked to narcolepsy. There are three types of Narcolepsy, the first type is Narcolepsy with Cataplexy. Cataplexy is a sudden and transient episode of muscle weakness followed by full conscious awareness, typically triggered extreme emotions inclusive to laughing, crying, or terror.

It can occur in the face, neck, and knees. Some people have only mild weakness, such as head or jaw drop, but some people completely collapse to the ground. Roller Coasters, or any activities that can promote any emotional response is not advised for patients with narcolepsy with cataplexy. There is also Narcolepsy without cataplexy which involves excessive daytime sleepiness. Excessive daytime sleepiness (EDS) is a persistent background feeling of sleepiness with a tendency to doze off at intervals throughout the day, often at inappropriate times. These are known as sleep attacks. It can lead to brain fog, poor concentration, decreased energy, memory lapses, exhaustion, and a depressed mood. Each diagnosed patient has various times where EDS is at it highest. These period of excessive daytime sleepiness can be determined by the workload, activity level and quality of sleep of the individual. Last type results from an injury to the hypothalamus. The hypothalamus is the master gland in the body and is the regulator of the sleep cycle. In a typical sleep cycle, individuals enter the early stages of sleep, followed by deeper sleep stages for 90 minutes where finally REM sleep occurs. REM sleep stands for Rapid Eye Movement Sleep. This sleep in a special phase in not just humans but mammals in general as well as birds and other animals. It is the dream phase and in a sleep cycle REM sleep and Non REM sleep alternate. However with narcolepsy instead of entering REM sleep within a 90 minute timeline the body enters within 15 minutes of falling asleep. The brains keeps muscles limp during typical REM sleep which prevents people from acting out their dreams.

Individuals that are diagnosed with narcolepsy frequently enter REM sleep rapidly. Also, the muscle weakness or dream activity of REM sleep can occur during wakefulness or be absent during sleep. This helps explain symptoms hallucinations and sleep walking. Narcolepsy affects 1 in every 2,000 people and in the event that this sleep disease goes untreated it can interfere with progress academically, socially, physically, and psychologically. Narcolepsy is diagnosed using a series of sleep studies and the levels of hypocretin as well as family history. Out of all cases of documented narcolepsy 10% can be traced back to familial commonalities in symptoms. Narcolepsy cannot be cured however it can be treated. Going by the commercial name of Nuvigil, Armodafinil is the designated drugs for narcolepsy. It reduces extreme sleepiness as well as addresses the periods of stopped breathing during sleep that Sleep Apnea causes. Adequate sleep should be the goal prior to the drug usage and it is also advised not to medicate unless a diagnosed narcoleptic(nih.gov/nuvigil). Other cautions in using this drug includes the decreased productiveness of birth control and other hormone regulators. In essence, there are several programs and foundations created and maintained just for the advancement of those individuals who fall victim to these very serious sleeping disorders. The National Sleep Foundation is one of the main contributors to accurate public information and aid. The mission of the National Sleep Foundation is to be dedicated to improving health and well-being through sleep education and advocacy. This is done through multiple facets.

While working to become and maintain the global voice for sleep health, the National Sleep Foundation's has established goals to promote the increased incorporation of sleep science in mainstream services and technological products. The NSF also works to make sure the world views sleep as a health related vital sign by not only medical professionals but to the general public as well. Additionally, the foundation has efforts to ensure schools, homes, transportation and workplaces are designed in lieu of sleep. The NSF has set the tone globally in making sleep disorders and knowledge of them attainable and easy to understand. In addition to the NSF serving as the main source of news and education we also have independent foundations such as Jack and Julie which provide scholarships to Narcolepsy students seeking to continue education and the Wake Up Narcolepsy which has the goals to mass fundraise, promote research and to generally bring increased amounts of support to individuals diagnosed and well as their to all families. As a diagnosed patient of Narcolepsy for going on 12 years the internal understanding lies within the fact that it Narcolepsy or Sleep Apnea is something to let defeat you or our activities for daily living yet instead, it is something to learn and understand. To work to push another day. Through education, advocacy and research we are one step closer to providing solutions to this critical health concern. It is also noted that within the sleeping disorder arenas is Hypopnea which isn't a complete stop in breathing but when the breathing level sporadically reduces.