Sleep Disorders

1. Sleep Disorders By: Mirella Cabrera Psychology Ms. McElmoyl Per. 7

2. Sleep-Wake Cycle… • A sleep cycle is divided into 4 different stages plus REM sleep. It is known to be, “defined by a segment of non-rapid eye movement (NREM) sleep followed by a period of rapid eye movement (REM) sleep.” Non-REM sleep is further divided into 4 deeper stages of sleep due to the different size and frequency of brain waves.

3. Sleep Apnea: This sleep disorder is caused by specific snoring, enlarged tonsils, obesity, and repeated infections in the throat. • Narcolepsy: Causes sleep attacks during the day due to being very sleepy during the day; sudden sleep and hallucinations may occur. • Insomnia: It is when you don’t get enough sleep which causes anxiety and depression. One of the major reasons for this disorder is alcohol and drugs. • Night Terrors: When intense stimulations in the parts of the brain working during REM sleep causing the person to scream, sweat, panic, have a rapid heart rate, and be confused. • Sleepwalking: Is when walking or talking takes place while sleeping, this causes stress and fatigue. This disorder can be caused by sedative medicine or may be genetic/heredity.

4. Illustration By: Kathryn Born • DANA Foundation states, “Hypocretin is manufactured by cells in the hypothalamus, which helps control sleep.” Many of the people who suffer from narcolepsy have lost these cells, due to an incorrect immune response.

5. Narcolepsy Affect… • This sleep disorder affects 1 in every 2000 Americans, it is considered to be a “neurological disorder” in which it affects the control of sleep and wake cycles. Sleep Disorders Health Center has explained the effect of this disorder in our “typical sleep cycle” by stating, “We initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep.” This means that for the people who suffer from this disorder would quickly fall into REM sleep while being asleep or awake. • REM sleep is the stage in which you dream and experience muscle paralysis.

6. Excessive Sleepiness (ES) • It is stated that everyone who suffers from narcolepsy also suffers from excessive sleepiness (ES). • Nuvigil website has stated, “People with narcolepsy do not necessarily sleep more than the average person. In fact, regardless of how well they sleep, patients with narcolepsy experience ES.”

7. Symptoms… • Excessive Daytime Sleepiness (EDS): Mental cloudiness, lack of energy and concentration, failure of memory, depression, and exhausted. • Cataplexy: Sudden loss of muscle movement causing loss of muscle control, weakness, and difficulties in speaking. • Hallucinations: Delusional experiences that are primarily visual, but other senses may be involved. • Sleep Paralysis: Not being able to move or speak while falling asleep or waking up; lasts between few seconds to several minutes.

8. Diagnosis… • Even though narcolepsy may occur to anyone at any age, the most popular age in which someone may become more familiar with this sleep disorder is at the ages 15-20 (Shown in this graph).

9. Diagnosis… • Narcolepsy usually begins between the ages 15 and 25, but can also be involved within younger or older people. It has been proven to be undiagnosed, therefore, narcolepsy cannot be treated. • A physical exam may be done in order to diagnose someone with narcolepsy, however, the tests may not be exact. It has been shown that, “Several specialized tests, which can be performed in a sleep disorders clinic or sleep lab, usually are required before a diagnosis can be established. • There are 2 tests that are considered to be good in diagnosing narcolepsy, they are; Polysomnogram (PSG) and the Multiple Sleep Latency Tests (MSLT).

10. Treatments… • Even though narcolepsy may not be cured just yet, some of the symptoms may be treated with medicines and changes in their lifestyles. • It is known by the National Institute of Neurological Disorders and Stroke that, “Modafinil and Sodium Oxybate are two drugs that have been approved by the U.S. Food and Drug Administration for the treatment of narcolepsy.” • Nuvigil tablets are prescriptions that people who suffer from narcolepsy may use in order to improve wakefulness.

11. Neurologists… • Once a person who suffers from narcolepsy arrives with the specialist, they begin observing their way of sleep. The next day, a multiple sleep latency test is performed. DANA Foundation states, “This starts with asking the patient to nap four to five times for 20 minutes every two hours.” With this, the doctor is able to measure how fast the person falls asleep and then notice the involvement of REM sleep throughout scalp electrodes.

12. Physicians… • They may also run tests on a person suffering from narcolepsy. They run blood tests in order to look for the humans leukocyte antigen (HLA). • Another possible test that physicians may apply to this sleep disorder is lumbar puncture (spinal tap) in order to measure hypocretin levels in a person’s cerebrospinal fluid (CSF).

13. Lifestyles… • Some people find it easy to control this sleep disorder by changing their lifestyles. • Examples would be napping at certain times and avoiding certain foods. • However, most people prefer the many medications applied to this sleep disorder.

14. Nuvigil • This is a medicine that people with certain sleep disorders such as sleep apnea, shift work disorder, and narcolepsy. For sleep apnea, this medication is used along with other medical treatments. It is proven that, “Nuvigil may help the sleepiness caused by these conditions, but it may not stop all of your sleepiness and does not take the place of sleep.”

15. “Narcolepsy Not Known” • Sometimes the people who suffer from narcolepsy wonder why they have this sleep disorder, the cause is not known. Many believe that the body’s immune system attacks the brain cells that are involved in regulating the sleep- wake cycle without meaning to. The Nuvigil website asserts, “It is believed that narcolepsy is the result of these cells being damaged or destroyed.”

16. The Key to Narcolepsy… • In 1999, Stanford University researchers announced, “After a decade-long search, they had identified a gene that causes the sleep disorder narcolepsy.” This research team was led by Emmanuel Mignot(M.D.,Ph.D.) who began his studies in two types of dogs; Doberman pinschers and Labrador retriever. This resulted in the founding of a small protein/peptide present in the brain cells of normal people were missing in the studies they made.

17. DANA Foundation… • “New treatments aimed at replacing the missing hypocretin hormone are being developed and will probably become very effective. Additionally, researchers are exploring the destruction of the hypocretin-containing cells in the brain.” • Overall, the researchers must be able to understand the sleep disorder in order to prevent or cure narcolepsy.

18. Resources… • "What Is Narcolepsy, Symptoms & Causes - WebMD." WebMD. WebMD, 03 Jan. 0000. Web. 12 Nov. 2013. • "Narcolepsy Fact Sheet." : National Institute of Neurological Disorders and Stroke (NINDS). N.p., n.d. Web. 12 Nov. 2013. • "About Narcolepsy | NUVIGIL® (armodafinil) Tablets [C-IV]." About Narcolepsy | NUVIGIL® (armodafinil) Tablets [C-IV]. N.p., n.d. Web. 21 Nov. 2013. • "Narcolepsy - The Dana Guide." - Dana Foundation. N.p., n.d. Web. 22 Nov. 2013.