WEBVTT - How Narcolepsy Works 0:00:01.120 --> 0:00:03.400 Welcome to Stuff. You should know a production of My 0:00:03.600 --> 0:00:12.200 Heart Radios How Stuff Works. Hey you, and welcome to 0:00:12.240 --> 0:00:15.600 the podcast. I'm Josh Clark, and there's Charles W. Chuck 0:00:15.720 --> 0:00:20.439 Bryan over there, and uh, I still know Jerry Chuck 0:00:20.480 --> 0:00:25.080 wake up. Huh, We're gonna get some mail for that. 0:00:25.280 --> 0:00:29.880 Right off of the bath, I feel quite refreshed. So, Chuck, 0:00:29.920 --> 0:00:32.839 you might have an earcolepsy. Then if you just fell asleep, 0:00:32.920 --> 0:00:36.559 were you able to resist that urge to sleep just now? No? 0:00:36.840 --> 0:00:39.240 As soon as I heard, Hey, welcome to the podcast, 0:00:39.320 --> 0:00:42.680 I went lights out. I think that happens to a 0:00:42.720 --> 0:00:46.600 lot of people. Have you ever known anyone with narcolepsy? 0:00:47.520 --> 0:00:50.479 I haven't. The closest I've I've come to that is 0:00:50.600 --> 0:00:56.720 um watching my own private Idaho. What do you find that? Uh? 0:00:57.360 --> 0:01:02.120 Sleep inducing? No? No, they is. I think it's remember 0:01:02.160 --> 0:01:05.360 Phoenix or Keiana Reeves? Has I forgot about that? I 0:01:05.360 --> 0:01:09.800 thought you were saying it so boring you can't stay awake? No? No, No, 0:01:10.000 --> 0:01:15.160 that's Cats. Did you see that? No? Don't you remember that? 0:01:15.200 --> 0:01:17.279 I tried to make myself go to sleep in Cats 0:01:17.280 --> 0:01:20.679 in the Middle. Now I have not seen the movie. Now, yeah, 0:01:20.680 --> 0:01:23.360 that's what I was wondering about. After having been on 0:01:23.440 --> 0:01:26.480 movie crush, I'm now I can't tell what's what anymore. 0:01:26.520 --> 0:01:32.039 What I said where? Uh So, my great aunt Laura 0:01:32.280 --> 0:01:38.000 had narcolepsy, which is my paternal grandmother's sister, and uh 0:01:38.040 --> 0:01:39.840 I only met her a few times. This is from 0:01:39.880 --> 0:01:43.319 my my dad's side of the like the Mississippi clan. 0:01:43.760 --> 0:01:46.399 So I think I only I only remember going to 0:01:46.440 --> 0:01:48.880 Mississippi like once when I was a kid and visiting her, 0:01:49.280 --> 0:01:51.160 and I just remember my brother and I. This is 0:01:51.200 --> 0:01:53.800 my only memory of the visit is Scott and I 0:01:53.880 --> 0:01:57.160 sitting in a room talking with her and her being 0:01:57.160 --> 0:01:59.720 in the middle of a sentence and then her head 0:01:59.720 --> 0:02:03.520 falling down and then ten seconds later she would pick 0:02:03.520 --> 0:02:07.040 her head up and continue that sentence. Wow, like like 0:02:07.080 --> 0:02:09.919 without missing a beat or was there like uh oh 0:02:10.000 --> 0:02:11.760 you know that? Was she aware that she had just 0:02:11.800 --> 0:02:15.400 fallen asleep and woken up. In my memory from being 0:02:15.440 --> 0:02:18.200 like ten years old, she didn't miss a beat and 0:02:18.240 --> 0:02:20.280 just finished her sentence like right in the middle of 0:02:20.320 --> 0:02:22.760 a sentence and didn't mention it. And my brother and 0:02:22.800 --> 0:02:25.519 I were just like, what is going on here? But 0:02:25.720 --> 0:02:28.680 your dad didn't prepare you for it. I don't remember. 0:02:29.000 --> 0:02:31.800 I blocked out, you know, purposely blocked out a lot 0:02:31.840 --> 0:02:35.240 of my childhood right right, So I don't know, but 0:02:35.360 --> 0:02:38.960 I hold it into the shuffle. That's the only thing 0:02:39.280 --> 0:02:41.920 I remember it. It may be a child's memory that 0:02:42.080 --> 0:02:45.720 is a little trumped up, but um, that's how I 0:02:45.760 --> 0:02:49.440 remember it. Wow. Man, Well, yeah, I've never known anybody 0:02:49.440 --> 0:02:54.320 with NARCILEPSI, and um, based on that going into this 0:02:54.360 --> 0:02:57.640 whole episode, like I was just basically going in like 0:02:57.680 --> 0:02:59.840 I'm sure most of our listeners are where it's just like, yeah, 0:03:00.120 --> 0:03:02.720 somebody falls asleep in the middle of the day, they 0:03:02.760 --> 0:03:04.639 can't help it, and then they wake back up, and 0:03:05.960 --> 0:03:09.320 who cares basically, you know. But the more that I've 0:03:09.360 --> 0:03:12.359 researched this some more, I'm like, you know, if it 0:03:12.560 --> 0:03:16.160 even if it were just that alone, it would be 0:03:16.320 --> 0:03:19.480 pretty disruptive to your normal life, depending on how often 0:03:19.480 --> 0:03:22.040 it happened to you, you know, every day. But the 0:03:22.040 --> 0:03:25.400 fact is it's not just that alone, and there's a 0:03:25.440 --> 0:03:28.320 lot of extra symptoms to it that make it frightening 0:03:28.440 --> 0:03:31.919 or terrifying or depressing or just completely disruptive or make 0:03:31.960 --> 0:03:34.920 it so that you are, um, maybe unable to hold 0:03:34.920 --> 0:03:37.160 down a job or go to school. There's a it's 0:03:37.200 --> 0:03:41.760 actually a much um it's a much sadder condition than 0:03:41.800 --> 0:03:44.520 I think most people think of because it seems innocuous. 0:03:44.520 --> 0:03:46.840 It's just like, hey, you fall asleep here there, it's fine, 0:03:47.120 --> 0:03:48.920 you know, and it's not. It's there's a lot more 0:03:48.960 --> 0:03:51.480 to it than that. Yeah, for sure. UM. I should 0:03:51.480 --> 0:03:55.040 also mention too that something that should not be confused 0:03:55.040 --> 0:03:59.720 with narcolepsy is something that Emily's family has. Uh and 0:03:59.840 --> 0:04:01.440 I saw this when we would go to visit when 0:04:01.440 --> 0:04:03.480 they lived in Ohio, when he would stay at her 0:04:03.480 --> 0:04:09.080 parents house. Well, you know, eating, drinking during the day, 0:04:09.320 --> 0:04:13.480 such that by seven to eight o'clock at night every night, 0:04:13.680 --> 0:04:16.120 I would Emily and I would look around, We're watching 0:04:16.120 --> 0:04:22.279 TV and there are four usually three sleeping adults. And uh, 0:04:22.320 --> 0:04:24.560 I dubbed it the gas leak, which everyone in their 0:04:24.600 --> 0:04:29.240 family thought was hysterical. Right now, that's just play a 0:04:29.240 --> 0:04:32.480 little funny. Yeah, that's that's not an earcalepsy at all. 0:04:32.520 --> 0:04:36.359 That's just you know, at what age does that start happening? 0:04:36.480 --> 0:04:38.159 Is what I want to know. Because I'm creeping up there, 0:04:40.200 --> 0:04:43.080 because I can still jam late into the night. I'm 0:04:43.120 --> 0:04:45.880 still you know, I might be sleepy the next day, 0:04:45.880 --> 0:04:49.479 but that's my only time when I don't have a 0:04:49.520 --> 0:04:53.040 five year old, so I used that time. I can 0:04:53.040 --> 0:04:55.320 stay up still till midnight one in the morning. If 0:04:55.360 --> 0:04:58.320 I am doing something that's really neat, you must have 0:04:58.360 --> 0:05:02.960 a lot of testostero and left. I don't think so well. 0:05:03.000 --> 0:05:07.120 I mean well, no, I mean, um like to have 0:05:07.440 --> 0:05:11.040 energy after you know, a certain time of day is 0:05:11.520 --> 0:05:13.960 I think I think you have a lot of test testerone, chuck, 0:05:14.000 --> 0:05:15.440 I would bet we're going to take you in for 0:05:15.480 --> 0:05:18.920 a test after this. Well, I feel like it. I 0:05:18.920 --> 0:05:22.360 feel like it kicks back in. Like I'm sleepy sometimes 0:05:22.440 --> 0:05:24.440 during the day, but then when the night comes and 0:05:24.520 --> 0:05:26.240 my daughter's to sleep, I'm like, all right, this is 0:05:26.240 --> 0:05:28.920 my this is my time to shine. No, that's very 0:05:28.960 --> 0:05:30.680 fortunate man, that you're not just like this is my 0:05:30.800 --> 0:05:33.080 time to netflix and chill like you're getting stuff done. 0:05:33.080 --> 0:05:34.960 I'm envious of you for that because I get a 0:05:34.960 --> 0:05:37.560 little tired. But I definitely don't have an ourcalepsy. I'm 0:05:37.600 --> 0:05:42.920 just kind of like I'm somewhere between you and Emily's family. 0:05:44.120 --> 0:05:49.160 They guess the correct yeah, so uh. An oarcilepsy is Uh, 0:05:49.440 --> 0:05:52.680 it's a chronic disorder. It's a sleep disorder. And I 0:05:52.760 --> 0:05:54.960 know we've talked a little bit about this in some 0:05:55.120 --> 0:05:58.200 of our other sleep disorder episodes, UM, so much so 0:05:58.320 --> 0:06:00.040 that I thought we might have actually covered this, but 0:06:00.120 --> 0:06:04.560 a quadruple checked and we have not. But UM, it's 0:06:04.640 --> 0:06:06.840 characterized by a few things. UM. One of the main 0:06:07.000 --> 0:06:11.159 tenants that basically everybody that has an eclepsy has what's 0:06:11.160 --> 0:06:15.800 called excessive daytime sleepiness. Right, that's what everybody thinks about 0:06:15.800 --> 0:06:18.159 when you think of narclepsy. Somebody just falling asleep. They 0:06:18.200 --> 0:06:21.680 can't help it, they're just suddenly out, that's right. Yeah. 0:06:21.760 --> 0:06:26.920 They also call those, um sleep attacks. It's pretty cute. Um. 0:06:27.080 --> 0:06:30.840 And no matter what variation of narcalepsy you have, you 0:06:31.040 --> 0:06:35.480 have excessive daytime sleepiness E D yes, right, that's right. 0:06:35.800 --> 0:06:38.600 And UM, this is not you know, this is nothing new. 0:06:38.680 --> 0:06:40.680 We're just now sort of figuring it out a little 0:06:40.720 --> 0:06:43.920 bit since the nineties, which we'll get to. But obviously 0:06:44.320 --> 0:06:47.800 this has been happening since there have been people, uh 0:06:47.880 --> 0:06:50.680 they they've probably been suffering from an eclepsy, you know, 0:06:50.720 --> 0:06:53.760 a small percentage of people. But it was first described 0:06:54.120 --> 0:06:59.800 in eight eight by a French physician named Jean Baptiste 0:07:00.320 --> 0:07:04.840 Eduard Guilleneo. Not bad. How would you have said it, 0:07:05.560 --> 0:07:10.600 Jean Baptiste dwar Jello? Is that is it a skip 0:07:10.720 --> 0:07:13.600 to put that little uptick on the end? I think 0:07:13.640 --> 0:07:18.800 that's called an exit agu right right, So yeah, that's 0:07:18.840 --> 0:07:20.280 how I would have said it. But either way, I 0:07:20.360 --> 0:07:22.240 think we we basically got it across. He was a 0:07:22.320 --> 0:07:26.520 French physician from eighteen eighty that's the part. Yeah. And 0:07:26.640 --> 0:07:30.520 the origin of the actual term is from Greek narca, 0:07:31.080 --> 0:07:33.400 which is numbness or stupor. Stupor is one of my 0:07:33.440 --> 0:07:38.360 favorite words, and leipsis to attack or two seize, right, 0:07:38.440 --> 0:07:42.240 So it's an attack of stupor basically is what they 0:07:42.800 --> 0:07:45.800 what he meant when he coined that term. And um, 0:07:46.240 --> 0:07:50.600 the reason Jean Baptiste dead Ward Jello came up with 0:07:50.760 --> 0:07:54.640 this is because the thirty six year old wine castmaker 0:07:54.720 --> 0:07:57.120 came to him and said, Hey, I think there might 0:07:57.160 --> 0:08:00.880 be something wrong with me. I follow as suddenly out 0:08:00.920 --> 0:08:04.640 of nowhere for one to five minutes, two hundred times 0:08:04.800 --> 0:08:09.800 a day every day. What do you think, Jelano said, 0:08:10.000 --> 0:08:12.040 I think I'm gonna make my career on you. Buddy, 0:08:12.680 --> 0:08:15.720 I did the math there. If you average about two 0:08:15.760 --> 0:08:17.800 and a half minutes between the one to five, that's 0:08:17.800 --> 0:08:21.920 about eight hours of dozing. Okay. I'm really glad you 0:08:22.000 --> 0:08:24.400 said that, Chuck, because this was something that I had 0:08:24.680 --> 0:08:28.640 no idea about. But if you take over a twenty 0:08:28.680 --> 0:08:33.040 four hour period somebody with narcolepsy and put their amount 0:08:33.080 --> 0:08:37.760 of sleep next to somebody without an ourcalepsy over twenty 0:08:37.840 --> 0:08:40.679 four hours, it's gonna wash out roughly the same. Did 0:08:40.760 --> 0:08:43.199 you know that. I didn't know that. But does that 0:08:43.320 --> 0:08:46.400 mean that this guy dozed eight hours a day and 0:08:46.520 --> 0:08:48.720 then stayed up all night or did he sleep another 0:08:49.040 --> 0:08:51.800 five hours at night and just slept a lot. No. 0:08:52.400 --> 0:08:54.920 So that's one of the one of the key reasons 0:08:55.080 --> 0:08:57.920 that there is such thing as excessive daytime sleepiness as 0:08:57.960 --> 0:09:01.199 part of narcolepsy. It's that your sleep is so disrupted 0:09:01.679 --> 0:09:04.640 that it's basically spread out over twenty four hours rather 0:09:04.720 --> 0:09:08.520 than concentrated over you know, eight hours at night. So 0:09:08.679 --> 0:09:11.120 they're up and awake in the middle of the night 0:09:11.240 --> 0:09:14.600 for very long periods, just like they fall asleep suddenly 0:09:14.760 --> 0:09:17.040 during the day. But if you put all those bouts 0:09:17.080 --> 0:09:20.000 of sleep together, even when they're trying at night, and 0:09:20.080 --> 0:09:22.040 then when they can't help it during the day, it 0:09:22.120 --> 0:09:25.240 adds up to about the same that a person without 0:09:25.720 --> 0:09:30.360 narcolepsy will sleep. That's my understanding. Now, that's pretty remarkable. 0:09:31.720 --> 0:09:34.719 Like the brains like, I'm getting sleep, whether whether you 0:09:34.840 --> 0:09:38.200 like it or not, we're making this happen. At least 0:09:38.240 --> 0:09:41.760 by twenty four hours, we're gonna have had enough. Uh. 0:09:41.880 --> 0:09:44.360 And of course, you know, since this has been you know, 0:09:44.400 --> 0:09:46.280 we're talking about the eighties, there's been a lot of 0:09:46.320 --> 0:09:50.319 explanations over the years, everyone from Freud to you know, 0:09:50.920 --> 0:09:53.319 it's about say, legitimate doctors that probably would have been 0:09:53.400 --> 0:09:56.280 certain people like Freud. I like Freud too, but I 0:09:56.360 --> 0:10:02.160 meant like, you know, um, never mind. Sure. But Freud 0:10:02.280 --> 0:10:06.440 of course said that sleep is an escape, and he said, 0:10:06.679 --> 0:10:09.040 you know, narcolepsy is a lot of times triggered by 0:10:09.520 --> 0:10:13.120 really intense emotions. So here's what I think. It's just 0:10:13.320 --> 0:10:17.320 an extreme defense mechanism that lets you escape from those emotions. 0:10:17.960 --> 0:10:22.560 I love it. It's pretty Freudian. It's about as Freudian 0:10:22.600 --> 0:10:25.800 an explanation for anything as I've heard. It's just classic right, 0:10:26.120 --> 0:10:30.319 of course, it's just utterly wrong. But I love. I 0:10:30.440 --> 0:10:33.400 just think Freud's attempts at explaining the world were great, 0:10:33.559 --> 0:10:38.800 invaluable in the way that like preserving classic art is. Yeah, 0:10:38.880 --> 0:10:43.760 I've been to his house. What where in Texas now? Yeah, 0:10:43.840 --> 0:10:47.720 the Sigmund Freud house and in uh Tyler, Texas. There 0:10:47.760 --> 0:10:49.760 are a lot of Germans in Texas. Although I know 0:10:49.880 --> 0:10:52.360 he was Austrian. Yeah, I mean I believe I saw 0:10:52.400 --> 0:10:55.160 it in Vienna if I'm not mistaken. That's neat, that 0:10:55.400 --> 0:10:58.400 is very neat. Was this when you're backpacking? Yeah, of 0:10:58.520 --> 0:11:00.800 course you need to do him. M are of that 0:11:01.040 --> 0:11:08.000 time in your life and call it backpacking to Freud's house. Okay, okay, 0:11:08.440 --> 0:11:10.560 so in the book could just be shaped like a penis. 0:11:12.320 --> 0:11:15.319 Sometimes a book is just a book, that's right. So 0:11:15.559 --> 0:11:17.920 Freud missed the mark a little bit, but still again 0:11:18.000 --> 0:11:22.319 it's worth mentioning, just like appreciating art. It wasn't until 0:11:22.360 --> 0:11:25.240 the sixties where they're like, okay, I think we're starting 0:11:25.280 --> 0:11:27.520 to get some real clues here. And that was when 0:11:27.640 --> 0:11:33.280 they first established that people with narcilepsy enter r e 0:11:33.559 --> 0:11:37.440 M sleep during these bouts of narcalepsy, which you are 0:11:37.480 --> 0:11:41.120 not supposed to do under normal sleep. Patterns which we 0:11:41.200 --> 0:11:43.720 talked about many many times before. Like you said, when 0:11:43.800 --> 0:11:46.600 you fall asleep, it should take you a little while 0:11:46.679 --> 0:11:49.280 to enter R E M sleep. That's a deeper phase 0:11:49.400 --> 0:11:53.800 of your sleep pattern. Right with with um narcilepsy, they're 0:11:53.880 --> 0:11:57.520 out and into R E M sleep so quickly. That 0:11:57.640 --> 0:12:00.960 A different way to characterize it that that ECLEPSI researchers 0:12:01.000 --> 0:12:05.559 put it is that R E M activity it intrudes 0:12:05.640 --> 0:12:10.760 into wakefulness. The line between being awake and being in 0:12:10.920 --> 0:12:14.000 deep R E M sleep is that blurred for people 0:12:14.040 --> 0:12:18.599 with narcolepsy. Yeah, And I feel like I've occasionally, in 0:12:18.679 --> 0:12:22.840 a really intense power nap had a dream, but that's 0:12:22.880 --> 0:12:25.240 only when it's and I don't get to nap anymore. 0:12:25.320 --> 0:12:28.240 But that's when I've just been so tired that I 0:12:28.360 --> 0:12:31.920 just napped and fall asleep like immediately. That's neat. I 0:12:32.040 --> 0:12:33.960 bet you do you feel refreshed when you wake up? 0:12:34.960 --> 0:12:37.760 M hmm. I tend to nap longer when I would nap, 0:12:37.880 --> 0:12:40.520 so I wouldn't do the When I say power nap, 0:12:40.600 --> 0:12:42.480 I don't mean the twenty minute disco nap. I mean 0:12:42.800 --> 0:12:45.640 you really power power through for a couple of hours, right, 0:12:46.120 --> 0:12:48.600 I thought you were recounting some of your cocaine using 0:12:48.679 --> 0:12:51.959 days no, no, no, I got you. So that was 0:12:52.040 --> 0:12:54.160 in the sixties. So they say, okay, R E M 0:12:54.280 --> 0:12:57.520 and and uh narc eilepsy they go together like chocolate 0:12:57.559 --> 0:13:00.959 and peanut butter. Right, we're onto something here. But finally 0:13:01.040 --> 0:13:04.520 in the nineties they're like really have started to figure 0:13:04.559 --> 0:13:07.679 it out, and they've zeroed in on the hypothalamus and 0:13:07.760 --> 0:13:11.240 specifically a small cluster of cells in the rear of 0:13:11.280 --> 0:13:14.559 the hypothalamus that we'll talk about later. And if you 0:13:15.600 --> 0:13:18.679 learn about that and as far as narcolepsy goes, you 0:13:18.880 --> 0:13:21.440 can find it pretty convincing that we have begun at 0:13:21.520 --> 0:13:25.560 least to finally truly understand the cause of narcolepsy. Yeah, 0:13:25.640 --> 0:13:29.319 I totally agree. It's they make a great case. So 0:13:29.520 --> 0:13:32.599 if you want to talk to some initial stats. It 0:13:32.679 --> 0:13:36.360 occurs in all ethnic groups. Uh, it has equal incidence 0:13:36.720 --> 0:13:41.880 uh on the gender spectrum. Evidently. Yeah, that's interesting. And yeah, 0:13:41.880 --> 0:13:44.360 because usually you would see it tilted one way or 0:13:44.400 --> 0:13:48.480 the other. Yeah, for sure. Um. And then as far 0:13:48.559 --> 0:13:51.640 as how often you're going to see this, it's in 0:13:51.720 --> 0:13:55.640 about point oh three to point one six percent of 0:13:55.800 --> 0:13:59.360 gin pop or about one and two thousand people. Yeah, 0:13:59.440 --> 0:14:02.840 which makes it which classifies it as a rare disease, which, 0:14:02.920 --> 0:14:06.640 by the way, shout out to, among several others, Rare 0:14:06.720 --> 0:14:11.000 Diseases dot Org for their take on narcalypsy. It was 0:14:11.120 --> 0:14:16.199 very instructive. Is it a disease or a disorder? Geez? 0:14:16.320 --> 0:14:20.760 I think because there's a um a brain dysfunction, that 0:14:20.920 --> 0:14:23.960 it would be characterized as a disease, wouldn't you. I 0:14:24.000 --> 0:14:25.840 don't know. I still don't know the difference after all 0:14:25.880 --> 0:14:28.760 these years. So it was I mean, when it was 0:14:29.120 --> 0:14:32.320 considered an R. E. M. Sleep disorder and maybe it's 0:14:32.320 --> 0:14:35.280 still is. It was considered a paras omnia like sleep 0:14:35.320 --> 0:14:37.360 walking or whatever, So that would have been considered a 0:14:37.480 --> 0:14:42.280 disorder them. But I think it's a disease. Now, Okay, Okay, 0:14:42.920 --> 0:14:44.240 you want to take a break and come back and 0:14:44.320 --> 0:15:18.360 talk about what anarcalypsy is. Okay, we'll be right back. Everybody. Okay, 0:15:18.400 --> 0:15:21.600 we're back. And it turns out, Chuck, that there are 0:15:21.800 --> 0:15:25.120 two types of narcilepsy, And just from all of the 0:15:25.200 --> 0:15:28.720 research that we've done over the years on interesting health stuff, 0:15:29.640 --> 0:15:32.280 this smells a lot to me like something that's going 0:15:32.360 --> 0:15:35.760 to be broken out into its own thing over time. Yeah, 0:15:35.920 --> 0:15:39.440 I agree, because we've seen that happen time and time again. Um. 0:15:39.600 --> 0:15:42.800 We have narcilepsy type two, which is what we were 0:15:42.840 --> 0:15:45.080 talking about, the sort of the more like when you 0:15:45.160 --> 0:15:47.760 think of n earcilepsy, this is probably what you're thinking 0:15:47.840 --> 0:15:52.440 of Aunt Laura falling asleep during the middle of a sentence, right. 0:15:52.920 --> 0:15:56.800 And it's type two because it's um by far less 0:15:56.880 --> 0:16:01.720 prevalent than type one. And type one is narcolepsy like 0:16:01.840 --> 0:16:06.520 you'd think of with the daytime excessive daytime sleepiness. But 0:16:06.640 --> 0:16:09.800 on top of that, there's something called cataplexy too. And 0:16:09.920 --> 0:16:13.720 cataplexy can exist on its own. It's the just sudden 0:16:13.840 --> 0:16:16.840 loss of voluntary muscle function, like you can't keep your 0:16:16.840 --> 0:16:19.840 head up because your neck muscles just went limp, or 0:16:19.960 --> 0:16:23.920 your arms go limp or something like that. And cataplexy 0:16:24.000 --> 0:16:26.880 can exist on its own. It can exist in conjunction 0:16:26.960 --> 0:16:30.920 with other diseases to or disorders. Um, but it very 0:16:31.040 --> 0:16:35.880 frequently coexists with narcolepsy. And one of the hallmarks of 0:16:35.960 --> 0:16:38.280 it from what I understand, because it gets it gets 0:16:38.360 --> 0:16:42.160 kind of confusing and I couldn't fully find this out, Chuck, 0:16:42.720 --> 0:16:47.480 but I I think that it can exist in a 0:16:47.640 --> 0:16:52.600 person with narcolepsy in conjunction with a sleep attack or 0:16:52.800 --> 0:16:56.600 separately to where you just suddenly like can't hold your 0:16:56.600 --> 0:17:00.120 head up anymore. The key is you're still conscious. Just 0:17:00.560 --> 0:17:04.000 oh my god, I just turned into an illiterate seventh grader. 0:17:05.119 --> 0:17:08.680 You're still conscious. You just you might look like you 0:17:08.800 --> 0:17:10.960 have just fainted or something like that, depending on the 0:17:11.320 --> 0:17:14.480 severity of the cataplexic attack. Yeah, it's almost like a 0:17:14.560 --> 0:17:19.040 fainting goat, right, Yes, very much like that, Almost exactly 0:17:19.119 --> 0:17:22.480 like that, because remember with the feinting goats, they would 0:17:23.040 --> 0:17:26.320 basically just fall over because they were startled. I think 0:17:26.400 --> 0:17:28.800 pretty much the same thing with catoplexy and humans, although 0:17:28.840 --> 0:17:31.640 it seems to be more associated with positive emotions. Yeah, 0:17:31.680 --> 0:17:34.359 it's so interesting. Um yeah, we're gonna get into that. 0:17:34.480 --> 0:17:38.639 There are four symptoms of narcolepsy, which we're going to 0:17:38.720 --> 0:17:42.760 break down in a second. But they are excessive daytime 0:17:42.760 --> 0:17:47.360 sleepiness like we've talked about. There is the cataplexy, their 0:17:47.400 --> 0:17:54.840 sleep sleep paralysis, and then hipnagogic hallucinations and um, if 0:17:54.920 --> 0:18:00.440 you have narcolepsy, you well there's about ants that you 0:18:00.520 --> 0:18:03.640 have all four and I don't think there's any rhyme 0:18:03.680 --> 0:18:07.920 or reason which ones you do have. But like we said, 0:18:08.080 --> 0:18:11.920 everybody has the excessive daytime sleepiness. And they're also talking 0:18:11.960 --> 0:18:17.240 about a fifth beatle. I was gonna say that Clarence 0:18:17.320 --> 0:18:20.800 was that his name? Yeah? Or a Pooh said he 0:18:21.040 --> 0:18:26.000 was too. The fifth symptom, which is disturbed nocturnal sleep, 0:18:26.800 --> 0:18:29.520 which about of the patients have, but they haven't. I 0:18:29.600 --> 0:18:31.560 think that'll end up in there at some point. And 0:18:31.760 --> 0:18:34.720 technically there may be a sixth one to um, which 0:18:34.800 --> 0:18:37.560 is called automatic behavior. Where have you ever been like 0:18:37.720 --> 0:18:41.600 driving and you're suddenly like five exits further than you 0:18:41.680 --> 0:18:44.280 thought you were, and you realize you just zoned out 0:18:44.320 --> 0:18:47.000 and we're just driving just fine, but you were, You're 0:18:47.160 --> 0:18:51.040 you're basically on autopilot. I don't know. I mean, is 0:18:51.080 --> 0:18:54.680 that like the same as just daydreaming or maybe I 0:18:54.760 --> 0:18:57.800 think so. But there's like no recollection of anything. You 0:18:57.880 --> 0:19:00.520 didn't note any landmarks that you just pa uster. Let's 0:19:00.520 --> 0:19:02.800 say you're gardening or something like that, you don't you 0:19:02.880 --> 0:19:06.320 don't remember finishing digging the hole with a trowel. It's 0:19:06.480 --> 0:19:10.080 it's you've just completed a task that you have no 0:19:10.359 --> 0:19:15.040 memory of. Of undertaking. I don't think that happens. Okay, 0:19:15.160 --> 0:19:17.720 so that's what's happened to me before. But that's a 0:19:17.880 --> 0:19:21.359 symptom of of UM. It's an additional symptom. It's not 0:19:21.400 --> 0:19:23.399 a classic symptom, but they're starting to figure out that 0:19:23.440 --> 0:19:26.040 it does. It is a symptom of narcolepsy. Yes, so 0:19:26.160 --> 0:19:27.879 you're like, I just I went in my garage one 0:19:27.920 --> 0:19:31.919 day and I had built a penny farthing. No memory 0:19:31.960 --> 0:19:35.080 of that how it got there. So it usually starts 0:19:35.119 --> 0:19:39.240 out in adolescence, which surprised me. I did not know that, 0:19:40.200 --> 0:19:43.159 just maybe because my Laura characterized it as something you 0:19:43.320 --> 0:19:46.520 got later in life. But they do worsen with age, 0:19:46.560 --> 0:19:49.800 so maybe that does make sense after all. And sometimes 0:19:49.920 --> 0:19:53.080 your symptoms can be very steady. Sometimes it can be 0:19:53.320 --> 0:19:56.880 months or years in between changes, and sometimes the symptoms 0:19:57.000 --> 0:20:01.119 change a lot too very quickly. Right, um. But the 0:20:01.359 --> 0:20:04.800 symptom that, again a hundred percent of UM people with 0:20:04.960 --> 0:20:09.240 narcilepsy have is excessive daytime sleepiness. And in almost every 0:20:09.359 --> 0:20:13.360 case of narcolepsy, that is the first symptom that starts. 0:20:13.800 --> 0:20:15.760 You almost never start with the other ones. It's that 0:20:15.880 --> 0:20:19.320 one first, And that's exactly what you think of where 0:20:19.640 --> 0:20:23.200 somebody just falls asleep and they're out for a few 0:20:23.280 --> 0:20:26.320 seconds to a few minutes, depending And it's not going 0:20:26.359 --> 0:20:28.840 to be the same amount of time every time. They're 0:20:28.880 --> 0:20:31.600 not going to have the same number of sleep attacks 0:20:31.680 --> 0:20:33.879 every time. A lot of it has to do with 0:20:34.040 --> 0:20:37.000 just how tired they are, like how poorly they slept 0:20:37.040 --> 0:20:39.600 the night before. That's going to make them more susceptible 0:20:39.640 --> 0:20:42.000 to sleep attacks during the day. And this is not 0:20:42.280 --> 0:20:45.800 the same as hitting the wall at three o'clock because 0:20:45.840 --> 0:20:47.680 you ate lunch and all of your coffee from the 0:20:47.760 --> 0:20:50.920 morning war off. I mean, it bears some resemblance to it, 0:20:51.040 --> 0:20:56.000 but this is it is irresistible. Um, this urge to 0:20:56.119 --> 0:20:59.360 sleep or just sleep, it just comes on. So that's 0:20:59.520 --> 0:21:03.560 that's a that's the main characteristic of an ecalepsy. But 0:21:03.880 --> 0:21:06.320 anybody who's kind of dozed off, like sitting in a 0:21:06.400 --> 0:21:09.159 comfortable chair when it was you know, a little warmer 0:21:09.240 --> 0:21:11.680 than normal at work or something like that, right like 0:21:12.160 --> 0:21:14.800 that is a it's it bears a resemblance to that 0:21:15.040 --> 0:21:18.800 specific symptom of narcolepsy. It's the other ones that you 0:21:18.920 --> 0:21:21.600 have in conjunction with that that really make an ecolepsy 0:21:21.720 --> 0:21:26.480 like its own disorder. Have you ever slept at any 0:21:26.640 --> 0:21:33.800 job you've ever had? It doesn't sound like me, but 0:21:34.000 --> 0:21:38.480 probably I'm sure. I'm sure I have you know here there? 0:21:38.560 --> 0:21:41.600 Why you well? I mean when I worked the midnight 0:21:41.680 --> 0:21:44.120 to seven am shift at the Golden Pantry and Athens, 0:21:44.320 --> 0:21:49.000 I had a regular routine of sleeping. Yeah, because you're 0:21:49.000 --> 0:21:50.800 allowed to close up the store and mop and do 0:21:50.920 --> 0:21:53.520 things for like an hour. So I would close up 0:21:53.520 --> 0:21:56.520 the store, go back in the back, and uh, lay 0:21:56.560 --> 0:21:59.160 down on a a little palette I made on top 0:21:59.200 --> 0:22:03.520 of a free r n. Did you get some good sleep? 0:22:04.280 --> 0:22:06.760 I would? It was pretty hard sleep, and I will 0:22:06.800 --> 0:22:11.680 admit that. Uh. When I had a baby, I took 0:22:11.760 --> 0:22:14.600 a nap or two right here in our own office. 0:22:15.200 --> 0:22:17.840 Oh nice, what can you tell me? Where is it 0:22:17.920 --> 0:22:21.800 still a secret? In one of the private telephone rooms. Oh, 0:22:21.960 --> 0:22:23.560 that would be a good place to take a nap, 0:22:24.119 --> 0:22:25.800 if you've ever gone in there and seen a pillow. 0:22:26.000 --> 0:22:34.480 Then in the camp stove, sleep machine, open bag of marshmell. 0:22:34.600 --> 0:22:37.840 Isn't a stick now? I took a couple of cat 0:22:37.960 --> 0:22:41.240 naps here at work, and uh, such that I was like, 0:22:41.359 --> 0:22:44.600 you know what, some countries and companies embrace this and 0:22:45.320 --> 0:22:48.440 there's a lot of value to to knocking out for 0:22:48.640 --> 0:22:51.080 twenty or thirty minutes during the work day. Is that 0:22:51.200 --> 0:22:54.520 what that one hr email they sent out was all about? Maybe? 0:22:54.840 --> 0:22:57.000 Did you try to convince them of that? Did you 0:22:57.080 --> 0:22:59.680 go to them and say, you know, some countries really 0:23:00.080 --> 0:23:03.800 race this. Why don't you guys be more more continental? 0:23:04.200 --> 0:23:08.639 At least don't fire me? Right? Yeah? So yeah, so 0:23:08.840 --> 0:23:13.040 this is this is akin to that, you know, falling asleep. 0:23:13.119 --> 0:23:16.080 But the key here is that it's unplanned, and with 0:23:16.240 --> 0:23:18.959 narcilepsy it is straight up irresistible, you know, like when 0:23:19.000 --> 0:23:21.119 you sit up and you like open your eyes a 0:23:21.160 --> 0:23:22.560 little bit, You're like, well, I can't fall asleep. I 0:23:22.600 --> 0:23:25.000 gotta I gotta stay a week because I'm being paid 0:23:25.119 --> 0:23:27.760 right now. Like if you have narcalypsy, you can't do that. 0:23:27.960 --> 0:23:31.040 You just fall asleep and you're out. And the other 0:23:31.160 --> 0:23:34.880 key is you feel really good and freshed right after 0:23:35.000 --> 0:23:38.320 one of those sleep attacks, yeah, which is uh, it's 0:23:38.560 --> 0:23:41.560 it's weird to think that ten seconds of that can 0:23:41.680 --> 0:23:44.920 refresh you. I know, it is very weird, but that's 0:23:45.000 --> 0:23:48.160 part of it for sure. So cataplexy, which we've talked 0:23:48.160 --> 0:23:52.320 about the fainting goat like thing. Um you mentioned positive 0:23:52.320 --> 0:23:58.920 emotions can trigger it, um, being surprised, laughter, elation, sometimes 0:23:59.000 --> 0:24:02.240