9 Facts About Narcolepsy

Korrawin/iStock via Getty Images
Korrawin/iStock via Getty Images

Everyone experiences occasional daytime sleepiness, but just a small fraction of the population knows what it’s like to have narcolepsy. The disorder is defined by persistent drowsiness throughout the day, and in some cases, sleep paralysis, hallucinations, and the sudden loss of muscle control known as cataplexy. Having narcolepsy can make doing everyday activities difficult or dangerous for patients, but unlike some chronic conditions, it’s also easy to diagnose and treat. Here are some facts you should know about the condition.

1. There are two types of narcolepsy.

If everything you know about narcolepsy comes from movies and TV, you may think of it as the disease that causes people to go limp without warning. Sudden loss of muscle control is called cataplexy, and it’s the defining symptom of type 1 narcolepsy. Type 2 narcolepsy, on the other hand, is mainly characterized by fatigue. Losing motor function while awake isn’t a problem for those with type 2.

2. Type 1 narcolepsy stems from a chemical deficiency.

Almost every patient with type 1 narcolepsy has low levels of hypocretin. Hypocretin is a neurochemical that regulates the wake-sleep cycle. When there isn’t enough of this chemical in the brain, people have trouble staying conscious and alert throughout the day. Most people with the second, less severe type of narcolepsy have normal hypocretin levels, with about a third of them producing low or undetectable amounts. Type 2 narcoplepsy has been studied far less than type 1 of the disorder, and scientists are still figuring out what causes it.

3. The exact causes of narcolepsy aren’t always clear.

So why do some people’s brains produce less hypocretin than others? That part has been hard for scientists to figure out. One possible explanation is that certain autoimmune disorders cause the body to attack the healthy brain cells that make this chemical. This disorder can be the result of genetic and environmental factors. Although people with narcolepsy rarely pass it down to their offspring (this happens less than 1 percent of the time), the sleep condition does occasionally crop up in family clusters, suggesting there is sometimes a genetic component at play. Head trauma that impacts the area of the brain responsible for governing sleep can also lead to narcolepsy in rare cases.

4. There are tests to diagnose narcolepsy.

If patients believe they might have narcolepsy, their doctors might ask them to detail their sleep history and keep a record of their sleep habits. There are also a few tests potential narcoleptics can take to determine if they have the condition. During a polysomnography test, patients spend the night at a medical facility with electrodes attached to their heads to monitor their breathing, eye movement, and brain activity. A multiple sleep latency test is similar, except it gauges how long it takes patients to fall asleep during the day.

5. Strong emotions can trigger cataplexy.

Cataplectic spells can sometimes be predicted by triggers. In some patients, feeling strong emotions—whether they’re crying, laughing, angry, or stressed—is all it takes for them to lose muscle control. These triggers vary from patient to patient, and they can even affect the same person randomly. Some people deal with them by avoiding certain situations and closing themselves off emotionally, which can disrupt their social lives.

6. Narcolepsy can make sleep terrifying.

Narcoleptics don’t just worry about their disorder during their waking hours. When they’re trying to fall asleep at night or wake up in the morning, narcolepsy can complicate things. One symptom is experiencing vivid, dream-like hallucinations while transitioning in or out of consciousness. These visions are often scary and may involve an intruder in the room with the sleeper. If they happen as the patient falls asleep, the hallucinations are called hypnagogic, and if they occur as they wake up, they’re hypnopompic.

A related symptom is sleep paralysis. This happens when a person’s brain cuts off muscle control of their body before they’re fully asleep or as they’re waking up. This combined with hypnagogic or hypnopompic nightmares can cause frightening experiences that are sometimes confused for real encounters.

7. Narcoleptics sometimes do activities half-asleep.

To outside observers, narcolepsy is sometimes hard to spot. A narcoleptic patient overcome by sleepiness won’t necessarily pass out in the middle of what they’re doing. Some act out “automatic behavior,” which means they continue with their actions—whether that’s walking, driving, or typing—with limited consciousness. This can cause poor performance at work or school, and in worst case scenarios, accidents while driving a car or operating machinery.

8. Harriet Tubman may have had narcolepsy.

One of the most famous likely narcoleptics in history is Harriet Tubman. The African American abolitionist was known to suffer from what were probably sudden narcoleptic episodes. The condition may have stemmed from the severe head trauma she sustained when a slave master threw an iron at another slave and hit her instead. The injury left her with permanent brain damage: In addition to narcolepsy, she also experienced chronic seizures and migraines throughout her life.

9. Medications and lifestyle changes are common narcolepsy treatments.

Though there’s no way to cure narcolepsy completely, there are many treatment options available. Taking medication is one of the most common ways to manage the disorder. Stimulants such as modafinil and armodafinil can be used to combat mild sleepiness, while amphetamines are often prescribed for more severe forms of fatigue. For hallucinations and sleep paralysis, selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors—drugs that suppress REM sleep—can help.

As an alternative or supplementary treatment to medications, doctors may recommend lifestyle changes. Sticking to a sleep schedule, exercising regularly, avoiding nicotine and alcohol, and taking naps during the day can all reduce the symptoms of narcolepsy.

Here’s What You Need to Know About the New Coronavirus

jarun011/iStock via Getty Images
jarun011/iStock via Getty Images

This morning, the Centers for Disease Control and Prevention (CDC) confirmed the second case of the recently discovered coronavirus in the U.S. Find out what it is, where it is, how to avoid it, and all the other need-to-know information about the illness below.

What is the new coronavirus?

Coronaviruses are a group of viruses named for the crown-shaped spikes that cover their surfaces (corona is the Latin word for crown). According to the CDC, human coronaviruses can cause upper-respiratory tract illnesses, including the common cold, and can sometimes lead to more severe lower-respiratory tract issues like pneumonia or bronchitis.

Because this latest coronavirus, 2019-nCoV, is so new, health officials are currently trying to figure out how it works and how to treat it. It’s not the first time a potent new coronavirus has caused an international outbreak: SARS-CoV originated in Asia and spread to more than two dozen countries in 2003, and MERS-CoV first infected people in Saudi Arabia before spreading across the globe in 2012.

Where is the coronavirus outbreak happening?

The majority of cases are in China, which counts more than 800 confirmed diagnoses. Most are in Wuhan, a city in China’s Hubei province where 2019-nCoV was first detected last month. Additional cases have been reported in South Korea, Japan, Singapore, Hong Kong, Macao, Taiwan, Thailand, and Vietnam.

The CDC has confirmed two U.S. cases—a man in his thirties outside Seattle, and a 60-year-old woman in Chicago—both of whom had recently returned from trips to Wuhan. A CDC official said another 63 potential cases are being investigated in 22 states, and airports in New York, Chicago, Los Angeles, Atlanta, and San Francisco are conducting health screenings on passengers arriving from China.

Chinese officials have shut down transportation to and from Wuhan. Tourist spots like Beijing’s Forbidden City, Shanghai Disneyland, and a portion of the Great Wall are also closed temporarily.

What are the symptoms of the new coronavirus?

Symptoms are similar to those caused by a cold or the flu, including fever, dry cough, and breathing difficulty. The New York Times reported that as of Friday morning, 25 people in China have died from the virus, and most of them were older men with preexisting health conditions like cirrhosis, diabetes, and Parkinson’s disease.

How does the new coronavirus spread?

Because most of the early cases of 2019-nCoV were traced back to a seafood and meat market in Wuhan, health officials think the virus originally spread from infected animals to humans, but it’s now being transmitted from person to person.

Though scientists are still studying exactly how that happens, the leading theory is that it travels in tiny droplets of fluid from the respiratory tract when a person coughs or sneezes.

How do you avoid the new coronavirus?

The CDC is warning everyone to avoid any nonessential trips to Wuhan, and to avoid animals or sick people if you’re traveling elsewhere in China. If you’ve been to China in the last two weeks and experience any of the symptoms listed above, you should seek medical attention immediately—and you should call the doctor’s office or emergency room beforehand to let them know you’re coming.

Otherwise, simply stick to the precautions you’d normally take when trying to stay healthy: Wash your hands often with soap and water, cover your nose and mouth when coughing or sneezing, stay away from sick people, and thoroughly cook any meat or eggs before eating them.

Should you be worried about the new coronavirus?

The global health community is taking 2019-nCoV seriously in order to curb the outbreak as quickly as possible, but you shouldn’t panic. The CDC maintains that it’s a low-risk situation in the U.S., and public health officials are echoing that message.

“We don’t want the American public to be worried about this, because their risk is low,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told USA Today.

[h/t USA Today]

10 Best U.S. Cities for Reducing Stress

Anaheim, California's Paradise Pier.
Anaheim, California's Paradise Pier.
Kirkikis/iStock via Getty Images

Looking to reduce your stress level? You might want to consider moving to Anaheim, California. Homeowner website House Method analyzed data from America’s largest 100 cities in order to determine the best—and worst—cities for managing your stress level.

The company looked at the same five factors across all 100 cities: commute time, mental health counselors per capita, the percentage of people who exercise regularly, walkability (specifically: to a park), and the number of yoga instructors and classes. Once all the data was tallied, Anaheim, California ended up in the top spot with an overall score of 38.5.

"The city has beautiful weather, lots of sunshine, and Disneyland. How could you be stressed when Mickey lives right down the road?," House Method’s senior editor and researcher David Cusick wrote of the results. "While Anaheim didn’t have the best score for commute time, it did rank number one for the city with the most mental health counselors per capita and has a very high percentage of people who like to exercise frequently."

California did well overall; four of the survey’s top 10 cities were located in The Golden State: Oakland came in second, Irvine came in fourth, and San Francisco came in fifth (despite its high housing costs). Seattle and Spokane, Washington—which came in eighth and tenth, respectively—tipped the scales in the west coast’s favor. Here are the 10 best cities for reducing stress:

  1. Anaheim, CA
  2. Oakland, CA
  3. Jersey City, NJ
  4. Irvine, CA
  5. San Francisco, CA
  6. Minneapolis, MN
  7. Madison, WI
  8. Seattle, WA
  9. Aurora, CO
  10. Spokane, WA

On the other end of the rankings were America’s worst cities for reducing stress, with Laredo, Texas taking the title as the very worst. “Laredo ranked last for the amount of mental health counselors per capita, percentage of people who exercise, and the amount of yoga instructors/classes,” Cusick wrote. “Filling out the bottom five cities are Bakersfield, California (96); Indianapolis, Indiana (97); San Antonio, Texas (98); and Jacksonville, Florida (99).”

For the full list of city rankings, visit House Method.

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