Wednesday, July 24, 2019

How Modafinil Can Be Useful in the Treatment of Narcolepsy


A part of our lives that we frequently overlook and take for granted is our sleep. It is easy to underestimate how important our sleep is to how we feel and function in our everyday lives. Sleep is considered one of the basic needs of every human being that is needed for us to be physically and mentally healthy.

The average person sleeps for 7-8 hours a day. It is easy for us to overlook that if the average human being sleeps for 8 hours a day that this then turns out to be more than 30 percent of our life.
Any disturbance to the quality and amount of our sleep ends up having a very negative effect on our lives. This includes our mood and energy levels during the day, how well we work and play and our relationships with the people in our lives.

Narcolepsy is a sleep disorder that affects both the quality and duration of sleep of approximately 1 out of every 2000 people. Men and women are equally affected by Narcolepsy. Unfortunately, despite being a common and one of the well-recognized sleep disorders, it is not diagnosed by physicians and other health care professionals as often as it should be. This means that many people who are currently suffering from the negative effects of Narcolepsy can go undiagnosed and untreated for many years before they are treated.

Once Narcolepsy is diagnosed, there are multiple approaches to treating it. The most effective way to treat Narcolepsy involves using a combination of behavioral techniques and medications. One category of medicine used to Narcolepsy is called Stimulants. A popular, safe and effective stimulant that is increasingly being used to treat Narcolepsy is Modafinil.

What is Narcolepsy?

Narcolepsy is a sleep disorder that affects almost 1 out of every 2000 people. Men and women are equally affected by this condition. However, many people do not even know they are experiencing symptoms of Narcolepsy. They often struggle with and live with the difficulties that this condition can have on the quality of their personal and professional lives.

The typical person with Narcolepsy will describe feeling sleepy and tired much more than what is considered normal during the day and also have disturbed sleep at night. They also describe falling asleep very quickly and having little to no control of when and where they fall asleep. When they do fall asleep, they can experience very intense dreams, nightmares, vivid hallucinations, and sleep paralysis. In sleep paralysis, people experience a feeling of waking up from sleep but not being able to move.

These symptoms leave those with Narcolepsy feeling powerless and at a disadvantage. Due to limited awareness, people can often mistake people with Narcolepsy to be lazy, unproductive and uninterested. Narcolepsy comes at a very high social cost to those with the disease. To make it worse, they often don't understand their own condition.

At what age does Narcolepsy start?

A person can begin to experience symptoms of Narcolepsy at any age but it is known to start between the ages of 10-30.

What are the symptoms of Narcolepsy?

Narcolepsy is a chronic neurological sleep disorder. People with Narcolepsy commonly start experiencing when they are adolescents or young adults.  Unfortunately, having a chronic condition often means that once a person starts experiencing the symptoms of Narcolepsy they will most likely experience them for the rest of their lives.

The symptoms experienced by those with Narcolepsy are:

Excessive daytime sleepiness:

Patients with Narcolepsy will frequently complain of falling asleep without any warning at a time when it is not appropriate for them to sleep. They also fall asleep in places that may not be appropriate places to sleep.

Disturbed nighttime sleep:

Even though having Narcolepsy means that a person may fall asleep frequently and at random throughout the day, it does not mean that they have a normal amount of restful sleep at night that matches their cycle of staying awake during the day and sleeping at night.

Cataplexy:

This is a partial or total loss of muscle tone. This can be a distressing symptom experienced by only some people with Narcolepsy in which they experience suddenly losing function of some or all muscles of their body. Cataplexy happens without warning.

This loss of control is not permanent and recovery usually happens slowly over the course of a day but because there is no knowing when it will happen or what will cause this to happen, it can be very concerning.

Intense dreaming:

The unexpected falling asleep in Narcolepsy is also experienced with intense and often very realistic dreams (including nightmares) that often begin immediately when a person falls asleep. Depending on the dream, it can be distressing for the person.

Sleep Paralysis and Hallucinations: 

Sleep paralysis is the experience of waking up but feeling like you are unable to move. It is common to experience this phenomenon in adolescents and sometimes in our lives. But people with

Narcolepsy may experience this regularly.

Hallucinations can also be experienced during sleep paralysis. These hallucinations usually occur either when the person is falling asleep or when they are waking up. They can be very realistic and frightening for the person experiencing them.

What causes Narcolepsy? 
 

The answer to this question is not straightforward. We do not currently know what causes Narcolepsy. There is more information today about what causes Narcolepsy than in the past but despite advances in the study of sleep and sleep disorders, our understanding about what the causes are and why it happens in only some people and not in others is limited.

How do we Diagnose Narcolepsy?

The diagnosis of Narcolepsy involves a doctor taking a detailed medical history and performing a physical examination. Patients suspected of having Narcolepsy are referred to doctors who are specialists in diagnosing, treating and managing sleep disorders and its complications. These doctors are often Neurologists, ENT (Ear, Nose, and Throat) specialists or Pulmonary specialists.

After the history and physical exam, a doctor will usually proceed to perform specialized tests that are usually performed in a sleep lab. Two important tests required for a diagnosis of Narcolepsy are:
  1. Polysomnography: This is commonly called a sleep study. This is an overnight study in which multiple measurements are made while a person is asleep that help doctors learn more about the details of a person's sleep cycle.
     
  2. Multiple Sleep Latency Test: This testing is performed during the day. It determines how often a person falls asleep during the day, how long it takes for them to fall asleep and if they dream during this sleep or not.
It is important to know and understand that once an accurate diagnosis of Narcolepsy is made,  then there are multiple treatment options that can be prescribed to a patient including new stimulants such Modafinil Now.

Treatment of Narcolepsy

For anyone diagnosed with Narcolepsy, it is important to understand that it is a sleep disorder that is life long and has no known cure. However, through modern medication it is still possible for

Narcoleptic patients to get quality sleep in their lives and overcome the challenges that come with having Narcolepsy.

Managing Narcolepsy involves using techniques to change a person's sleep behavior and medication. Medications like Modafinil can help manage Narcolepsy and other sleep disorder conditions with relatively few side effects resulting in healthier more quality sleep.

What medications are used to treat Narcolepsy?

There are different medications that can be used to treat the disabling symptoms of Narcolepsy. These include:
  1. Stimulants  
  2. Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin and Norepinephrine Reuptake Inhibitors (SNRI’s) 
  3. Tricyclic Antidepressants (TCA) 
  4. Sodium Oxybate (Commonly known by its commercial drug name, “Xyrem”)
SSRIs, SNRI and TCA are used to manage the symptoms of Cataplexy (sudden loss of control of muscle), Hallucinations and Sleep Paralysis that often coexists with Narcolepsy. Sodium Oxybate is also useful for managing the symptom of cataplexy and also helps improve sleep at night.

Stimulants such as Methylphenidate, better known as Ritalin and Amphetamines an example of which is “Adderall” work by releasing the same chemicals in our body that are released when we have an adrenaline rush. They have been effective at managing excessive sleepiness in Narcolepsy but are associated with many side effects such as heart palpitations, high blood pressure, sleep deprivation, exhaustion, stomach disorders and more.

Fortunately, new medications such as Modafinil have proven to be a game-changer for managing the symptoms of Narcolepsy with fewer side-effects.

What is Modafinil and how does it work?

As described at Modafinil Now, Modafinil is commonly known as “Provigil”, “Modavigil”, and Alertec" depending on the market. Modafinil works on the histamine chemical system to promote alertness and decrease the tendency for a person to fall asleep.

Modafinil does not have the same habit-forming and addiction potential as other stimulants. Many patients describe feeling awake and present without it having an effect on their moods.

Modafinil blocks the same system that is often activated when a person takes an allergy or cold medication and then feels drowsy. This is the histamine system. This system has a role to play in promoting our state of wakefulness.

By only targeting the main symptom responsible for triggering Narcolepsy, Modafinil is able to promote wakefulness, increase alertness and reduce excessive sleepiness during the day.

What are the side effects of Modafinil? 

The side effects with the use of Modafinil are fewer and less serious than with the use of other stimulants. The most common side effect noticed by patients is Headaches. This side effect goes away within a day. Other less common side effects with the use of Modafinil include, dry mouth, feeling dizzy and an upset stomach.

How Modafinil can be useful in the treatment of Narcolepsy?

The use of new stimulants like Modafinil and the use of behavioral techniques that promote healthy sleeping habits are proving to be very useful in helping those with Narcolepsy. Patients can now maintain wakefulness, feel less tired, experience fewer side effects and have a significantly better quality of life. 

This is a guest blog entry.

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