Narcolepsy and Idiopathic Hypersomnia are both disorders that make it difficult to stay awake during the day. Both of these are characterized by Hypersomnolescence.
Hypersomnolescence is a condition in which the person suffering from it may feel the urge to sleep excessively. Narcolepsy has some symptoms that distinguish it from other disorders with similar symptoms, including Idiopathic Hypersomnia. In this article, we are going to discuss the types, signs, and differences between Narcolepsy and Idiopathic Hypersomnia.
What is Narcolepsy?
Narcolepsy is a neurological disorder. It causes a person to feel excessively sleepy during odd times of the day. It also causes sudden episodes of sleep during the daily routine, for instance, while working, or driving, and may last a few minutes.
What are the 3 Types of Narcolepsy?
There are typically two types of narcolepsy, but there’s a third type as well, which occurs in rare cases:
TYPE-1 Narcolepsy:
A person has to meet symptomatic criteria to be diagnosed with Narcolepsy Type 1. One of the symptoms is that they feel the need to sleep excessively during the day. They may also experience sleep paralysis which is one of the symptoms along with hallucinations. The person may also feel sudden “sleep attacks” while going through their daily schedule. The major cause of Type 1 Narcolepsy, as researchers say, is Cataplexy.
Cataplexy is characterized by a sudden loss of muscle control. Cataplexy episodes can vary from mild to severe. In mild conditions, the person may experience his facial muscles sagging and his head dropping forward. But in severe conditions, the person may lose complete control of the muscles resulting in a fainting spell. Cataplexy is associated with a deficiency of a particular neurotransmitter called Hypocretin.
Type 2 Narcolepsy:
Type 2 narcolepsy has similar symptoms which include excessive daytime sleeping, hallucinations, disrupted sleep, and sleep paralysis. What makes it different from Type 1 is the absence of Cataplexy.
Secondary Narcolepsy (Type-3):
A third type of rare narcolepsy is secondary narcolepsy, which is usually the result of a traumatic brain injury.
What Causes Narcolepsy?
Earlier, researchers weren’t unable to find any direct reason for narcolepsy. However, in recent years it has been found that a gene called HLA-DQB1 is linked with narcolepsy. This gene is involved with regulating autoimmune responses and may be responsible for destroying the cells that produce Hypocretin.
Hypocretin is a neurotransmitter that helps in sleep regulation and rapid eye movement (REM) phases. Low levels of hypocretin are the most common reason why people with Type 1 narcolepsy enter the REM phase much faster than others.
What are the 5 Signs of Narcolepsy?
There are five signs of Narcolepsy. These signs are identified by the acronym CHESS:
1. Cataplexy: Sudden loss of muscle tone.
2. Hallucinations: Dream-like hallucinations that may be frightening.
3. Excessive Daytime Sleeping: Feeling fatigued and sleepy during the day.
4. Sleep Paralysis: This is a phenomenon in which a person experiences temporary paralysis of the body during sleep or upon waking up.
5. Sleep Disruption: A person may have trouble staying asleep during the night.
Idiopathic Hypersomnia vs Narcolepsy: How to Differentiate?
Idiopathic Hypersomnia is a broad term used to describe excessive daytime sleepiness. The term idiopathic refers to an “unidentifiable cause.
Hypersomnia VS Narcolepsy: they both share similar symptoms, but are distinct conditions with different underlying causes.
Idiopathic Hypersomnia occurs by various factors, such as sleep deprivation, sleep apnea, depression, medications, and other medical conditions. If left untreated, Idiopathic Hypersomnia can cause fatigue, and impaired alertness, and can have many negative health impacts. Whereas, Narcolepsy is a chronic neurological disorder where the brain’s unable to regulate sleep-wake cycles.
Idiopathic Hypersomnia VS Narcolepsy: Can Hypersomnia Lead to Narcolepsy?
While Idiopathic Hypersomnia is not a direct cause of Narcolepsy, some people with Hypersomnia may eventually develop Narcolepsy. However, this is not the case with every individual.
Narcolepsy VS Hypersomnia: Causes
The exact cause of Idiopathic Hypersomnia is not fully understood, but some possible contributing factors that identify with IH, include:
- Abnormal Neurotransmitter Function: Evidence suggests that neurotransmitters that promote sleep, when synapses in the brain for longer than usual, lead to Idiopathic Hypersomnia.
- Genetics: There may be a genetic component to Idiopathic Hypersomnia, as it is known to run in families.
- Hormonal Imbalances: Hormones such as melatonin and cortisol play essential roles in regulating sleep and wakefulness. Imbalances in these hormones are majorly associated with Idiopathic Hypersomnia.
- Structural Abnormalities In The Brain: Some studies have found that individuals with Idiopathic Hypersomnia may have structural abnormalities in the hypothalamus.
- Chronic Inflammation: Evidence suggests that chronic inflammation in the body may also contribute to Idiopathic Hypersomnia.
Type-2 Narcolepsy VS Hypersomnia: Difference?
Comparing Narcolepsy VS Idiopathic Hypersomnia, both lack Cataplexy. What differentiates the two and helps in identifying one from the other is that in type 2 Narcolepsy, the Multiple Sleep Latency Test (MSLT) typically shows a mean sleep latency of fewer than 8 minutes, which means that the person falls asleep quickly during the day. In Idiopathic Hypersomnia, the mean sleep latency on the MSLT is greater than 11 minutes.
Individuals with type 2 Narcolepsy may experience sleep fragmentation, disrupted night-time sleep, and vivid dreams, while individuals with Idiopathic Hypersomnia typically do not.
Type 2 Narcolepsy is typically more responsive to treatment with medications that promote wakefulness, than Idiopathic Hypersomnia.
Narcolepsy VS Hypersomnia: Diagnosis
There are various ways doctors can detect these conditions:
- Medical History: A detailed medical history can help the doctor to identify the symptoms properly.
- Physical Exam: A physical exam can help identify any underlying medical conditions that may be present.
- Sleep Study: A sleep study or polysomnography can help confirm the diagnosis of the conditions.
- Multiple Sleep Latency Test (MSLT): The MSLT measures can help differentiate Narcolepsy from other sleep disorders such as Idiopathic Hypersomnia.
- Measurement Of Hypocretin Levels: Measuring the Hypocretin level in the brain.
Narcolepsy VS Hypersomnia: Diagnostic Tests:
Prominently, tests that help determine Narcolepsy VS Hypersomnia require blood samples or urine samples. The tests will help the doctor in ruling out other conditions that may play a part in causing similar symptoms.
Polysomnography:
Polysomnography is a sleep study that measures brain waves, eye movements, and muscle activity during sleep. It is performed during the entire night and it monitors each phase of sleep the patient enters during the whole night and also monitors heart rate, breathing rate, and blood oxygen levels. It can help identify abnormalities in the sleep architecture and rule out other sleep disorders that can cause.
Multiple Sleep Latency Test (MSLT):
This test measures how quickly a person falls asleep during the day and can help differentiate Narcolepsy from other sleep disorders such as Idiopathic Hypersomnia.
Hypocretin-1 (orexin-A) Levels In Cerebrospinal Fluid (CSF):
The test measures the level of hypocretin in the cerebrospinal fluid, which is typically low in people with Narcolepsy with cataplexy. This test is reserved for cases where the diagnosis is either unclear or needs confirmation of Type-1 Narcolepsy.
Genetic Testing:
Genetic testing is performed to detect mutations in the genes associated with Narcolepsy, such as the HLA-DQB1 gene. This gene is typically associated with reduced Hypocretin levels.
The tests used can vary depending on the individual’s symptoms and medical history. A healthcare provider with experience in diagnosing and treating sleep disorders can help determine which tests are necessary for an accurate diagnosis.
Narcolepsy VS Hypersomnia: Treatment
Narcolepsy VS Hypersomnia: treatment depends on the severity of the symptoms and the individual’s response to treatment. Here are some standard treatment options for these sleep disorders:
Stimulant Medications:
Stimulants such as modafinil and methylphenidate are often used to promote wakefulness and reduce excessive daytime sleepiness in both Narcolepsy vs Idiopathic Hypersomnia.
Sodium Oxybate:
Sodium oxybate, or Xyrem, is a medication that can help improve nighttime sleep and reduce daytime sleepiness in individuals with Narcolepsy with cataplexy.
Antidepressant Medications:
Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can be used to reduce symptoms of cataplexy and improve nighttime sleep in individuals with Narcolepsy.
Scheduled Naps:
Scheduled naps during the day can help reduce excessive daytime sleepiness in individuals with both Narcolepsy and Idiopathic Hypersomnia.
Narcolepsy VS Hypersomnia: Lifestyle Changes
Your doctor may guide you to adopt healthy lifestyle changes such as:
- Creating a quiet, comfortable, and disturbance-free environment for sleep.
- Designing and following a sleep schedule.
- Doing something relaxing or exercising before going to bed.
- Avoiding heavy meals 2-3 hours before bed.
- Avoiding having caffeine, nicotine, and or alcohol before bed.
Safety Counselling for Narcolepsy VS Hypersomnia
Doctors may provide you with some safety counseling because these conditions can cause a sudden bout of sleep or sudden loss of muscle control. Hence, it becomes extremely dangerous for you to drive during the day or operate heavy machinery.
Conclusion:
Narcolepsy VS Hypersomnia both share almost similar symptoms. However, both of them are two different diseases. Although prolonged and untreated Hypersomnia can lead to Nracolepsy this is not true for every case. Since type-1 Narcolepsy has additional symptoms. Both of these diseases can be managed if diagnosed on time. If you experience such symptoms as described above in the article, make sure to get an appointment with a professional.
