Narcolepsy Type 1 (Narcolepsy with Cataplexy)

Posted by maddyjulia @maddyjulia, Sep 19, 2021

Hi there. After years of unexplained symptoms, my daughter was finally diagnosed with narcolepsy type 1, aka narcolepsy with cataplexy. I too suffer from hypersomnia, but the cyclical nature and neurological symptoms seems much more in line with Kleine-levin syndrome. Does anyone know if there’s a connection between the two? Also, kleine-levin is so rare I feel like it would be hard to get a doctor the take me seriously. It was hard enough getting my daughter diagnosed with narcolepsy—it took years!

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Profile picture for sleepstate @sleepstate

Thank you! I get it, it's okay. No, not at all spam. They actually do work in our brains to reverse severe fatigue, cataplexy and other symptoms. They gave me my life back for nearly 30 years without serious problems. Of course it's not for everyone. I believe it can do the same for others who manage their medications well and carefully. Thank you for posting them. I understood why the delay 🙂

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As I mentioned I don't have cataplexy, but the other symptoms are bad enough. I'm alrey taking hydrocodone. What did you have to do for this @sleepstate?

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Profile picture for Critically Thinking @timbrownfl

As I mentioned I don't have cataplexy, but the other symptoms are bad enough. I'm alrey taking hydrocodone. What did you have to do for this @sleepstate?

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What did I have to do for what? I'm not sure what you mean. Yes the fatigue, sleep paralysis, no energy and depression it all triggers is worse than my cataplexy is. I've been on a low dose of my meds 34 and 28 years and slowly become tolerant to it. It doesn't work nearly enough to live life every day anymore. It does if I increase it but my Dr is too worried he'll have the feds on him if he does. I don't blame him. The way things are he might. It's terrible, so many people are having their meds reduced or cut off and really suffering because of over regulating.

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Sorry, I must hav misunderstood something. I have a strange case where my symptoms didn't hit until I was 61. Maybe I can hang in there before my meds stop working.

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I developed narcolepsy with cataplexy over 40 years ago. The cataplexy was so bad that it made it relatively easy for a neurologist to diagnose. Most of the medications available in 1980 were stimulants to help me stay awake, but they had little effect on cataplexy. Thankfully, I started xyrem in 2005, and it was a miracle for me after years of falling asleep at all the wrong times. The last 4 or 5 years it is not quite as effective in terms of sleepiness, but it really controls cataplexy. Actually, I control much of my cataplexy because I have learned what triggers it and try to avoid those situations. For me, the worst cataplexy happens when I say something funny and people laugh. This means I really curtail my personality unless I am with family/friends. Be careful if you start Xyrem/Xywav -- at the beginning it can really knock you out quickly. Most people I know who use it have taken some bad falls in the middle of the night. Some sleep walking resulting in night eating. We put up a gate at the top of the stairs to prevent me from going downstairs and grazing and to prevent falls. Xywav is a low sodium dosage of Xyrem. I would strongly rec. you take it. Results are the same EXCEPT you are not taking in a day's worth of sodium each night. Over 15 years of Xyrem and I now have CKD -- chronic kidney disease which is not reversible. The pharmacists working with Xyrem/Xywav assure me the meds are the same without the huge dose of sodium in xywav. In my opinion, they should only be selling Xywav since the kidney problem doesn't materialize for many years, but when it does, there is no real treatment. I have met older people who have been successfully treated with the codone, but they usually don't talk about it, fearful that it will be taken away from them if their doctor is found to be prescribing it routinely.

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Hello @maddyjulia, Welcome to Connect. You will notice that we added a little to your title to hopefully bring members into the discussion who may not know that narcolepsy type 1 is now what the medical community calls narcolepsy with cataplexy. I have no medical background or training but did read some information that leads me to think there is a connection between Kleine-Levin Syndrome and hypersomnia. --- "Recurrent hypersomnia (also known as Kleine-Levin syndrome) is characterized by periods of excessive sleeping up to 20 hours a day, which lasts from 2–35 ..." -- Kleine-Levin Syndrome - an overview: https://www.sciencedirect.com/topics/medicine-and-dentistry/kleine-levin-syndrome.

Also you might find the following Narcolepsy Fact Sheet helpful - https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet. You might also find the following site helpful for preparing what to discuss and planning the conversation with your doctor - https://patientrevolution.org/visit-tools.

Have you thought about seeking help at a major teaching hospital or health facility like Mayo Clinic?

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I think N1 should be called Orexin deficiency disorder. There's so much more to it than with N2. Sleep/wakefulness and Cataplexy are only some of the symptoms due to low Orexin levels. Also Opiates work well at greatly reducing the severity of symptoms in N1, I don't believe that is the case in N2.

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Profile picture for Critically Thinking @timbrownfl

Sorry, I must hav misunderstood something. I have a strange case where my symptoms didn't hit until I was 61. Maybe I can hang in there before my meds stop working.

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Opioids to my knowledge don't work for Narcolepsy without Cataplexy. It's Narcolepsy with Cataplexy. So, if you don't have Cataplexy, I wouldn't think it would be beneficial to try them. With stimulants as with most controlled medication the best thing to do to keep them working as much as possible is to take med breaks whenever possible and switch similar medications such as Ritalin for Adderall. Tolerance is an unfortunate factor with many of these medications, and it does take work to keep it at bay.

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Profile picture for sdanderson007 @sdanderson007

I developed narcolepsy with cataplexy over 40 years ago. The cataplexy was so bad that it made it relatively easy for a neurologist to diagnose. Most of the medications available in 1980 were stimulants to help me stay awake, but they had little effect on cataplexy. Thankfully, I started xyrem in 2005, and it was a miracle for me after years of falling asleep at all the wrong times. The last 4 or 5 years it is not quite as effective in terms of sleepiness, but it really controls cataplexy. Actually, I control much of my cataplexy because I have learned what triggers it and try to avoid those situations. For me, the worst cataplexy happens when I say something funny and people laugh. This means I really curtail my personality unless I am with family/friends. Be careful if you start Xyrem/Xywav -- at the beginning it can really knock you out quickly. Most people I know who use it have taken some bad falls in the middle of the night. Some sleep walking resulting in night eating. We put up a gate at the top of the stairs to prevent me from going downstairs and grazing and to prevent falls. Xywav is a low sodium dosage of Xyrem. I would strongly rec. you take it. Results are the same EXCEPT you are not taking in a day's worth of sodium each night. Over 15 years of Xyrem and I now have CKD -- chronic kidney disease which is not reversible. The pharmacists working with Xyrem/Xywav assure me the meds are the same without the huge dose of sodium in xywav. In my opinion, they should only be selling Xywav since the kidney problem doesn't materialize for many years, but when it does, there is no real treatment. I have met older people who have been successfully treated with the codone, but they usually don't talk about it, fearful that it will be taken away from them if their doctor is found to be prescribing it routinely.

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Yes, I broke 3 ribs falling not once but twice in one night. I always had knots on my head from hitting the doorknob in the bathroom, lol. When I was on Xyrem I was constantly eating night and day but mostly at night. I lost weight though, 40lbs in something like 4 months maybe less. My primary care was really worried about it, but I told her I positive it's the Xyrem I'm on. I was really worried when I had to stop taking it over cost that I would gain it all back, but I didn't. If I could afford it I would get back on it. I really hate the antipsychotics and antidepressants like Trazodone, Quetiapine and others that leave me feeling out of it all day. I feel like they're damaging my brain. The copay for it is twice what my income is. I do talk about taking hydrocodone or oxycodone for Narcolepsy with Cataplexy on several forums, I also write law makers, the CDC, NIH, DEA about it. It's the one medication that has actually really worked and turns out there's a reason it does. I feel that it's very important for people to know that, for science to have it documented. My last specialist made it a point to write on my scripts and in my visit summaries that I take it for Narcolepsy with Cataplexy, not for pain. My new one is afraid to put why I take it. He isn't doing himself, me or anyone any favors and I'm worried because I am so vocal about it, it will come back and bite him in the you know what. I will fight anyone, DEA included if they try and harass him or interfere in anyway with my treatment, but I'd rather not have too. I have told him I want to know right away if someone does say something, he did when my insurance company wrote him suggesting I take other medications, which I have and do and tells him opiates cause sleepiness and should not be used for Narcolepsy. I about went through the roof! I sent them all the studies and articles I could find and told them it would be in their best interest not to make recommendations on things they obviously know nothing about!

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