Do you faint when you laugh or get angry? Let's talk about cataplexy!

Imagine that you are laughing with your friends and suddenly your jaw drops open, or your neck suddenly bends forward. Or when you are talking angrily to someone, your knees suddenly give out and you have to sit on the floor. Have you ever had this experience? Don't be afraid. I am here today to talk about this condition. In medicine, we call this cataplexy.

What exactly is cataplexy?

Simply put, cataplexy is when you experience a sudden and brief loss of muscle function while you are awake, when you experience a strong emotion such as laughter, excitement, or anger. This is actually a key symptom of a sleep disorder called narcolepsy. Narcolepsy is a chronic (lifelong) condition that causes uncontrollable daytime sleepiness.

Cataplexy can cause muscle weakness that can range from mild to severe. For example, you may only lose control of your facial muscles, causing your jaw to droop, or your neck to bend forward slightly. In severe cases, you may lose all control of your body and fall to the ground.

This condition usually lasts only a few seconds to a few minutes. It then gets better on its own. Some people get it several times a day, while others get it once or twice a year.

What is the difference between cataplexy and narcolepsy?

Many people confuse the two. Cataplexy is just one symptom of narcolepsy. There are two main types of narcolepsy. The two are distinguished based on whether cataplexy is present or not.

How do children cope when this happens?

Cataplexy in children is a little different. It mostly affects the muscles of the face, jaw, and eyelids. It can look like they are in pain or grimacing in disgust. Some children will even stick out their tongues during this time.

Often when this happens to a young child, parents or others assume that it is a sign of inattention, a seizure, a tantrum, or just a way to get attention . Therefore, if you notice such an undetectable change in your child's behavior, it is very important to take it to a doctor immediately .

Why is this happening? What is the reason?

The main cause of cataplexy is narcolepsy type 1. It is caused by a deficiency of a chemical (neurotransmitter ) in the brain called orexin . This orexin helps keep us awake and controls REM sleep (the deep sleep where we dream) when we are asleep.

Now, it's normal for some of our muscles to go into a state of paralysis when we're in REM sleep. This is to prevent us from actually doing the things we dream about and causing harm to ourselves. But when Orexin is low, even when we're awake, when we have a strong emotion like laughing, our brain thinks we're in REM sleep. Then the paralysis that occurs during that sleep occurs while we're still awake. That's called cataplexy.

How is it treated?

This condition is mainly treated with medication. The same medications used to help you stay awake and control cataplexy symptoms are used to treat narcolepsy. Your doctor will examine you and prescribe the treatment that is best for you.

There are several types of medications approved for cataplexy:

• Sodium oxybate
• Lower-sodium oxybate
• Pitolisant

In addition, doctors may prescribe other medications for this purpose. This means that even if the medication is actually designed for another condition, it also works well for cataplexy. For example, some antidepressants (SSRIs, SNRIs, TCAs) are used for this purpose.

How can I take care of myself while living with this condition?

Cataplexy may not always be preventable, but many people report that it occurs more often on days when they are feeling particularly tired. So getting a good night's sleep can go a long way in helping to control it.

Here are some simple practices that will help:

• Go to bed at the same time every day and wake up at the same time.
• Keep your bedroom quiet, dark, and at a comfortable temperature.
• Remove electronic devices like TV, computer, and phone from the sleeping area.
• Avoid heavy meals, coffee, and alcohol at least two hours before bed.
• Get some exercise during the day. It will help you sleep better at night.

In addition, there are other things you can do:

• Think about safety: Sudden loss of consciousness can be dangerous, especially if you are driving or working at heights. Talk to your doctor about this and learn about ways to protect yourself.
• Tell others about this: Tell your family, friends, and people at work about this. So that if something happens to you suddenly, they know what's going on and don't be afraid.
• Get support: Living with this condition can be emotionally difficult. Join support groups where others with this condition can be found. Also, if this is causing you a lot of stress or anxiety, don't be afraid to talk to your doctor or a mental health professional , such as a psychiatrist .

If you or your child have any of these symptoms, see a doctor without delay. These are conditions that can be well controlled with treatment.

Cataplexy, Narcolepsy, Muscle weakness, Laughter, Emotions, Sleep, Orexin, Sri Lanka, Sinhala