How To Manage Cataplexy
Cataplexy is a sudden, uncontrollable paralysis or weakness of the muscles that occurs in the day. It's most commonly triggered by strong emotions like laughter or excitement. Seemingly without warning, an individual dealing with cataplexy might lose muscle tone and have weakness in their trunk, legs, arms, and face. Their speech might be broken, their knees may buckle, and their jaw might go slack. During an episode of cataplexy, which typically lasts a minute or two, patients are awake and conscious of the situation but unable to move. Some individuals fall asleep following the episodes. Cataplexy episodes occur with varied frequency in individuals who have narcolepsy.
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Maintain A Regular Sleep Schedule
Cataplexy is commonly associated with narcolepsy, which is a sleep disorder that causes overwhelming drowsiness during the daytime and sudden 'sleep attacks,' in which patients can fall asleep seemingly without warning. A narcoleptic individual tends to have difficulty staying conscious for long time periods no matter the circumstances. While researchers still aren't sure what causes cataplexy, the main theory is it occurs when the muscle movements that usually happen during REM sleep instead occur during the waking hours. One of the main ways to manage this is by sticking to a sleep schedule. Individuals with cataplexy should have a strict bedtime and wake up at the same time each morning, even on the weekends. It might also help to schedule short naps regularly throughout the day.
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Exercise Regularly
Regular exercise can help patients manage symptoms of narcolepsy and cataplexy. Experts recommend engaging in moderate exercise at least four or five hours prior to sleeping. This helps expend some of the energy in the body and has been shown to promote more restful sleep. When an individual's sleep quality increases, they'll also feel more awake during the day. The endorphins released during the exercise itself may also promote wakefulness. When an individual's sleep cycle is more strictly regulated, they're less likely to have episodes where their body initiates REM movements while they are awake. Individuals should try engaging in forms of exercise they enjoy rather than forcing themselves to keep up fitness regimens they don't like.
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Use Medication When Needed
It's important for patients dealing with cataplexy to use medication when needed. Since cataplexy and narcolepsy are sleep disorders, patients probably won't be able to mitigate all the symptoms through simple sleep hygiene. After they've made normal sleep hygiene changes, medication can help them further manage cataplexy. The United States Food and Drug Administration (FDA) has approved doses of sodium oxybate between six and nine grams, which patients can take nightly for cataplexy. Sodium oxybate has been shown to reduce the intensity and frequency of cataplexy episodes. Possible side effects include nausea, headache, and dizziness. Some research indicates antidepressants like serotonin-noradrenaline reuptake inhibitors (SNRIs) can help manage cataplexy. Some patients have also shown results with antidepressants like desipramine, imipramine, and clomipramine. With that said, the evidence is varied and needs more research. Though some patients may benefit from these medications, others might not.
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Consume A Healthy Diet
One way to manage cataplexy is by consuming a healthy diet. Narcolepsy patients should pay careful attention to the foods they eat, as food has a serious impact on energy. It's best to avoid smoking or drinking alcohol, as these substances can cause symptoms to worsen. Some cataplexy medications also can't be taken with alcohol or there's a risk of serious, potentially life-threatening interactions. Carbohydrate-rich and heavy meals tend to increase tiredness during the 'energy crash.' Individuals also naturally become less alert in the middle or late afternoon, so eating a heavy lunch can just add to this. Heavy or spicy meals before bed can cause sleep disruptions. Experts recommend eating small portions that focus on protein and vegetables rather than carbohydrate-rich foods like bread and pasta. If individuals are not sure what they should be eating or what nutrients they need, it might be helpful to consult a nutritionist regarding their specific dietary requirements.
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Practice Stress Management
Cataplexy can lead to injury if an individual falls suddenly, especially if they fall in perilous conditions like on a staircase or in the road. Practicing stress management and relaxation techniques can help reduce the severity of attacks. It might also help reduce episode frequency, especially if patients experience episodes triggered by stress. Different stress management techniques work for different individuals. One thing that helps is to accept some things can't be controlled and to take steps to control the things that can be. Physical relaxation techniques like yoga and meditation may also help. It's important to make time for hobbies and for taking care of oneself. It's also important for individuals to set limits and establish boundaries in every area of their life including personal relationships, work, and their own habits.