Monday, April 15, 2024

Can You Have Chronic Fatigue Syndrome And Narcolepsy

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What Causes Excessive Sleepiness

How to manage Narcolepsy & Chronic Fatigue Syndrome? – Dr. Vykunta Raju K N

There are many possible causes of excessive daytime sleepiness. One of the most common reasons is a chronic lack of sleep, whether due to long work hours, an irregular schedule, insomnia, or other reasons.

Excessive sleepiness can also be caused by getting fragmented or otherwise poor-quality sleep. Getting up multiple times a night to use the washroom, for example, disrupts the natural progression of the sleep stages and may reduce the proportion of restorative slow-wave sleep. Smoking, not exercising enough, and other lifestyle habits may also interfere with sleep quality and cause daytime sleepiness.

Many people who experience excessive daytime sleepiness dont appear to have any problems sleeping enough. In these cases, sleepiness may be a sign of an underlying health condition or sleep disorder.

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Narcolepsy: Sleep Intruding On Your Days

Narcolepsy is a disorder of sleep-wake control sleep intrudes into wakefulness and wakefulness intrudes into sleep. There are specific signs that point to narcolepsy:

  • Excessive daytime sleepiness. Many people with narcolepsy are unable to stay awake and alert during the day. There are times when they have an irrepressible need for sleep, or unintended lapses into sleep. This is more severe at times and is more likely to happen when youre sedentary or in a boring or monotonous situation, such as when youre watching TV or driving a vehicle.
  • Hallucinations. Some people have vivid, often frightening visual, tactile, or auditory hallucinations as they fall asleep, referred to as hypnagogic hallucinations.
  • Sleep paralysis. Some people are completely unable to move for one or two minutes after they wake up or just before they fall asleep.
  • Sudden loss of muscle tone. Cataplexy is a sudden loss of muscle tone that leaves you weak in reaction to strong emotion, especially laughter and excitement. The muscle weakness often affects only parts of the body often the face, neck and knees. You likely will not lose consciousness, but often are temporarily unable to respond. Not everyone with narcolepsy has cataplexy.
  • Most people wake up refreshed after sleeping, but begin to feel sleepy again prematurely. Staying active may help you fight the urge to sleep.

Children With Narcolepsy Are Especially At Risk For Delays In Diagnosis

More than half of people with narcolepsy say that their symptoms started before age 18. However, it can take as long as 10 or more years to get an accurate diagnosis, and some people may have about 6 doctor visits before their symptoms are recognized as narcolepsy. Sadly, in children and adolescents, narcolepsy can often be mistaken for laziness or lack of motivation.

Undiagnosednarcolepsy can contribute to problemsnot only in childhood but throughout a persons life.

Children can suffer many years without a diagnosis.

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Treatment For Chronic Fatigue Syndrome

Unfortunately, there is no cure for ME/CFS. People with the disorder shouldnt give up hope, however. A variety of treatments may be used to lessen or eliminate symptoms.

  • Cognitive Behavioral Therapy . CBT teaches patients how to recognize fears of potential fatigue. With the aid of CBT, patients can also learn how to redirect thoughts that may provide a more positive outlook about recovery.
  • Exercise. Through graded exercise therapy, patients with ME/CFS exercise to increase overall physical and mental function.
  • Sleep Management. Poor sleep is a common symptom of ME/CFS. Treatment of sleep disorders that accompany ME/CFS can lessen its overall effects. Patients can begin by improving their sleep hygiene. However, additional steps, such as prescription medications or therapies for specific sleep disorders may be necessary.
  • Pharmacologic Therapy. Currently, there are no drugs that specifically target ME/CFS. Instead, patients may take drugs to treat symptoms of ME/CFS, such as pain, depression, and sleep deprivation.
  • Stress Reduction and Relaxation. Certain practices can help with managing chronic pain and fatigue. These include meditation, massage, and acupuncture.

Summary Narcolepsy Vs Chronic Fatigue

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Narcolepsy and chronic fatigue are categorized under neurological disorders. Narcolepsy is a chronic neurological disorder that is characterized by daytime drowsiness and sudden attacks of sleep while chronic fatigue is a chronic neurological disorder that is characterized by extreme tiredness and fatigue. So, this is the key difference between narcolepsy and chronic fatigue.

Reference:

2. Sampson, Stacy. Chronic Fatigue Syndrome. Healthline, Healthline Media.

Image Courtesy:

2. Chronic fatigue syndrome By Shanghai killer whale Own work via Commons Wikimedia

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Frequency And Severity Of Autonomic Symptoms In Idiopathic Hypersomnia

Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, California

Stanford Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Redwood City, California

Stanford Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Redwood City, California

Stanford/VA Alzheimers Center, VA Palo Alto Health Care System, Palo Alto, California

Sierra Pacific Mental Illness Research Education and Clinical Centers, VA Palo Alto Health Care System, Palo Alto, California

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How To Combat Excessive Daytime Sleepiness

EDS can get in the way of work, school, and home life. If a lack of sleep causes your EDS, you can keep the following sleep tips in mind to try to improve your nightly rest:

  • Get eight hours of sleep each night
  • Leave the phone out of bed
  • Get regular exercise
  • Avoid alcohol and caffeine before bed
  • Try to avoid naps in the afternoon
  • Dont work late into the night

However, if excessive daytime sleepiness is significantly impacting your life and the above tips arent working, you should visit your doctor.

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Narcolepsy And The Pandemrix H1ni Flu Shot

Narcolepsy has been a topic of much discussion in Finland after the Pandemrix shot for H1N1 flu shot was found to have caused narcolepsy first in children and later in adults. The trigger was first thought to be a new adjuvant in the vaccine that was not used in other H1N1 shots, but later studies suggested a specific viral protein was to blame. . Those persons able to prove vaccine-related injury received compensation from the state.

Narcolepsy has a heavy genetic predisposition and sometimes infections can trigger it as well. It is worth noting that a Chinese study indicated that the H1N1 influenza is able to trigger narcolepsy in suspectable individuals.

Pandemrix has also been suspected of causing PANS but because most Finnish children were vaccinated against the H1N1 flu its been hard to draw a connection . This is a common problem with vaccines: most people receive vaccines and when they get sick with anything, they look for a cause and associated it with the vaccine. Statistically even some heart attacks will occur on the days of vaccination without any causality.

How Is Chronic Fatigue Syndrome Diagnosed

Solving the mystery of chronic fatigue syndrome

Before diagnosing chronic fatigue syndrome, a doctor examines a person and rules out other possible causes of their symptoms.

There is no specific test that conclusively proves the existence of chronic fatigue syndrome. Instead, testing may involve physical tests of blood, urine, thyroid function, muscle enzymes, gluten tolerance, and other analyses depending on the persons symptom profile.

The doctor also asks questions and may administer questionnaires, such as the Centers for Disease Control Symptom Inventory or the DePaul Symptom Questionnaire, for a better picture of the symptoms.

Symptoms of chronic fatigue syndrome can come and go, and they vary from person to person. This variability can make it difficult for diagnostic measures to capture how a person is affected by the disease, even if the effects are real and noticeable. Some experts argue that chronic fatigue syndrome should be further divided into different subtypes based on groups of symptoms.

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Behaviorally Induced Insufficient Sleep Syndrome

Behaviorally induced insufficient sleep syndrome is characterized by chronic insufficient nocturnal sleep, typically sleeping 23 more hours on weekend days than weekdays. Actigraphy is helpful to rule out IBISS as many patients’ subjective view of their sleep time is not accurate. BIISS must be ruled out as it can present with similar PSG/MSLT findings as IH.

What Is Chronic Fatigue Syndrome

People with chronic fatigue syndrome experience persistent fatigue lasting longer than six months that does not get better with rest. They have an abnormal lack of energy and sometimes are confined to bed. In fact, the fatigue of patients with ME/CFS is so severe that they must reduce their usual activities by 50%. The disorder can negatively impact everything in daily life, from taking a shower to holding a job.

For some people with ME/CFS, day-to-day activities, both physical and mental, can worsen the fatigue, even if these activities would not have been a problem before the onset of the syndrome. The medical term for this experience is post-exertional malaise . People who experience ME/CFS describe the worsening fatigue as a crash or relapse.

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Causes Of Idiopathic Hypersomnia

While the exact causes of IH are not known, researchers have investigated a number of potential factors that may contribute to the development of idiopathic hypersomnia. Several studies have looked at the potential roles of neurotransmitters, including orexins, dopamine, serotonin, histamines, and gamma-aminobutyric acid . Research suggests that there may also be a genetic component to IH since a family history of the condition is present in 26% to 39% of IH patients.

Although one diagnostic criteria for IH is that its symptoms arent caused by a circadian rhythm disorder, some research suggests that there may be a connection between IH and the bodys internal clock. Studies have found that the regulation of certain genes involved in circadian rhythm may be different in people with IH.

  • difficulty remaining awake and attentive during the day
  • Falling asleep unintentionally at inopportune times
  • Difficulty waking up after sleeping all night or after daytime naps

Other indicators of IH include excessive sleeping which can be upwards of 10 hours at night. sleep drunkenness is another indicator. This is where a person vacillates between various stages of being awake up to four hours after initially waking up. This state can lead to people being violent, clumsy and irritable, and can sometimes occur following naps as well.

Chronic Fatigue Syndrome And Similar Disorders

Narcolepsy Treatment Specialist Seattle

Chronic fatigue syndrome encompasses a wide range of symptoms that affect most systems in the body, so doctors may easily confuse it for another disorder. Examples of the many conditions that may cause similar symptoms include anemia, hypothyroidism, hyperthyroidism, diabetes, cancer, celiac disease, obstructive sleep apnea, and inflammatory bowel disease.

Chronic fatigue syndrome may look especially similar to hypersomnia, narcolepsy, fibromyalgia, depression, and obstructive sleep apnea.

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Narcolepsy Is An Unusual Condition With The Typical Stereotype Being Of A Person Sleeping Throughout The Day Or Falling Asleep With Little Provocation Including Falling Asleep In The Middle Of The Party It Has A Genetic Basis And Can Certainly Run In Families The Cause Of Typical Narcolepsy Has Been Identified And Specific Treatments Are Currently Being Developed

As narcolepsy in its most severe forms can significantly impact the ability to maintain alertness, a full and frank discussion as to how it may affect your well-being and your livelihood is usually undertaken. Individuals in task critical occupations such as driving or materials handling may be at risk of harming themselves or others.

The focus of narcolepsy treatment is to trial a stimulant medication of which there are two major types. Narcoleptics should take the necessary steps to keep themselves safe and work out a strategy for work and for driving. For the group of individuals who have a more severe form of narcolepsy where they fall asleep with little provocation, such as during the day or with emotional stimuli, further medication is usually trialled. Support groups are available but a reliance on postings on the Internet is often fraught with inaccuracy and inappropriate individual cases which cannot be generalised.

There are also a number of atypical forms of narcolepsy with people describing excessive sleepiness, tiredness and fatigue, despite adequate time in bed and no obvious cause for complaint. This is often termed idiopathic hypersomnolence and can overlap with chronic fatigue syndrome.

What Is Chronic Fatigue Syndrome /myalgic Encephalomyelitis

Chronic fatigue syndrome , also known as myalgic encephalomyelitis , is a chronic , complex and disabling illness that causes extreme fatigue and other symptoms that cannot be explained by any other medical condition.

If you have ME/CFS, you are likely to feel very tired, very often, even if you have not been active. You may also have a host of other symptoms.

Doctors do not yet understand the cause of ME/CFS, and there is no simple cure. If you or your child has ME/CFS, your doctor can suggest treatments you may find helpful.

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Fatigue: A Struggle To Keep Going

  • Lack of energy. Fatigue is a self-reported lack of physical or mental energy. People with fatigue do not usually complain of excessive daytime sleepiness. But when they do sleep or rest, it often fails to boost their energy levels.
  • Difficulty staying active. You may have a hard time getting yourself going, and once you start an activity you may struggle to keep going.
  • Trouble with memory and mood. Some people find that its difficult to concentrate or remember things. Some people struggle with emotional stability.

Maintaining A Healthy Weight With Narcolepsy

What is Chronic Fatigue Syndrome (ME/CFS, SEID)? A Doctor Explains

Obesity and narcolepsy can be closely related. Individuals with narcolepsy may have a body weight between 15 percent and 20 percent higher than expected on average in the general population. Some evidence suggests this could be related to both lower resting energy expenditure as well as eating behaviors .

Lack of sleep can create hormone disruption that may contribute to weight gain as well. Hypocretin is a brain chemical that regulates wakefulness and appetite. Hypocretin deficiency is linked with narcolepsy, and may decrease basal metabolic rate and food intake. However, more research in humans needs to be done to determine whether this is a direct result of hypocretin deficiency or other causes.

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Adele: My Idiopathic Hypersomnia Diagnosis Story

1/17/2022 1:36:13 PM

I donât really know exactly when it began, all I know is I started noticing strange symptoms when I was in VCE. I was finding it difficult to concentrate, feeling tired all the time, struggling to get out of bed in the morning and losing my memory. At first, I brushed it off and thought, maybe I just need more sleep. As time went on, I began to feel like I was going crazy, my memory loss had gotten much worse, I was doing things without consciously being aware of it and falling asleep during the day in random places like the doctors waiting room. I downloaded brain training apps to help improve my memory, but it continued to worsen. The only explanation I could think of was early onset dementia.At this point in time, I didnât know that in a few yearsâ time my whole world would be flipped upside down.

Narcolepsy â short naps are refreshing, sleep-onset REM, sleep paralysis, hallucinations, sleep attacks that last a few seconds to a few minutes, cataplexy , vivid dreams, and disrupted sleep.What symptoms are the same?Excessive Daytime Sleepiness , automatic behaviour, memory issues, insomnia, and brain fog.

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Cfs/me And The H1n1 Vaccine

CFS/ME has also been anecdotally connected to the H1N1 vaccine, especially in Sweden which also used the Pandemrix version of the vaccine and experienced increased cases of narcolepsy. An increased prevalence of postural orthostatic tachycardia syndrome or POTS has also been suggested. POTS, which is a form of dysautonomia that presents with symptoms similar to those found in CFS/ME, often has a viral trigger.

Hanna Nohynek, a vaccine researcher at Finnish health authority THL, commented in December 2012 to the Finnish tabloid newspaper Iltalehti that while no vaccine-connected CFS/ME cases had been reported in Finland, she believed they probably exist.

Did the vaccine trigger ME/CFS in some or was it the flu itself? Either way immune activation was involved.

That was an extraordinary admission coming from a government official given according to Finnish authorities CFS/ME does not even exist.

In 2015, however, a THL response signed by Nohynek to a letter from patients about the Pandemrixs connection with CFS/ME, POTS and PANS expressed doubts that they were connected. The letter noted that in the recent years new diagnoses of G93.3 , I49.8 , G93.8 and F42.8 have been more common in patients who did not receive the H1N1 vaccine.

The PANS and narcolepsy connection to the Pandemrix vaccine and their resemblance to CFS/ME, however, makes the question particularly interesting.

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The Dopamine Infection Connection

Some readers may be familiar with the popular Hollywood movie Awakenings starring Robin Williams. Based on a book by the famous neurologist Oliver Sacks, the movie showcases patients who exhibit a peculiar lack of volition. They seem almost like statues. They have trouble starting things but once a process is started they can finish them.

If someone plays the first card in a card game they can play cards. One patient could not walk to the water tap because the checkered pattern in the floor ended too early. After Sacks had the floor painted the patient could reach the tap.

Sacks had noticed that L-DOPA, the precursor to neurotransmitter dopamine used in the treatment of Parkinsons disease, worked almost miraculously for encephalitis lethargica patients. They awoke from their zombie-like states into normal consciousness and were able to live almost normally.

Unfortunately, the effects of L-DOPA were very short-lived and the patients quickly built tolerance. Over time they required massive doses which caused serious side effects. After the drug was stopped the patients returned to their vegetative states.

Some infections appear to be able to knock out dopamine production causing problems with fatigue and movement

Dopaminergic Parkinsons drugs, including L-dopa, are not thought to help narcolepsy , although modafinil, the main stimulant treatment used in narcolepsy, is believed to act via dopamine receptors.

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