Cataplexy is a sleep disorder; find a remedy 

Overview

Cataplexy is a neurological condition that causes muscular tone and control loss temporarily. Most “cataplectic attacks” are caused by intense emotions like anger, tension, anxiety, fear, depression, joy, and laughing.

Most cataplexy sufferers have type 1 narcolepsy, a persistent sleep and neurological disease in which the brain has problems coordinating wake and sleep cycles. Few people without narcolepsy have experienced cataplexy.

Living with cataplexy is hard. Your emotions can change randomly, causing cataplectic attacks. Some must continually monitor their bodies to avoid losing control.

Discover the causes of cataplexy, how narcolepsy affects it, and how to manage its crippling symptoms.

Signs and Symptoms of Cataplexy

• Cataplexy of uncontrollable muscle weakness
• May last for seconds to minutes 
• Can happen once a year
• They typically occur a few times a day.
• caused by intense emotions such as joy, excitement, sadness, or another 

As stated by clinical associate professor of neurology Shelley Hershner, MD, of the University of Michigan in Ann Arbor, 

• Their heads may bob, their knees may buckle, or they may lose control of their leg muscles while standing and fall.
• Cataplexy is sometimes mistaken for a seizure disorder. 
• They are always awake and aware of what's happening.
• After the cataplexy is over, some people might nod off.
• They should remain vigilant at all times to evade harm. 
• During cataplexy, an individual may slump, lose his or her grip on something, or fall.
• According to Dr. Hershner, "Few people may avoid taking a bath, swimming, or climbing a ladder."

 Risk factors  

Although cataplexy can cause muscle weakness anywhere in the body, it usually affects the face (eyelids may droop, jaw may go slack, speech may become slurred, head may nod) and limbs (hands may drop whatever they are holding, knees may buckle, legs may collapse). The severity of the attacks can vary from minor, like a slight drooping of the eyelids, to severe, like a complete collapse of the body.

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Cataplexy's causes and risk factors

• The majority of cataplexy cases are caused by type 1 narcolepsy. 
• It is unclear exactly what causes narcolepsy. 
• People may have abnormally low levels of hypocretin, also called orexin, a brain hormone that regulates sleep and wakefulness. 
• Rapid eye movement (REM) can be brought on by this deficit.
• Not getting enough sleep can be annoying.
• Although the cause of this hypocretin loss is unknown, immune system changes may cause the immune system to target hypocretin-containing brain cells.
• Most people who have been diagnosed with narcolepsy also have cataplexy.

Narcolepsy without cataplexy, or type 2 narcolepsy, can sometimes progress to narcolepsy with cataplexy. 

• Understanding REM sleep and how narcolepsy disrupts sleep cycles can help explain cataplexy. 
• Normal sleep cycles include three NREM stages preceding REM.
• The first NREM-REM cycle takes 70–100 minutes, and the following cycles take 90–120 minutes.
• These cycles repeat throughout the night. But narcolepsy disrupts these cycles.
• They may skip NREM and enter REM sleep quickly after falling asleep. 
• This can occur during naps during the day and at night, causing a blurring of sleep and consciousness.

Another important thing to remember is that during the REM phase of sleep, we dream and become immobilized to keep ourselves safe. Because REM sleep paralysis happens at the wrong time, people with narcolepsy experience vivid hallucinations and sleep paralysis when they go to sleep or wake up.

Cataplexy episodes mimic REM sleep-induced muscular control loss but occur during wakefulness.

Research suggests that positive emotions may cause muscle weakness in healthy people (laughing can make you weak), but the brain chemical hypocretin (missing in narcolepsy) prevents this from lasting. This may explain why cataplexy-afflicted narcolepsy patients react more strongly. We need more research to understand why and how intense emotions elicit this response, as well as how hypocretin affects narcolepsy symptoms and therapy.

How to Diagnose Cataplexy?

• Most of the cataplexy cases have type 1 narcolepsy, of which 10% of cases start with it. 
• Others presume it is a seizure disease.
• Narcolepsy with cataplexy happens when you sleep during the day 
• Doze off at inappropriate times (when working or talking to a friend).
• Experience momentary paralysis while awake.
• If you suspect narcolepsy, contact a sleep specialist.
• The doctor may ask for a sleep history. 
• This includes the Epworth Sleepiness Scale, which is used to diagnose narcolepsy with cataplexy.

Maintain a sleep journal.

Your doctor may ask you to stay overnight at a sleep center for tests

These tests can assess narcolepsy severity or discover alternative causes.

Tests may include:

• Polysomnography 
• Multiple Sleep Latency Tests A daytime nap study is the standard narcolepsy diagnosis tool.
• Measure hypocretin. This test measures hypocretin. 

Cataplexy Treatment and Medication

Also, read https://sleepdoctor.com/physical-health/cataplexy.

• No cure exists for cataplexy or narcolepsy.
• Cataplexy may last a lifetime.
• A person with cataplexy may have one or two attacks in their lifetime 
• Dr. Olson warns that cataplexy can be deadly and “life-restricting” without a narcolepsy diagnosis and treatment. 
• Cataplexy sufferers may learn to adapt their behavior and activities 
• Avoiding driving or socializing with friends can greatly impact quality of life.
• Narcolepsy with cataplexy is lifelong; however, some drugs can assist.

Treatments for Cataplexy

• Studies have shown that certain medications can treat cataplexy.
• Medical treatments may eradicate cataplexic attacks or reduce them by 90%.
• The main therapeutic options are drugs that keep individuals awake during the day and put them to sleep at night.
• Tricyclic antidepressants like Anafranil, Tofranil, Norpramin, and SSRIs may aid with cataplexy and other narcolepsy symptoms. Sodium oxybate, a nighttime sedative, can cure extreme daytime sleepiness and cataplexy bouts.

Rare cataplexy occurrences may not require intervention. People with regular attacks or those that substantially disrupt their lives should discuss drug alternatives with their doctor and weigh the benefits and adverse effects. Medication to control attacks may improve social engagement, safety, and quality of life for severe cataplexy patients.

Alternative Cataplexy Treatments

• Cognitive behavioral therapy (CBT), or learning to modify behavior, may help control narcolepsy symptoms like cataplexy in addition to drugs.
• CBT for narcolepsy can help patients identify triggers and learn how to prevent cataplectic symptoms. 
• Stimulus satiation, another CBT method, exposes the patient to the cataplectic trigger until it loses its impact. 
• CBT for narcolepsy needs more research because most studies have focused on other sleep disorders.
• Counseling and support groups can help narcolepsy patients cope with symptoms like cataplexy. Support groups are available through the Narcolepsy Network. Ask your doctor for a support group or counselor referral.

Prevention of Cataplexy

• Cataplexy prevention is best with medications, although alternative methods may work:
• Sleep plenty or take strategic naps.
• “Exhausted people are more vulnerable to emotional triggers, so being well-rested is important.” Take short, scheduled naps at your sleepiest periods. Krahn said narcolepsy patients can benefit from 20-minute naps.
• Get up. Regular exercise may prevent daytime sleepiness and reduce cataplexy. 
• Walking is a beneficial alternative to napping if you're tired.
• Ask friends, family, and coworkers for aid. 
• Tell people if intense emotions or events cause cataplexy. 

Problems with Cataplexy

• Cataplexy often causes bodily injury. Injuries might result from cataplexy when driving, cooking, or operating machinery.
• Head damage, such as cerebral hemorrhage, can result after severe attacks.
• Cataplexy can disrupt relationships and daily life. 
• Many attacks are caused by intense emotions like wrath and delight; hence, cataplexy sufferers avoid social situations.

Statistics: How Common Is Cataplexy?

1. Sleep disorders include insomnia, sleep apnea, RLS, and narcolepsy, affecting 70 million Americans.
2. Narcolepsy affects 1 in 2,000 Americans or 200,000 Americans, and 3 million worldwide. About 50% of narcolepsy patients suffer from cataplexy. Narcolepsy is often misdiagnosed, so the actual figure may be greater.
3. Narcolepsy (including cataplexy) can occur at any age, but it usually starts in childhood, adolescence, or young adulthood (7–25). The symptoms will grow over months and last forever.

Conclusion

Try to avoid daytime sleep. Keep a sleep schedule. Avoid coffee, alcohol, and smoking before bed. Avoid big meals before bed. Establish a bedtime routine. Warm baths help relax before bed. Keep your bedroom peaceful, pleasant, and distraction-free.