Every year almost 150,000 Americans get diagnosed with narcolepsy; making it a rare type of neuro-related disease. According to the National Institute of Health (NIH), narcolepsy is defined as a neurological disorder, which chronically affects the brain cells; particularly responsible for controlling sleeping cycles. It is often called “sleep attacks”. People, who are unaware often ask if narcolepsy is a disability? The answer is Yes, to a certain level! If it disrupts the normal life of an individual to a certain level.
What is Narcolepsy?
In simple words, narcolepsy is a sleeping pattern disorder. The individuals who suffer from it, feel drowsy and sleepy all day long even if they had a good night’s sleep. The sleeping disorder can be so critical that they may fall asleep while doing any day-to-day activities like talking, walking, driving, eating, etc.
Narcolepsy can be a real menace for the sufferer as it disrupts normal life by causing a halt in the activities and making it impossible for the individual to perform one’s social duties with recurring interferences.
Narcolepsy is often accompanied by “cataplexy”, a sudden muscular weakness leaving the person shunned and unable to make any movement. Cataplexy is a sudden attack and it can be caused by raging emotions like fear, laughter, crying, or anger.
Cataplexy can also cause sleep paralysis. Sleep paralysis is an extension of cataplexy which occurs right before a person falls asleep or soon after one wakes up. The level of sleep paralysis differs from person to person as sometimes it is also accompanied by hallucinations or some kind of vivid dreams.
Is narcolepsy a disability for people who are aged below 25? It can be at times, but as the cause of this ailment is not known thus there is no cure for it as well. It is a rare disease that can occur in both genders and may last a lifetime.
Is Narcolepsy a Disability?
Narcolepsy is not a disability of physical nature, but it affects the life of the sufferer to a greater extent than almost all of one’s day-to-day activities are halted. Narcolepsy is often caused by some sort of autoimmunity disorder. It is also observed that the genetic history of narcolepsy also budgies in the disease. A brain injury can also trigger this ailment but that is very rare.
An individual who suffers both from narcolepsy and cataplexy experiences a high level of hypocretin. It is a chemical that regulates rapid-eye-movement sleep (REM) in the brain.
Narcolepsy – The Diagnosis
The diagnosis of narcolepsy is made by a neurologist after thorough checkups and by frequent visits. The neurologist critically examines the current physical condition of the patient along with going through one’s complete medical history. At times the symptoms of narcolepsy are so obvious; it is not difficult to conclude that a person is suffering from it; still, there are certain mandatory tests required to be performed to confirm that the patient is suffering from narcolepsy.
Tests to Diagnose Narcolepsy
Some of the tests which are conducted to confirm narcolepsy are:
The polysomnogram test is also known as a sleep study. It is a recording of brain and muscular activity, eye movements, and breathing conducted overnight. A PSG result determines whether the REM sleep is occurring in the sleep cycle of the individual causing narcolepsy or if one is suffering from some other neural disease such as sleep apnea.
Multiple Sleep Latency Tests (MSLT)
This test is performed on an individual by assessing the sleepiness cycle in the daytime particularly to measure how long it takes for an individual to fall asleep and whether one enters the REM sleep or not.
When MSLT is performed, the person is asked to sleep for five short naps during the day hours with an interval of two hours between them. If the result shows that the person fell asleep within 8 minutes on average in every nap of the day, then one is indeed suffering from excessive daytime sleepiness. However, to determine if the said person is suffering from narcolepsy, it is very important to consider the night sleep pattern. If a person sleeps within 15 minutes; in any two naps out of five and had a good night’s sleep before – this indicates that REM sleep is occurring and it is being caused by narcolepsy.
At times a neurologist might perform a spinal tap test. A sample of cerebrospinal fluid is withdrawn from the brain and spinal cord using the lumbar puncture technique. This test is performed to measure the hypocretin-1 level in the fluid which surrounds the spinal cord and brain.
Low levels of hypocretin-1 indicate that a person is suffering from narcolepsy.
Treatment of Narcolepsy
There is no complete cure available for narcolepsy but there are certain medicines and actions which can most certainly reduce the daytime drowsiness and improve the alertness in the patient.
At times when narcolepsy has gone to a severe stage, neurologists prescribe amphetamine-like stimulants such as methylphenidate. This medicine requires to be monitored carefully; as it garners side effects such as irritability, shakiness, nighttime sleep disruption, nervousness, and a disturbed rhythm of the heart. The potential of drug abuse is very high so whoever takes it should be very careful with the dosage.
Modafinil is usually the first medicine prescribed to the patients because of its fewer side effects and mild addiction compared to the other drugs. It works on most people reducing drowsiness in the daytime and keeping them alert throughout the day.
Two broad spectrums of antidepressants are often effective to control narcolepsy accompanied with cataplexy in the patients.
Tricyclics include desipramine, protriptyline, imipramine, and clomipramine; along with certain noradrenergic inhibitors and serotonin such as atomoxetine, venlafaxine and fluoxetine are prescribed in a combination.
Antidepressants have lesser side effects compared to amphetamines, still, they may result in adverse effects such as high blood pressure, impotence, and irregular heart rhythm.
Sodium oxybate is also termed gamma hydroxybutyrate or GHB. It is officially approved by the United States Food and Drug Administration for the treatment of cataplexy and narcolepsy accompanied by excessive daytime sleepiness.
Sodium oxybate is a very strong sedative and it should be taken in moderate quantity only. The distribution of this drug is highly restricted and is sold by the pharmacies only on doctor’s assurance.
People suffering from narcolepsy are advised to change their lifestyle, and adopt healthier means of living. Avoid drugs and alcohol and caffeine, exercise and eat healthily and take short naps, and if smokes then quit it completely.
These are certain drugs that are prescribed to cut down the effect of narcolepsy in an individual but it varies from person to person.
All of the above medications should be taken by doctors’ prescription only as they come with adverse side effects.
Disability Benefits of Narcolepsy
To gain disability benefits on account of narcolepsy; from Social Security (SSDI) or Long Term Disability Benefits (LTD), it is important to check how it is affecting the concerned person’s workability.
The medical record should administer the frequency, intensity, and duration of the daytime sleep along with the factors which aggravate it. A complete detailed account of medicines and treatment should be part of the documents to assure the authorities that the person is facing limitations because of narcolepsy disability.
The daytime sleepiness may prevent a person from performing their job or staying active in the work premises causing a delay in their daily tasks. The medicinal side effects can also impair a person from performing well at the job.
All these factors can contribute to making a person liable to gain disability benefits on the account of narcolepsy.
A person may apply for SSDI or other disability benefits on account of narcolepsy and cataplexy; as it is a medical condition that may last a lifetime.