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When Sleep Is Unwelcome

© Kylie Carberry

When Diane* was 16 she became hampered with bouts of daytime sleepiness that caused the need to nap. Over the following years this somnolence did not abate and medical practitioners attributed it to depression. She was prescribed therapy and medication, problem solved.

Yet two years ago at 33, Diane, a library assistant, student and mother of four, still found the urge to sleep was intruding her days. She was having increasing difficulty resisting slumber, and at times literally not able to keep her eyes open. "I became very drowsy while driving, something I had never done before. I also began to stay in my office during the lunch hour and fall asleep on the floor. I made excuses-the sun was too bright, the sky was overcast, I wasn't feeling well, it was my depression," Diane says.

Other peculiar symptoms also manifested. Diane had intense dreams she says were hard to distinguish from reality. She was certain she was going crazy. At times she would slur her words, fall asleep whilst standing, or lose control of her neck muscles. One day during class she had taken notes but could not remember writing them.

It was through some medical research of her own that Diane says she discovered the cause of problems. "I ran across the symptoms of narcolepsy, and it all clicked."

Narcolepsy is a chronic sleep disorder, one of its core symptoms being the intrusion of an excessive, overwhelming and often irresistible desire to sleep. The sleepiness associated with narcolepsy occurs regardless of the amount of sleep had at night; although this night-time sleep is often interrupted with wakefulness. 'Sleep attacks', can encroach at any time - during an important meeting, through dinner, or, whilst driving.

The other core symptom of narcolepsy is cataplexy, the abrupt loss of muscle power, usually triggered by emotions such as laughing, surprise, or anxiety. Attacks can range from a brief sensation of weakness to total physical collapse, lasting several minutes. Those with narcolepsy may also experience sleep paralysis - the inability to move on waking or falling asleep; hypnagogic hallucinations - vivid, often terrifying dreams that occur at the beginning or end of a sleep period; and automatic behavior - performing tasks with a greatly reduced awareness and control over the activities involved.

These symptoms occur when the part of the brain that regulates sleep and wakefulness called the hypothalamus does not function properly, causing sudden intrusions of rapid eye movement (REM) sleep - the dreaming state of sleep. In normal brain function REM sleep does not start sooner than 90 minutes into the sleep episode.

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