What exactly is the difference between narcolepsy and sleep apnea?

Narcolepsy and sleep apnea are two diseases that can cause you weary during the day. Their symptoms, causes, and therapies, on the other hand, are vastly different.

Narcolepsy is an uncommon condition that causes episodes of extreme tiredness that can occur at any time. Cataplexy is a condition in which some people experience an abrupt loss of muscular tone.

Sleep apnea, on the other hand, is a frequent condition in which a person’s breathing stops and causes disturbances while sleeping. It can cause fatigue as a result of poor sleep quality.

The differences between narcolepsy and sleep apnea, as well as the link between the two sleep disorders and how doctors diagnose them, are discussed in this article.

What is narcolepsy?

narcolepsy

Narcolepsy is a neurological condition that impairs the brain’s capacity to regulate its sleep-wake cycle. This can cause people to fall asleep spontaneously and unexpectedly during the day, even when performing tasks that need focus, such as driving.

Narcolepsy patients frequently have disrupted sleep owing to intense dreams, hallucinations, or sleep paralysis.

Narcolepsy is classified into two types: type 1 and type 2. Cataplexy, or a decrease of muscular tone, is a symptom of type 1. Cataplexy causes a section of or the entire body to become limp. Type 2 occurs in the absence of cataplexy.

Narcolepsy symptoms often appear in childhood or early adulthood, but they can appear at any age. Many studies believe that the condition is frequently misdiagnosed or underdiagnosed.

What is sleep apnea?

Sleep apnea is a frequent condition in which a person’s breathing temporarily stop or becomes very shallow during sleep. These are known as “breathing pauses” by doctors, and they can last anywhere from a few seconds to a few minutes.

People who suffer from sleep apnea experience frequent breathing pauses, which can occur 30 times or more per hour. Sleep apnea can be classified into numerous categories, including:

  • OSA (obstructive sleep apnea): This is the most frequent type of sleep apnea, and it is caused by an obstruction in the upper airways.
  • Central sleep apnea: This condition happens when the brain fails to provide the necessary impulses for breathing.
  • Complex sleep apnea syndrome: This is a combination of obstructive and central sleep apnea.

Symptom differences

The symptoms of sleep apnea and narcolepsy are compared in the table below:

Sleep apneaNarcolepsy
excessive daytime sleepinessexcessive daytime sleepiness that may occur suddenly
gasping or choking noises during sleepcataplexy, which strong emotions such as fear, laughter, stress, anger, or excitement often trigger
loud snoringvivid dreams, sleep paralysis, or hallucinations
dry mouth when wakingacting out dreams
frequent waking during sleepdifficulty sleeping at night
difficulty focusing or rememberingautomatic behaviors, which occur when a person briefly falls asleep but carries on with their activity
headaches

Sleep apnea is also linked to bedwetting, exacerbated asthma, and academic performance difficulties in children.

Can sleep apnea progress to narcolepsy?

According to research, OSA is widespread in people who have narcolepsy. An earlier 2010 study discovered that 33 people with narcolepsy — nearly 25 percent — also had sleep apnea symptoms.

Sleep apnea, on the other hand, does not cause narcolepsy. Narcolepsy is a neurological condition in which the brain is unable to control its sleep-wake cycle.

Sleep apnea is common in people with narcolepsy, although it may be related to the other sleep abnormalities that people with narcolepsy frequently encounter, according to doctors.

Hypocretin, a hormone, is deficient in people with type 1 narcolepsy. Hypocretin awakens people and regulates rapid eye movement (REM) sleep. Excessive tiredness during waking hours and irregular sleep cycles cause in symptoms such as vivid nightmares when this hormone is deficient.

Doctors aren’t clear why certain people have low hypocretin levels, although various variables could be at play:

  • Autoimmune disease: Autoimmune disorders, in which the immune system assaults healthy cells, are common in people with type 1 narcolepsy. The immune system may also assault the cells that produce hypocretin, resulting in a deficit, according to researchers.
  • History of the family: Most cases of narcolepsy do not have a familial history of the condition. However, approximately 10% of people indicate they have a family relative who likewise suffers with narcolepsy symptoms. This shows that in some circumstances, there may be a hereditary component.
  • Injuries or diseases to the brain: In rare cases, narcolepsy develops as a result of an injury to a brain area that regulates sleep or as a result of another condition that affects the brain, such as a tumor.

Hypocretin levels in people with type 2 narcolepsy are frequently normal. Researchers are still trying to figure out what causes this condition.

Similar conditions

There are numerous reasons why a person may feel excessively fatigued during the day. Other things that may contribute to this symptom are as follows:

  • insufficient sleep
  • certain medications, such as antihistamines, antidepressants, and beta-blockers
  • other sleep disorders, such as circadian rhythm disorder
  • hypothyroidism
  • depression
  • insomnia
  • traumatic brain injuries

Some more serious illnesses, such as Parkinson’s disease, multiple sclerosis, and muscular dystrophy, can also cause extreme sleepiness. However, these are generally accompanied by additional symptoms.

Diagnosis

A doctor can determine the cause of extreme tiredness, frequent awakening during the night, and other symptoms that may indicate sleep apnea or narcolepsy. They will start the diagnostic procedure by:

  • asking the person to keep a sleep journal to record their symptoms
  • taking a medical history
  • performing a physical examination

Sleep studies, on the other hand, are the major tool used by doctors to identify sleep apnea. A person will spend the night at a health center, where doctors will monitor them and count the number of breathing pauses in an hour. Doctors will also look to see if the blood oxygen levels change.

If a doctor suspects narcolepsy, he or she may order a polysomnography (PSG) and a multiple sleep latency test (MSLT).

A PSG is a form of sleep study that monitors breathing, eye movements, brain activity, and muscle movements while the patient is sleeping. It can detect narcolepsy and other sleep-related problems, such as sleep apnea.

An MSLT is usually performed the morning after a PSG. The individual will take a nap every two hours until they have had five naps in total. This test allows doctors to detect how quickly a person falls asleep and whether they enter REM sleep.

A lumbar puncture is sometimes performed to assess the hypocretin levels in a person’s cerebrospinal fluid.

Treatment

To treat these sleeping disorders, doctors employ a variety of treatments.

Treatment for sleep apnea

The following are some of the possible therapies for OSA:

  • surgery, if OSA is due to enlarged tonsils or adenoids
  • mouthpieces
  • breathing devices
  • lifestyle changes, such as quitting smoking or maintaining a moderate weight

A continuous positive air pressure (CPAP) machine is the most commonly recommended breathing equipment by doctors. To keep the airway from collapsing, these devices blast pressurized air into the individual’s neck.

Sleep apnea mouthpieces move the lower jaw forward sufficiently to keep the airway open. If OSA treatment is ineffective, it could be a symptom that the person has another kind of sleep apnea, another sleep disorder, or a condition such as narcolepsy.

Treatment for Narcolepsy

There is no cure for narcolepsy, however medication can help most people regulate their extreme sleepiness and cataplexy. A doctor may order:

  • tricyclic antidepressants
  • selective serotonin reuptake inhibitors
  • modafinil (Provigil)
  • amphetamine-like stimulants
  • noradrenergic reuptake inhibitors

To help control their symptoms, an individual may need to make lifestyle changes like as avoiding coffee before bed, taking short naps, exercising everyday, and maintaining a regular sleep pattern.

Conclusion

Both sleep apnea and narcolepsy cause daytime tiredness. Sleep apnea, on the other hand, causes weariness as a result of sleep disturbances caused by frequent pauses in breathing. People with the condition frequently snore, produce gasping or choking noises while sleeping, or wake up with a dry mouth.

Narcolepsy is a neurological condition that causes excessive sleepiness, causing people to fall asleep unexpectedly throughout normal tasks. Insomnia, vivid dreams, sleep paralysis, and hallucinations are also possible. It is conceivable to have both sleep apnea and narcolepsy, but sleep apnea is significantly more prevalent on its own.

People who are concerned about their symptoms should seek medical attention, especially if their tiredness is interfering with their mental health or activities that could be risky, such as driving.

Sources:

  • https://www.sciencedirect.com/science/article/abs/pii/S1389945720301210?via%3Dihub
  • https://rarediseases.org/rare-diseases/narcolepsy/
  • https://www.medicalnewstoday.com/articles/narcolepsy-vs-sleep-apnea
  • https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815780/
  • https://pubmed.ncbi.nlm.nih.gov/19699146/
  • https://medlineplus.gov/sleepapnea.html
  • https://www.nhlbi.nih.gov/health-topics/sleep-apnea

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