Narcolepsy: The Evasion of Consciousness

Since one of our only two followers of this blog happened to have narcolepsy I wanted to write about a specific topic in another book I have been reading (still) “The Dream Drugstore” by Dr. Allan Hobson. Again if you don’t know who Allan Hobson is, he is what I like to call one of the leading scientists in dream research as well as having a strong goal to disprove anything that does with Freud.

Before I go on a tangent about how much I agree with Dr. Hobson in the sense that Freud was completely wrong (something that I have changed from before) I wanted to write about what Dr. Hobson had to say about narcolepsy and sleep.

Narcolepsy like many disorders have a strong tie to sleep and problems with sleep, but rather than getting enough of sleep or not enough, it’s a matter of when for narcoleptic patients. In narcolepsy the patients have a problem of staying awake. Not awake in the sense that they always feel sleepy and just fall asleep on spot, more like they fall asleep for what seems to be no good apparent reason. Looking more into the research and what Dr. Hobson says about the research, the effects of narcolepsy occurs when someone is stimulated. I say stimulated because it someone situations it would see that fear is the stimulant as in others it would seem that happiness is the cause.

In a “normal” person we have degrees of stimuli that our body seems to regulate to moderate how we function. In this perfect functioning system, if our bodies are over stimulated to the extreme, we may experience an altered state of consciousness in reaction to defense, or the inability to defend. In a narcolepsy patient it would see that this system is over sensitive. This over stimulation is thought to be caused by an imbalance either chemically or genetically in either the amount of chemicals or reaction of those chemicals that affect the brainstem. This brainstem activation causes what in most cases could be considered as dream onset, since most narcoleptic patients complain of dreaming once they experience an episode (Hobson, 2001). These dreams are typically overlays of waking life with hallucinations since all the key components to alter states of consciousness in dreaming are not yet into place (see sleep model). This slight spontaneous sleep onset (preferably amygdale activation, PNG activation, and anterior horn cells deactivation) during an episode of narcolepsy could be put to blame by the possibility of having a unnaturally strong cholinergic REM on system and weak amirnergic REM-off system (Hobson, 2001). In plain terms, the mechanism that controls all this (brainstem or activating chemicals) is not acting according to the best interest of the person.

Interesting enough many of the types of pharmaceuticals that are given to patients for narcolepsy deal with dopamine, norephinephrine, or serotonin. I would like to put special interest into serotonin since enhancing serotonin seems to cause super-abundance of rapid eye movement (yes rapid eye movement is not only limited to REM stage) during N-REM stages (Hobson, 2001). If someone was to have an overabundant amount of serotonin or the brainstem serotonin activators are over sensitive, it could cause a problem with keeping dreams in REM where they seem to belong. As stated before by Hobson is that the weak amirnergic REM-off system seems to be a cause. It sounds a lot like dreams are leaking through into waking life much like they do into non-REM stages when someone is influenced of SSRI’s.

In relation to the limited information that I know about narcolepsy, If I was researching the causes, I would am my research into the areas of the serotonin aminergic system as well as medicate patients with elevated the cholinergic system like acetylcholine and other type neurotransmitters. I would also look into the effects of MAOI’s on patients as it might try to help elevate and hopefully monitor the system naturally after a period of time (Clemons, Makela, Young, 2004) as the introduction of MAO’s into the system has shown decrease of narcoleptic events.

References:

Clemons, William, Makela, Eugene , & Young, John (2004). Concomitant use of modafinil and tranylcypromine in a patient with narcolepsy: a case report. Sleep Medicine. 5, 509–511.

Hobson, A. J. (2002). The Dream Drugstore: Chemically Altered States of Consciousness. MIT Press.

-L