NODDING off at work even after a full night’s sleep can be a sign of narcolepsy, a chronic sleep disorder. There is no cure, but the condition can be brought under control and sufferers can go on to lead normal lives.
Mdm Christine Leong (not real name) often fell asleep at work. She did not stay up late, often went to bed early, and usually had a good night’s sleep. Yet, she was always feeling tired and sleepy during the day, often nodding off at her desk no matter how hard she tried not to. She decided to see a doctor, who ran some tests and found her to be suffering from narcolepsy.
Narcolepsy is a sleep disorder characterised by overwhelming daytime drowsiness and sudden attacks of sleep which can seriously disrupt a sufferer’s work routine. Left untreated, it may even endanger the lives of the patient and those around him. Imagine a driver falling asleep while driving.
There is no cure for narcolepsy, but with the right treatment and lifestyle changes, the condition can be kept in check, helping sufferers lead normal lives.
Narcolepsy is estimated to affect 25 to 50 people in every 100,000, but this may be understated. A lack of awareness or understanding about this ailment may lead many to think that they are merely sleepy, said Dr WS Shahul Hameed, Consultant, Department of Neurology, National Neuroscience Institute (SGH Campus). The condition is equally common among men and women, and typically shows up in the teens and early 20s. The exact cause of narcolepsy is not yet known, but doctors believe it might be linked to genes, virus attacks and head traumas.
Besides excessive daytime sleepiness, sufferers may experience other symptoms including cataplexy (where intense emotion like laughter or anger or strenuous exercise triggers a loss of muscle control), sleep paralysis (where the person is unable to talk or move for brief periods when falling asleep or wakening), as well as hypnagogic hallucinations (where the person experiences vivid dreams and sounds as he is about to fall asleep).
Sufferers tend to be depressed, with obesity commonly seen in child sufferers.
To diagnose narcolepsy, the patient must first undergo a detailed medical history and physical examination, and keep a sleep diary to rule out bad sleeping habits such as frequent late nights and insufficient sleep as the cause of his symptoms.
This is followed by an overnight polysomnogram: the patient’s sleep is monitored in a hospital, and various bodily functions and indicators like breathing, blood oxygen levels, snoring and heart rate are taken through the night. A multiple sleep latency test is also performed to assess how easily the patient falls asleep in the day, and the type of sleep patterns produced during these bouts of sleep.
As part of the treatment, a specialist may prescribe medication and lifestyle modifications to boost alertness and control symptoms. For example, a post-lunch power nap can be a simple and effective way to keep daytime sleepiness in check.
Dr Hameed said: “Health awareness is high in Singapore and bosses are generally understanding when their employees approach them (about their diagnoses). They often don’t have a problem with their employees taking a catnap during the day if that helps to manage the sleepiness caused by narcolepsy.”
Undiagnosed narcoleptic sufferers can face problems at work, with their sudden bouts of sleepiness often mistaken for laziness, said Dr Hameed.
However, once they have been diagnosed and receive treatment, the situation can change “dramatically” for the better, he added. For example, patients can take 20 to 30 minutes of their hour-long lunch break for a nap in a quiet spot in the office, before getting back to their daily responsibilities. Besides power naps, medication can be prescribed to help patients stay alert during long meetings.
Dr Hameed recalled the case of a teenage patient whose cataplexic episodes caused problems at school. He prescribed medication to help keep her attacks under control.
Patients can also cultivate lifestyle habits like keeping to a healthy regimen of sleeping seven to eight hours a night, not drinking excessively, and avoiding medication that causes drowsiness.
• This story was first published in Singapore Health, Jul-Aug 2014 issue.
* pseudonym