Posted by Elizabeth on February 7, 2002, at 14:58:23
In reply to REM Sleep Narcolepsy » Elizabeth, posted by IsoM on February 2, 2002, at 20:52:42
> Thanks Elizabeth for the post. I wasn't aware there were REM suppressors & will look into that.
Oh yes! Those daytime sleep attacks in narcolepsy are REM sleep attacks. Similarly, at night you probably spend a disproportionate amount of your sleeping time in REM sleep. Modafinil (and, I'm guessing, adrafinil) only prevents the sleep attacks, not the cataplexy. Everyone loses skeletal muscle tone during REM sleep, BTW, not just narcoleptics. Although there's a disorder -- which I have had spells of since I was a kid -- called REM sleep behavior disorder [silly name] where you act out your dreams physically because your muscle tone is sustained. People with narcolepsy and some other neurological disorders often get this.
> For me adrafinil looks after the constant struggle with trying to maintain alertness. The all-day struggle with staying awake is to me, the most disabilitating feature of narcolepsy.
Of course it would be. Cataplexy, I imagine, is mostly just embarrassing. :-}
> I started TCAs 15 years ago for migraines (which never did help) but it did stop the sleep paralysis & the hypnogogic/hynopomic halluications but never dealt with the sleepiness.
TCAs often make people more tired. I think if you're going to use ADs for narcolepsy, MAOIs are a better choice. Which TCA(s) did you try?
> The cataplexy is infrequent & fairly mild (if I'm laughing or crying when it happens, I just collapse with weak muscles).
Interestingly, it's often triggered by strong emotions (of the sort that would cause you to laugh or cry).
> TCAs were too constipating for me & my heart rate was always around 120, so tried SSRIs & they stop the same symptoms TCAs did.
I had similar problems with TCAs (not the tachycardia so much, but the constipation was pretty bad) -- turned out I didn't metabolize them normally. I hadn't heard that SSRIs were being used for narcolepsy. They do suppress REM sleep to some degree, not as much as TCAs and certainly less than MAOIs.
> It's not like I have bad dreams but it seems like most of my sleep is in that stage, meaning less for deep sleep which may account for my excessive sleeping & not feeling like I'm well rested. Just my feeling abut it.
"Just?"
Yes, an increase in REM sleep can lead to not feeling rested. (But it could be good for your memory! :-) )
> I'm off to check what sort of REM suppressors are out there.
Lots. Amphetamine. Benzos. TCAs (any anticholinergic, really). SSRIs and Effexor, but less so, as I said. MAOIs are probably the strongest ones.
BTW, the main link between REM sleep and depression is that some people with depression tend to go into REM sleep earlier than normals do (around 70 minutes REM latency instead of 90). REM latency is much shorter in narcolepsy, though. Also, this feature isn't found in the sleep of all depressives -- many have normal REM latency.
-elizabeth
poster:Elizabeth
thread:92585
URL: http://www.dr-bob.org/babble/20020131/msgs/93205.html