Nicotine use and narcolepsy

A research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), provides the first description of nicotine use by narcolepsy patients.

Because people with narcolepsy can fall asleep suddenly and without warning, even while eating, walking or driving, those who smoke nicotine in bed are at a high risk of burning either themselves or the objects around them, or starting a fire, if they fall asleep. Further, the excessive sleepiness brought on by their narcolepsy may also complicate any attempt by them to quit the habit of nicotine use.

The study, authored by Lois Krahn, MD, of the Mayo Clinic in Scottsdale, Ariz., focused on unpublished data from a community-based study of narcolepsy, followed by a questionnaire distributed at last year’s Narcolepsy Network national meeting to obtain more information.

According to the results, in the community-based study, 62.5 percent of narcolepsy patients were past or present smokers. Seventeen questionnaires were completed, in which 47 percent of respondents were past or present nicotine users. All respondents identified nicotine as an effective in decreasing sleepiness. Thirty-seven percent fell asleep while smoking. Twenty-five percent smoked in bed. Burns were reported by 75 percent involving clothing, furniture or carpet. One respondent started a fire. One substituted nicotine patches for cigarettes years ago to continue a “powerful” means to decrease cataplexy. All tried to quit smoking, but described having difficulty because sleepiness worsened without nicotine.

“Burns are a potentially serious complication for patients smoking nicotine. Although burns appear to be common in our preliminary survey, the lack of a denominator precludes conclusions about their frequency. Narcolepsy patients who smoke may have more trouble quitting because of increased sleepiness. The role of nicotine to self-medicate sleepiness and cataplexy merits more study,” said Dr. Krahn.

Narcolepsy is a sleep disorder that causes people to fall asleep uncontrollably during the day. It also includes features of dreaming that occur while awake. Other common symptoms include sleep paralysis, hallucinations and cataplexy. About one out of every 2,000 people is known to have narcolepsy. The chance that you have narcolepsy is higher when a relative also has it. Narcolepsy affects the same number of men and women.

It is recommended that adults get between seven and eight hours of nightly sleep.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night’s sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night’s sleep every night.
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• Do not bring your worries to bed with you.
• Do not go to bed hungry, but don’t eat a big meal before bedtime either.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool.
• Get up at the same time every morning.

Those who suspect that they might be suffering from narcolepsy, or another sleep disorder, are encouraged to consult with their primary care physician or a sleep specialist.