Do I have Sleep Apnea or Narcolepsy?
Narcolepsy and sleep apnea can seem interchangeable. Sometimes it can be difficult to pinpoint the differences.
You are constantly sleepy during the day. Whether at your job or at home, you feel like you could use a nap. Snoring has been affecting your ability to sleep, leaving you sleepy during the day. Do you fall asleep at work, or have you fallen asleep while driving? If you find that you are exhausted most of your life, you could be facing worse problems than just needing a nap.
You may have a condition such as obstructive sleep apnea (OSA), or even narcolepsy.
What is obstructive sleep apnea? OSA is a sleep disorder in which a person’s breathing pauses or is shallow periodically during sleep. When the person’s breathing pauses, it can last for a few seconds up to a few minutes, repeating itself many times per night. This cessation in breathing occurs after a person has been snoring loudly. When a person’s breathing resumes, there are usually choking or snorting sounds that occur.
OSA occurs as a result of partially or completely blocked airflow during sleep, which prevents you from breathing. This happens when the soft tissue in the back of your throat, which includes the soft palate, the uvula, the tonsils, and the tongue, partially or completely collapses.
Obstructive sleep apnea prevents you from getting enough sleep causing excessive daytime sleepiness, impaired alertness, and even vision problems. OSA can also cause restlessness in bed, dry mouth or sore throat upon awakening. Other results of sleep apnea are morning headaches, difficulty concentrating during the day, experiencing depression or irritability, and high blood pressure.
There are many factors that put you at increased risk of having OSA:
- Excess weight: Approximately 50% of people with OSA are overweight. Fat deposits surrounding the upper airway might obstruct breathing.
- Narrow airway: You may have narrow airways. Also, you can have enlarged tonsils or adenoids that can block your airway.
- Smoking: Smokers are normally more susceptible to having obstructive sleep apnea because smoke inflames and, consequently, narrows the airways making OSA more likely to occur.
- Asthma: Asthma is a chronic condition that causes your airways to become inflamed, which causes them to narrow. Again, this makes OSA more likely to occur.
- Sex: Men are approximately twice as likely as women to have obstructive sleep apnea.
- Family History: If any of your family members have OSA, you are more likely to have it.
- Age: Obstructive sleep apnea normally occurs in people around 50 years old.
Treatment for OSA includes lifestyle changes, such as losing weight, avoiding alcohol, quitting smoking, and sleeping on your side. For people with moderate to severe OSA, mouthpieces, surgery, and breathing devices, like a CPAP machine, may be necessary.
Narcolepsy is a common cause for problem sleepiness.
However, the cause of the disorder is completely different. Narcolepsy is a neurological disorder in which the brain is not able to regulate the sleep-wake cycles. With narcolepsy, the dreaming period of sleep, called rapid eye movement (REM) sleep, not only occurs at night, but can happen during the day. Since the muscles in your body are paralyzed during REM sleep, occurrence of REM sleep during the day can cause sudden loss of muscle control, or cataplexy. This is triggered by fatigue or emotions and can cause daytime weakness or even complete body collapse.
Narcolepsy, similar to OSA, has the primary symptom of excessive daytime sleepiness.
Narcolepsy’s sleepiness is more disabling, with brief moments of uncontrollable sleep that occur with no warning. Another symptom of narcolepsy, dissimilar to OSA, is that during sleep it can cause insomnia, temporary paralysis, and vivid (and sometimes frightening) dreams or hallucinations.
The primary cause of narcolepsy is the lack of a neurotransmitter called hypocretin, which helps sustain alertness and prevents REM sleep from occurring during the day. Some other possible causes for narcolepsy include genetics, certain types of infections, disorders of the auto immune system, hormonal imbalances, as well as stress. In contrast to OSA occurring at around 50 years old, narcolepsy’s onset is generally between the ages of 10 and 25.
There is No Cure for Narcolepsy.
There are many treatment options, including lifestyle changes and medicine, that can reduce many of the symptoms of narcolepsy. Lifestyle changes include:
- Following a regular sleep schedule
- Doing something relaxing before going to bed, such as yoga
- Exercise regularly, but not within 3 hours before bedtime
- Avoid caffeine for several hours before bedtime
- Avoid large meals before bedtime
- Avoid bright lights and screens before bedtime
Some medicines can be taken to reduce excessive daytime sleepiness, including sodium oxybate, modafinil, and methylphenidate (Ritalin). For reducing cataplexy, antidepressants to repress REM sleep can be taken, such as serotonin norepinephrine reuptake inhibitors, like venlafaxine (EffexorSR), and selective serotonin reuptake inhibitors, like fluoxetine (Prozac) and sertraline (Zoloft).
Doctors typically determine whether you have obstructive sleep apnea or narcolepsy by observing if you have the most identifiable sign of narcolepsy, cataplexy.