Narcolepsy is a disorder that is characterized by moderate to severe daytime sleepiness, cataplexy (emotionally triggered muscle weakness), hallucinations when falling asleep or awakening, as well as the inability to move for one or two minutes after awakening. It is uncommon for a person with narcolepsy to have all of these symptoms and it is important to rule out other conditions that can cause similar symptoms.
If narcolepsy is suspected, a polysomnogram (sleep study) is performed to rule out other sleep disorders and it is followed by a Multiple Sleep Latency Test (MSLT) the next morning. An MSLT is a test that involves measuring the amount of time it takes for you to fall back asleep during several interrupted nap periods.
If your MSLT is positive, you will likely need medications to treat Narcolepsy and you will discuss treatment options with your sleep physician.
Complex Disorders Requiring Advanced forms of Ventilation
There are many conditions that may require advanced forms of ventilation beyond CPAP therapy. Some patients with neuromuscular and other neurodegenerative conditions such as Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), and Parkinson’s Disease have loss of respiratory muscle function. This is especially evident while laying down to sleep. Other risk factors include obesity and COPD. If the respiratory muscles aren’t working properly, hypoventilation occurs. Hypoventilation leads to the build up of carbon dioxide and/or lack of oxygen in the bloodstream which can lead to respiratory failure. Advanced modes of ventilation at night are often necessary for these patients to ensure effective gas exchange.
Central Sleep Apnea and Cheyne Stokes Respirations
Central Sleep Apnea is a condition characterized by improper signaling from the brain during sleep and results in repetitive cessation or decrease in airflow and ventilatory effort. Risk factors for central sleep apnea include: heart failure, stroke, and chronic opioid therapy (pain medications). Symptoms of central sleep apnea are similar to obstructive sleep apnea and may include daytime sleepiness, insomnia, headache, and witnessed pauses of breathing during sleep. Diagnosis of Central Sleep Apnea is made by a sleep study and treatment often includes Positive Airway Pressure (PAP) therapy. If you or a loved one has any of the symptoms above, a consultation with a certified sleep physician is recommended.