Sudden Fatique/Narcolepsy?

[MomWithOCDSon]

My DS13 will occassionally come home from school and report that he fell asleep in class; it is usually the last class of the day and seems to be largely a stress reaction. Usually, his "naps" coincide with being given an in-class assignment that appears tedious and confusing to him. He reports having a sudden difficulty in holding his head up, and once he lays it on his desk, he literally falls asleep until someone (usually his teacher) awakes him.

 

I had recorded a program on the Discovery network called "Is It Possible?" thinking that my scientifically-minded DS would enjoy watching it at some point; that point came this morning. One of the story lines on the report was about narcolepsy in dogs and humans, and the doctor researching and identifying the causes of narcolepsy in both said that when a narcoleptic animal becomes excited, frightened or stressed, they lose muscle control and fall asleep.

 

THEN . . . and here's the clincher . . . he says that infectious agents such as strep can cause narcolepsy! Now I'm wondering if DS has been dealing with that: a combination of stress and strep!

 

I tried Googling this, and I found some references to scholarly articles that discuss the following abstract, but I can't find an accessible copy of the whole article:

 

Narcolepsy is widely believed to have an autoimmune basis, but conventional immunological approaches have failed to detect a serum autoantibody marker. Since cholinergic hyperactivity is a feature of narcolepsy-cataplexy, we transferred IgG from nine patients with narcolepsy and nine healthy controls to mice and assessed the effect on smooth muscle contractile responses to cholinergic stimulation. IgG from all narcolepsy patients significantly enhanced bladder contractile responses to the muscarinic agonist carbachol and to neuronally released acetylcholine compared with control IgG (p<0·0001), whereas contraction of the sympathetically innervated vas deferens was unaltered. Our findings provide direct evidence for the autoimmune hypothesis of narcolepsy.

 

Have any of you seen anything similar with respect to your kids?

[peglem]

When my daughter was an infant and toddler, she would fall asleep like somebody had flipped the sleep switch any time she was overwhelmed with sensory input. We were told it was a defense mechanism. When we flew to see Dr.L at the beginning of January, she did this as the plane was taking off (scary, because she was on a high dose of valium at the time). I've never thought of this as sleep, though, so much as shutting down-

[MomWithOCDSon]

I've never thought of this as sleep, though, so much as shutting down-

That's what I thought, too; that DS was "shutting down" in class because he was being confronted with something he couldn't or strongly didn't want to do. Plus, I thought narcolepsy was an entirely"fast-switch" thing, that your whole body would go limp involuntarily along with the suddent sleep, etc. And I thought it was strictly a rare, genetic disorder.

 

But now, looking it up and doing some reading on it for the first time, it seems to have a real link to some of the other behaviors our kids can experience. Not only is there a strep link, but an H. pylori link, as well, according to a Stanford University study, and sufferers refer to an actual "urge to sleep," rather than a 100% automatic and sudden shut-down. I guess the cataplexy (the loss of muscle control) can also be a part of the disorder, but is not always present.

 

Genetic factors alone are not sufficient to cause narcolepsy. Other factors-such as infection, immune-system dysfunction, trauma, hormonal changes, stress-may also be present before the disease develops. Thus, while close relatives of people with narcolepsy have a statistically higher risk of developing the disorder than do members of the general population, that risk remains low in comparison to diseases that are purely genetic in origin.

Excessive daytime sleepiness

 

EDS, the symptom most consistently experienced by almost all patients, is usually the first to become clinically apparent. Generally, EDS interferes with normal activities on a daily basis, whether or not patients have sufficient sleep at night. People with EDS describe it as a persistent sense of mental cloudiness, a lack of energy, a depressed mood, or extreme exhaustion. Many find that they have great difficulty maintaining their concentration while at school or work. Some experience memory lapses. Many find it nearly impossible to stay alert in passive situations, as when listening to lectures or watching television. People tend to awaken from such unavoidable sleeps feeling refreshed and finding that their feelings of drowsiness and fatigue subside for an hour or two.

 

 

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[Worried_Dad]

Fatigue, yes... but our son's sleep problems were on the other end of the spectrum. He had a terrible time getting to and staying asleep. At one point, he was pulling all-nighters 2-3 times a week, which was terrible for his health in general and wiped him out. But - even after staying up all night - the anxiety / adrenaline would keep him awake until bedtime the following night.

 

I couldn't stay awake that long if I tried!

[matis_mom]

I don't know if this qualifies as narcolepsy, but when our ds12 started with this whole thing (we did not know what it was then), he was overall tired, and would fall asleep on the couch at any time during the day. He also had a much harder time getting his school work done. I remember so clearly seeing him just sitting there in front of his school work and just tearing up, he wanted to get it done, but his brain was just not responding. Now, after 7 months on antibiotics, he does not have any of that any more.

Edited April 4, 2010 by mati's mom

[MomWithOCDSon]

I guess what I'm thinking is not that any of our kids have true, clinical narcolepsy, but that this is yet another telling link about infection and neurological dysfunction. And there may be an interrelatedness here that could further inform folks on both sides of the equation as well as no side at all: those with PANDAS, those with stress/anxiety disorders, those with narcolepsy.

 

Plus, honestly, I was just floored by what was new information to me (the link between bacterial infection and narcolepsy), and the fact that a narcoleptic actual feels an "irresistable urge" to sleep, rather than just immediately slumping into a sonambulent heap like the dogs in the videos they used to show us in high school psychology class. The sense of confusion and "mental cloudiness" that comes with the urge to nod off. There seem to be so many parallels with some of the PANDAS symptoms and behaviors we've experienced.

 

Some of what I've read -- blogs by narcoleptics, for instance -- just ring so many bells with me in terms of how my DS13 expresses himself sometimes: the sense of stress and anxiety that makes him feel so tired he just needs to put his head down on his desk for a minute, the way in which he is frequently misunderstood by others without the disorder (whether it be PANDAS or narcolepsy), etc.