is best managed with a combination of medications and common
sense! Treatment must be tailored to the needs of the individual
patient, and medications alone are not the answer. One must
also eliminate aggravating factors that would make the symptoms
worse and the prescribed medications less effective.
example: one does not manage diabetes by giving insulin
and then informing the patient that since they now have medicine,
they can do whatever they please...such as eating entire
pies and cakes and drinking a case of beer every day! It
would be illogical to use such a "medications
only" approach for any illness--including narcolepsy.
physician treating the patient with narcolepsy should
be experienced in its management and also take the time needed
to educate the patient about the condition and factors
that can make it worse--empowering the patient and enabling
him or her to "outsmart" the
disorder as much as possible.
Are there other disorders of impaired
brain alertness mechanisms beside narcolepsy?
Even if one excludes causes of their impairment by sedating medications,
hormonal imbalances such as hypothyroidism and the like, there
are individuals with severe "brain sleepiness" not secondary to
problems (such as sleep apnea) occurring during overnight sleep--and
who do not have either cataplexy or a tendency to enter REM sleep
too rapidly. The term "idiopathic
hypersomnia" has been used to describe such individuals.
hypersomnia is a diagnosis that is made by excluding
other possible causes. Idiopathic is a polite way of saying
that the doctor has no idea what caused the problem!--which
does not mean that it cannot be effectively treated.
IS IMPORTANT TO KNOW THAT MANY PATIENTS WHO HAVE BEEN DIAGNOSED
AS HAVING IDIOPATHIC CNS HYPERSOMNOLENCE IN FACT HAVE UPPER
AIRWAY RESISTANCE SYNDROME--WHICH CAN READILY BE MISSED BY
CONVENTIONAL SLEEP MONITORING TECHNIQUES.
--Upper airway resistance syndrome
is treated much differently than idiopathic CNS hypersomnolence--and
it is inherently treatable!
one should not hesitate to ask whether a sleep center possesses
the special monitoring capabilities needed to detect and
document upper airway resistance syndrome if it happens to
FOR MORE INFORMATION ON DISORDERS
OF EXCESSIVE SLEEPINESS, CLICK HERE TO VISIT THE NEW SLEEP SITE.
COLUMBUS COMMUNITY HEALTH
REGIONAL SLEEP DISORDERS CENTER Accredited by the American
Academy of Sleep Medicine.
Robert W. Clark, M.D., Medical
1430 South High Street, Columbus OH 43207