Insomnia Key Points

•  Insomnia is a common condition in which you have trouble falling or staying asleep. The condition can range from mild to severe, depending on how often it occurs and for how long.
• Insomnia can be chronic (ongoing) or acute (short-term). Chronic insomnia means having symptoms at least 3 nights a week for more than a month. Insomnia that lasts for less time is acute insomnia.
• Insomnia causes you to get too little sleep or poor-quality sleep that may not leave you feeling refreshed when you wake up.
• There are two types of insomnia. The most common type is secondary insomnia. This type of insomnia is a symptom or side effect of an emotional, neurological, or other medical or sleep disorder. Secondary insomnia also may result from using certain medicines or substances, such as caffeine.
• Primary insomnia isn't a symptom or side effect of another medical condition. It is its own disorder. A number of life changes can trigger primary insomnia, such as long-lasting stress or emotional upset. Even if these issues are resolved, the insomnia might not go away.
• Insomnia is a common disorder. One in 3 adults has insomnia sometimes. One in 10 adults has chronic insomnia.
• The main symptom of insomnia is trouble falling and/or staying asleep, which leads to a lack of sleep. The lack of sleep can cause other symptoms, such as trouble focusing, anxiety, depression, and irritability.
• Usually, your doctor will diagnose insomnia based on your medical and sleep histories and a physical exam. He or she also may recommend a sleep study.
• Lifestyle changes often can help relieve acute insomnia. These changes may make it easier to fall asleep and stay asleep. Lifestyle changes include avoiding substances that make insomnia worse, adopting good bedtime habits, and going to sleep and waking up around the same time each day.
• A type of counseling called cognitive behavioral therapy (CBT) can help relieve the anxiety linked to chronic insomnia. CBT targets the thoughts and actions that can disrupt sleep and uses several methods to relieve sleep anxiety.
• Medicines also are used to treat insomnia. Some medicines are meant for short-term use, while others are meant for longer use. Side effects can occur, so talk to your doctor about the risks and benefits of using medicines to treat insomnia.
• Also, talk to your doctor before taking over-the-counter (OTC) products to treat insomnia. These products may pose risks for some people. Your doctor can advise you whether OTC products will benefit you.

Insomnia Key Points

Narcolepsy

Narcolepsy is a sleep disorder that causes excessive sleepiness and frequent daytime sleep attacks.

Symptoms
The most common symptoms of narcolepsy are:

• Periods of extreme drowsiness every 3 to 4 hours during the day. You may feel a strong urge to sleep, often followed by a short nap (sleep attack).
  • These periods last for about 15 minutes each, although they can be longer.
  • They often happen after eating, but may occur while driving, talking to someone, or during other situations.
  • You wake up feeling refreshed.
• Dream-like hallucinations may occur during the stage between sleep and wakefulness. They involve seeing or hearing, and possibly other senses.
• Sleep paralysis is when you are unable to move when you first wake up. It may also happen when you first become drowsy.
• Cataplexy is a sudden loss of muscle tone while awake, resulting in the inability to move. Strong emotions, such as laughter or anger, will often bring on cataplexy.
  • Most attacks last for less than 30 seconds and can be missed.
  • Your head will suddenly fall forward, your jaw will become slack, and your knees will buckle.
  • In severe cases, a person may fall and stay paralyzed for as long as several minutes.

Not all patients have all four symptoms.

Treatments
There is no known cure for narcolepsy. The goal of treatment is to control symptoms.
Lifestyle adjustments and learning to cope with the emotional and other effects of the disorder may help you function better in work and social activities. This involves:

• Eating light or vegetarian meals during the day and avoiding heavy meals before important activities
• Scheduling a brief nap (10 to 15 minutes) after meals, if possible
• Planning naps to control daytime sleep and reduce the number of unplanned, sudden sleep attacks
• Informing teachers and supervisors about the condition so you are not punished for being "lazy" at school or work

You may need to take prescription medications. The stimulant drug modafinil (Provigil) is the first choice of treatment for narcolepsy. It is much less likely to be abused than other stimulants. The medicine also helps you stay awake. Other stimulants includedextroamphetamine (Dexedrine, DextroStat) and methylphenidate (Ritalin).
Antidepressant medications can help reduce episodes of cataplexy, sleep paralysis, and hallucinations. Antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline, and venlafaxine
• Tricyclic antidepressants such as protriptyline clomipramine, imipramine, and desipramine

Sodium oxybate (Xyrem) is prescribed to certain patients for use at night.
If you have narcolepsy, you may have driving restrictions. Restrictions vary from state to state.

Narcolepsy