Constant muscle spasms and drowsiness may be signs of a more serious condition
Cataplexy is associated with another sleep disorder that experts say has been exacerbated by lockdowns.
You’ve probably woken up in the middle of the night feeling like you’re falling or standing on the edge of a precipice. Although relaxed during sleep, the body responds with one or more brief spasms that wake it up. When these involuntary muscle contractions occur during the day, they are associated with a state of extreme drowsiness and may indicate that it is time to seek medical attention.
Sleep is essential for the proper functioning of the body. A bad night’s sleep has happened to (almost) everyone: the alarm clock rings and you realize right away that you haven’t slept enough. Dark circles, yawning and that tired body feeling. It is easy to guess that the day that has just begun will not be easy. If there’s only one, it’s not really a problem. But sometimes there’s something deeper going on, especially when our nighttime sleep patterns don’t allow us to get enough rest. When this problem is associated with the low levels of a hormone – hypocretin – the more likely you are to start experiencing symptoms of a sleep disorder-related condition, cataplexy.
“Episodes of this disease occur during wakefulness, due to the sudden loss of muscle tone, i.e. people lose strength in the muscles, a feature of the REM phase of sleep,” explains psychotherapist Tânia Annes at NiT. He continues: “Usually we have to go through non-REM phases before the REM (Rapid Eye Movement) phase, but due to a sleep regulation problem caused by low levels of the hormone hypocretin, a person with cataplexy can go through stages of sleep without even falling asleep, i.e. the person is awake and seems to suddenly fall into a deep sleep, no matter what they are doing or where.
This problem then ends up triggering symptoms such as weakness, droopy eyelids, a feeling of paralysis of the facial muscles, difficulty speaking and even a feeling of fainting, but without your eyes closing completely. In extreme cases, the person may fall.
Signs and treatments
Cataplexy affects both sexes in the same way. It usually appears before the age of 25, but it can appear at any other stage of life. Episodes can be triggered by strong emotions such as fright, surprise, a moment of anger, fear or even anxiety.. However, experts believe that this neurological problem is triggered by a hormonal crisis, as it occurs when the hormone hypocretin is very low.
These episodes, usually lasting less than two minutes, occur without warning and can be very dangerous. “People can drive and lose control of the car; if they are standing or sitting, they can fall and hurt themselves”, emphasizes the specialist in psychotherapy. The frequency can vary: a few times a year or several times a day.
This condition is associated with another neurological disease, narcolepsy, another sleep disorder. “About 75% of people with narcolepsy have episodes of cataplexy, which is often the first symptom,” explains Tânia Annes. And this disease is not so rare. According to the Rare Disease Database, “one in two thousand people have this disorder” and many more are thought to go undiagnosed.
Successive confinements may have increased the risk of developing this disease. According to a study published in April 2021 in the journal “Pub Med”, being in quarantine can worsen many symptoms of narcolepsy, including cataplexy.
“There is no cure, but there is a treatment that uses drugs to control the hormonal part in order to avoid these more serious episodes of the disease”, explains the specialist. However, for this a precise diagnosis must be made, which is sometimes complicatedbecause the mildest symptoms are usually very similar to other pathologies, such as dizziness and vertigo.
“What worries me a lot in these cases are the psychological problems that these people develop”, reveals Tânia Annes. As it is a life-limiting condition for people, because they are afraid that the episodes will occur at the least opportune times, they end up taking refuge at home and losing quality of life. “It’s really limiting and embarrassing,” he concludes. The best thing to do, in case of suspected diseases related to sleep disorders, is to consult a doctor, advises the psychotherapist of the Clínica da Mente.