Melatonin is a hormone synthesis in the brain, increased by darkness and decreased by light. It helps to keep falling asleep and wake up cycle.

What is Melatonin?

Melatonin is a hormone synthesis in the brain by the pineal gland, from tryptophan (amino acid). The synthesis and release of melatonin are increasing by darkness and decrease by light. It helps regulate other hormones and maintain the body's circadian rhythm. The circadian rhythm is an internal 24-hour clock that plays a critical role in when to fall asleep and when to wake up. High levels of melatonin in the blood are common prior to bedtime. Bright light in the evening and dull light in the morning can disturb the body’s normal melatonin secretion.

Melatonin also helps control the release of reproductive hormones in females. It helps to determine when to start menstruation, frequency, duration of menstrual cycles, and when to stop menstruation (menopause).

Some researchers show that melatonin levels may be related to aging, that is younger children have the highest levels of melatonin secretion at nighttime as compared with adults. Therefore, it believes that melatonin levels to drop with aging. Some even think lower levels of melatonin may be the reason behind some older adults have sleep problems and tend to go to bed and wake up earlier than when they are younger.

Melatonin is misspelled as melatonin, melatonin, melatonin, melatonin, melatonin, melatonin.

Synthetic Melatonin

Synthetic melatonin can be useful for the treatment of difficult falling and/or staying asleep. It can also take to prevent jet lag (condition marked by fatigue, insomnia, and irritability that cause by air travel through changing time zones). Melatonin has antioxidant property, and many of its proposed therapeutic or preventive uses are base on this property.

Melatonin sleep supplements

Many studies suggest that melatonin supplement may help people with disrupted circadian rhythms (jet lag or night shift working) and those with low melatonin levels (aged adults and people with schizophrenia) to sleep better.
A few clinical studies suggest that when taken for short-term (days to weeks) melatonin is more effective in limiting the time it takes to fall asleep, increases sleeping hours, and boost daytime alertness.

Other benefits of melatonin

Melatonin is considered being supportive of the treatment of many diseases, but need further study to confirm it.

• Sleep disturbances in children with neuro-psychiatric disorders, Sleep enhancement in healthy people, Insomnia, REM sleep behavior disorder(narcolepsy), Work shift sleep disorder
• Alzheimer's disease (sleep disorders), Parkinson's disease, Seizure disorder, Stroke,
• Attention deficit hyperactivity disorder (ADHD), Bipolar disorder (sleep disturbances),
• Cancer treatment, Chemotherapy side effects,
• Depression, Glaucoma, Headache prevention (including migraine), High blood pressure, inflammatory bowel disease, Periodic limb movement disorder, Rett syndrome, Schizophrenia, Seasonal affective disorder.

Possible side effects of melatonin: fatigue, dizziness, headache, irritability, and sleepiness, still may be occurred due to jet lag and not by melatonin itself. Fatigue may be due to morning use or high doses, and irregular sleep-wake cycles may occur. Disorientation, confusion, sleepwalking, vivid dreams, and nightmares may occur. Due to daytime sleepiness, those driving or operating machinery should be careful.

Melatonin safety: Melatonin is selling without a prescription in health-food stores and drug stores still are not approving by the U.S. Food and Drug Administration. So, its purity, safety, and effectiveness are not regulating by a government agency.

Over-the-counter medications for the treatment of a sleep problem are those that can purchase without a prescription.

OTC Sleep aids

Over the counter sleep aids are non-habit forming; no allergic reactions and complex sleep related behaviors that can occur with prescribed sleep medication.

Because it is available over the counter, it does not mean to say that they are not having any side effects.

Antihistamines

Most of these OTC medications are antihistamines; they work to inhibit the brain's neurotransmitter in order to depress the central nervous system. They work well but can cause some drowsiness the next day. They are safe enough to sell without a prescription. Antihistamines make many people feel groggy and tired rather than feel rested.

Commonly available Antihistamine’s medications are:

• Acrivastine (Semprex-D),
• Azatadine (Optimine),
• Brompheniramine (Dimetapp, Bromphen, Dimetane, Nasahist, Lodrane 24, Brovex, Lodrane 12 Hours, Dimetapp Allergy),
• Carbinoxamine (Palgic, Pediatex, Carboxine, Pediox),
• Chlorpheniramine (Chlor-Trimeton, Allergy Relief, Chlorphen, ChlorTan),
• Clemastine (Tavist, Allerhist-1, Tavist Allergy, Tavist-1),
• Dexbrompheniramine (Sinadrin Plus, Drixoral Cold/Flu, Complete Sinus Relief, Drixoral Allergy Sinus),
• Diphenhydramine (Benadryl, Benadryl Allergy, Diphen, Simply Sleep),
• Loratadine (Claritin, Alavert, Wal-itin, Claritin 24-Hour Allergy),
• Pheniramine (Theraflu Flu & Sore Throat, Theraflu Cold & Sore Throat),
• Phenyltoloxamine (Digex NF),
• Promethazine (Phenergan, Promethegan, Phenadoz, Phenazine 50),
• Pyrilamine (Liqui-Minic Infant, Triactin, Triaminic Infant, Triaminic Pediatric),
• Triprolidine (Zymine, Zymine XR, Tripohist)

Antihistamine medications provide temporary relief for runny/stuffy nose and other symptoms (such as ear congestion, watery/itchy eyes, itchy throat) caused by allergies, hay fever, the common cold, or other breathing problems.

Who should not use these Antihistamines medications?

• Those who currently using a monoamine oxidase inhibitor (MAOI)
• Narrow-angle glaucoma
• Breastfeeding

Possible side effects of antihistamines: daytime drowsiness/dizziness, lack of coordination, lack of mental concentration and alertness, mouth and throat dryness, Urine retention, Blurred vision, before driving a car or operating machinery, make sure the antihistamine does not affect the ability of concentrate.

Acetaminophen and antihistamine combination

Over-the-counter (OTC) sleeping aids such as Tylenol PM that is a combination of two medications acetaminophen and diphenhydramine (antihistamine). Other nighttime pain relievers such as Alka-Seltzer PM and Excedrin PM contain diphenhydramine. Acetaminophen helps to reduce fever and/or mild to moderate pain (such as headache, backache, aches/pains due to muscle strain, cold, or flu).

The combination of acetaminophen and antihistamine is useful to treat runny nose, sneezing, watery eyes, and pain or fever caused by allergies, the common cold, or the flu. This medication is also useful to treat nighttime pain and help support sleep.

There are many sleep-aid products available as over the counter medication on pharmacies and supermarkets. Many of these OTC products can contain a pain medication or a cold/cough medication; choose the most appropriate based on the health condition.

Acetaminophen and diphenhydramin combination

Brand names: Anacin P.M. Aspirin Free, Coricidin Night Time Cold Relief, Excedrin PM, Excedrin PM Caplet, Headache Relief PM, Legatrin PM, Mapap PM, Midol PM, Percogesic Extra Strength, Tylenol Cold Relief Caplet, Tylenol Cold Relief Nighttime, Tylenol Cold Relief Nighttime Caplet, Tylenol Extra Strength PM, Tylenol Extra Strength PM Vanilla Caplet, Tylenol PM, Tylenol Severe Allergy Caplet, Tylenol Sore Throat Nighttime, Unisom with Pain Relief, Bayer Select Max Strength Night Time Pain, Genapap PM, Sominex Pain Relief Formula, Tylenol Extra Strength PM Rapid Release Gelcaps, Excedrin PM Express Gels.

Acetaminophen and chlorpheniramine combination

Brand names: Coricidin, Coricidin HBP Cold & Flu

Acetaminophen and phenyltoloxamine combination

Brand names: Aceta-Gesic, Acuflex, Alpain, Apagesic, BeFlex, BP Poly-650, Dologesic, Flextra-650, Flextra-DS, Genasec, Hyflex-650, Hyflex-DS, Lagesic, Major-gesic, Percogesic, Phenagesic, Phenylgesic, Q Flex, Q-Gesic, Relagesic, RhinoFlex, RhinoFlex 650, Staflex, Vistra, Vitoxapap, Duogesic, Uni-Perr, Dolorex (obsolete), Staflex (obsolete).

Who should not use acetaminophen and antihistamine medications?

People with liver disease, glaucoma, kidney disease, enlarged prostate, or urination problems should not use this medication.

Possible side effects of Acetaminophen and antihistamine combination

• Fast, pounding, or uneven heartbeats;
• confusion, hallucinations, unusual thoughts or behavior;
• severe dizziness, anxiety, restless feeling, or nervousness;
• urinating less than usual or not at all, dark urine, clay-colored stools,
• easy bruising or bleeding,
• unusual weakness, fever, chills, body aches, flu symptoms, nausea, stomach pain, low fever, loss of appetite, jaundice (yellowing of the skin or eyes).

Patient with chronic pain experiencing depression, depression can develop sleep problems. Therefore, for these patients’ sedative antidepressants are the best choice; it can provide relief from depression, pain and promote sleep.

Sedative Antidepressants

The sedative antidepressants most commonly used to promote sleep include:

• Trazodone (Desyrel),
• Amitriptyline (Elavil), 
• Doxepin (Sinequan)
• Nortriptyline (Pamelor)

For the use of sleep problems, these antidepressants should use in much lower dosage compared to the treatment of depression.

Possible side effects of antidepressants include dry mouth, blurred vision, hangover (in the next morning), constipation, urinary retention, and nausea.

Trazodone (Desyrel)

Trazodone is useful to treat depression. Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonins, a natural substance in the brain that helps maintain mental balance.

Taking trazodone is not advisable if high blood pressure, Interacts with warfarin (Coumadin) and many herbal supplements.

Amitriptyline (Elavil)

Amitriptyline is useful for the treatment of depression. Amitriptyline is in a class of medications called tricyclic antidepressants, works by increasing the amounts of certain natural substances in the brain that need to maintain mental balance. Amitriptyline is also useful for the treatment of eating disorders, post-herpetic neuralgia, and prevents migraine headaches.

Taking amitriptyline is not advisable if recovering from a heart attack or using a monoamine oxidase inhibitor (MAOI), history of seizures, hyperthyroidism, liver disease, schizophrenia, or bipolar disorder.

Doxepin (Sinequan)

Doxepin is useful for the treatment of depression and anxiety. Doxepin is in a class of medications called tricyclic antidepressants, works by increasing the amounts of certain natural substances in the brain that need for mental balance.

Nortriptyline (Pamelor)

Nortriptyline is useful for the treatment of depression. Nortriptyline is in a group of medications called tricyclic antidepressants, works by increasing the amounts of certain natural substances in the brain that need to maintain mental balance.

Taking nortriptyline is not advisable if recovering from a heart attack or using a monoamine oxidase inhibitor (MAOI), Have a history of glaucoma, seizures or schizophrenia.

Living with narcolepsy can be hard. It can affect the ability to drive, work, at school, and maintain relationships. Besides taking medicine, Narcoleptics need to perform many things to have a safe and satisfied life.

Helpful tips for narcolepsy life

In this article let us see some useful tips for people living with narcolepsy. For ease the topic is classifying as below:

• Helpful tips to narcoleptics for the safer drive
• Work or Job’s choice for narcoleptics
• Getting moral narcolepsy support
• Narcolepsy in school going children
• Pregnant Women with narcolepsy

Helpful tips to narcoleptics for the safer drive

Driving can be dangerous for people who have narcolepsy, discuss with the doctor regarding this before doing so.

• Have naps before driving - helps narcoleptics with extreme daytime sleepiness.
• Stop often during long drives – Stretch, jack, and walk around during the stops.
• Have family or friends in the car so that keep engaging, or get rides from them.

Work or Job’s choice for narcoleptics

Narcoleptics can undertake all types of jobs, but some are better than others are. For example, a job with a flexible work schedule can help to take naps when needed. A job frequent interact with coworkers can help keep awake. A job that does not require driving or located closer to home is always preferable. Certain laws may apply to workers who have particular medical conditions, such as narcolepsy.

Getting moral narcolepsy support

Support from friends, family, and coworkers can help cope with narcolepsy. Gain more knowledge about narcolepsy, and educate family and friends about this disorder.

Narcolepsy in school going children

Children with narcolepsy may have trouble studying, concentrating, and remembering things. To help the child in school: Discuss with the child's teachers and school administrators about the child's narcolepsy and the best ways to handle his medical condition. For example, the child may need to take naps or have some walks during the day to overcome sleepiness.

Discuss and educate the school nurse about the child's narcolepsy, his or her medications, place to keep the medication and a schedule for taking them at school.

Pregnant Women with narcolepsy

Pregnant or planning for it and have narcolepsy, discuss with the doctor about whether continue taking the narcolepsy medication or need any chances, because certain medication may interfere with the pregnancy.

Medication is very useful for the treatment of the symptoms of narcolepsy. Commonly prescribed medications for narcolepsy are stimulants, antidepressants, and sodium oxybate. All these medications have certain common side effects so talk with the doctor.

Narcolepsy drugs

It may need one or more drugs for the treatment of narcolepsy. These may include:

• Stimulants – stimulate the central nervous system, relieve from daytime sleepiness, and raise daytime alertness.
• Anti-depression medication - to treat depression, it also suppresses REM sleep, help to prevent cataplexy, hallucinations, and sleep paralysis.
• Sodium oxybate (Xyrem) - relieves cataplexy, helps to improve nighttime sleep, and it may help control daytime sleepiness even if it is taking at night.

Stimulants medication drugs for narcolepsy

Modafinil (Provigil, Alertec, Vigicer, Modalert) - a newer stimulant, it does not cause addictive and not produce the high and low often associated with older stimulants. It enhances wakefulness, concentration, and vigilance. It is useful to treat excessive sleepiness caused by narcolepsy or sleep disorder due to shift work. It is in a class of medications called as wakefulness promoting agents. It works by changing the amounts of particular natural substances in the area of the brain that controls sleep and wakefulness.

Possible side effects include: headache, dizziness, difficulty falling or staying in asleep, drowsiness, nausea, diarrhea, constipation, gas, heartburn, appetite loss, unpleasant tastes, mouth dryness, too much thirst, nosebleed, flushing, sweating, muscles tightness or difficulty moving, back pain, confusion, uncontrollable shaking of body parts, burning, tingling, or skin numbness, visual difficulty or pain in the eye.

Other serious side effects include: rash, blisters, skin peeling, mouth sores, hives, itching, hoarseness, difficulty breathing or swallowing, swelling (of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs), chest pain, fast, pounding, or irregular heartbeat, frenzied, abnormally mood excitement, hallucinating, anxiety, depression, thinking about killing or harming oneself.

Methylphenidate HCl (Methylin, Methylin ER, Ritalin, RitalinSR) – it is a mild central nervous system (CNS) stimulant; it works by changing the amounts of certain natural substances in the brain. It is used for the treatment of symptoms of attention deficit hyperactivity disorder (ADHD; difficulty concentrating, and remain still or quiet). It is also useful to treat narcolepsy.

Possible side effects include nervousness, difficulty falling or staying in asleep, dizziness, nausea, vomiting, appetite loss, stomach pain, diarrhea, heartburn, mouth dryness, headache, muscle tightness, uncontrollable movement of the body parts, restlessness, numbness, burning, or the hands or feet tingling, reduced sexual desire, menstrual pain.

Other serious side effects:

• fast, pounding, irregular heartbeat, chest pain, shortness-of-breath,
• much tiredness, fainting, weakness (or numbness of an arm or leg), fever,
• motor tics (or verbal tics), seizures, speech-difficulty, blurred vision, breathing (or swallowing) difficulty
• agitation, hallucinating (believing things that are not true, or feeling unusually suspicious of others),
• depression, abnormal mood excitement, mood changes,
• Hives, rash, blistering (or peeling) skin, itching.

Dextroamphetamine-Sulfate (Dexedrine, Dextrostat, Dexedrine-SR) - The stimulant effect may bring down depression and fatigue by changing the amounts of certain natural substances in the brain. It is used for the treatment of attention deficit hyperactivity disorder (ADHD; difficulty to concentration, and remain still or quiet). It is also useful to treat narcolepsy.

Possible side effects include restlessness, difficulty falling or staying in asleep, headache, uncontrollable shaking of body parts, mouth dryness, unpleasant taste, diarrhea, constipation, appetite loss, weight loss, impotence.

Other serious side effects include fast or pounding heartbeat, shortness of breath, chest pain, too much tiredness, speech difficulty, dizziness or faintness, weakness or numbness of an arm or leg, seizures, mood changes, believing things that are not true, feeling unusually suspicious of others, hallucinations, abnormally excited mood, aggressive or hostile behavior, abnormal movements, verbal tics, blurred vision, hives.

Methamphetamine-HCl (Desoxyn) – methamphetamine is a very addictive stimulant medication. It affects the brain and can create feelings of pleasure, increase energy and mood elevation. Abusers may become addicted to it, needing higher doses more often.

Possible side effects include heartbeat irregularity, blood pressure rise and a variety of psychological problems. Long-term side effects may include severe mental disorders, loss of memory and dental problems.

Pemoline (Cylert) - is a central nervous system stimulant, indicated in Attention Deficit Hyperactivity Disorder (ADHD). It is a link with life threatening hepatic failure, so it should not consider as first-line therapy for ADHD.

Possible side effects include life- threatening hepatic failure, mild depression, dizziness, headache, insomnia, weight loss, nausea, stomachache, and growth-suppressant.

Mazindol (Sanorex) - stimulates the central nervous system, increases heart rate and blood pressure and appetite loss.

Possible side effects include an allergic reaction, heartbeat irregularity, blood pressure rise, severe headache, blurred vision, hallucination, confusion, restlessness, tremor, nervousness, dizziness, insomnia, mouth dryness, unpleasant taste, diarrhea, constipation, and impotence.

Anticataplectic Compounds medication drugs for narcolepsy

Venlafaxine (EffexorSR) – is an anti-depressant medication prescribed for the treatment of depression, depression with associated symptoms of anxiety, generalized anxiety disorder, and social anxiety disorder.

Possible side effects include: drowsiness, tiredness or weakness, dizziness, headache, nightmares, nausea, vomiting, stomach ache, constipation, diarrhea, gas, heartburn, burping, mouth dryness, unpleasant taste, appetite loss, weight loss, uncontrollable shaking of body parts, pain, burning, numbness, or tingling in body parts, muscle tightness, twitching, yawning, sweating, hot flashes or flushing, urinate often, urination difficulty, sore throat, chills, or other signs of infection, ringing in the ears, impotence, pupils enlargement.

Other serious side effects include rash, hives, itching, breathing, or swallowing difficulty, chest pain, fast, pounding, or irregular heartbeat, seizures, unusual bruising or bleeding, skin with small purple spots, eye pain/redness, blurred vision, fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness, fever, coordination problems, hallucinations, and coma.

Atomoxetine (Strattera) - is useful for the treatment to increase the ability to pay attention and decrease impulsiveness and hyperactivity in children and adults with ADHD.

Possible side effects include: heartburn, nausea, vomiting, appetite loss, weight loss, constipation, stomach ache, gas, mouth dryness, too much tiredness, dizziness, headache, mood swings, decreased sex drive or ability, urination difficulty, painful or irregular menstruation, muscle pain, sweating, hot flashes, unusual dreams, burning or tingling in the hands, arms, feet, or legs.

Other serious side effects: fast or pounding heartbeat, chest pain, shortness of breath, speech difficulty, dizziness or faintness, weakness or numbness of an arm or leg, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, swallowing or breathing difficulty, hives, rash, abnormal thoughts, hallucinating, erection that lasts for several hours or longer, and seizures.

Protriptyline (Triptil, Vivactil) - is used to treat depression, a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that help maintain mental balance.

Possible side effects include: nausea, vomiting, diarrhea, appetite loss, weight changes, unpleasant taste, stomach ache or cramps, heartburn, mouth dryness, constipation, drowsiness, dizziness, nightmares, headaches, frequent urination (especially at night), urination difficulty, wide pupils, changes in sex ability, breast enlargement in men and women, unsteadiness, ringing in ears, hair loss, flushing, sweating and black tongue.

Other serious side effects include:

• speech difficulty, arm or a leg weakness or numbness, blurred vision, walking difficulty,
• crushing pain in the chest, rapid, pounding, or irregular heartbeat,
• rash or hives, itching, swelling of the face or tongue, skin or eye yellowing,
• jaw, neck, and back muscle spasms, uncontrollable shaking of body part, fever, pain, burning, or tingling in the hands or feet
• fainting, unusual bleeding or bruising, seizures,
• confusion, hallucination, believing things that are not true

Imipramine (Janimine, Tofranil) – are used to treat depression, also used to prevent bedwetting in children. It is a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that need to maintain mental balance.

Possible side effects include: nausea, drowsiness, weakness or tiredness, excitement or anxiety, nightmares, mouth dryness, skin more sensitive to sunlight, appetite or weight changes, constipation, urination difficulty, frequent urination, blurred vision, changes in sex drive or ability, excessive sweating.

Other serious side effects include: jaw, neck, and back muscle spasms, speech difficulty, shuffling walk, uncontrollable shaking of body parts, fever, sore throat, or other signs of infection, breathing or swallowing difficulty, severe rash, skin or eyes yellowing, heartbeat irregularity.

Desipramine (Norpramin, Pertofran) - is used to treat depression, a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that need for mental balance.

Possible side effects include: nausea, drowsiness, weakness or tiredness, nightmares, mouth dryness, skin more sensitive to sunlight, appetite or weight changes, constipation, urination difficulty, frequent urination, blurred vision, changes in sex drive or ability, excessive sweating.

Other serious side effects include: jaw, neck, and back muscle spasms, speech difficulty, shuffling walk, uncontrollable shaking or movement of body part, fever, breathing or swallowing difficulty, severe rash, skin or eyes yellowing, heartbeat irregularity, sore throat, fever, and other signs of infection.

Clomipramine (Anafranil) - is useful to treat people with obsessive-compulsive disorder (a condition that causes repeated undesirable thoughts and the urge to perform certain behaviors repeatedly). It is in a group of medications called tricyclic antidepressants. It works by increasing the amount of serotonin, a natural substance in the brain that needs to maintain mental balance.

Possible side effects include drowsiness, mouth dryness, nausea, vomiting, diarrhea, constipation, nervousness, decreased sexual ability, decreased memory or concentration, headache, stuffy nose, appetite or weight change.

Other serious side effects include: uncontrollable shaking of body parts, seizures, fast, irregular, or pounding heartbeat, urination difficulty or bladder control problems, believing things that are not true, hallucinations, eye pain, shakiness, difficulty or fast breathing, severe muscle stiffness, too much of tiredness or weakness, sore throat, fever, and other signs of infection.

Florentine (Prozac, Carafe) - is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that do not go and the urge to perform certain actions repeatedly), some eating disorders, and panic attacks. It is useful to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. It is a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

Possible side effects include nervousness, nausea, mouth dryness, sore throat, drowsiness, weakness, uncontrollable shaking of body parts, appetite loss, weight loss, changes in sex drive or ability, excessive sweating.

Other serious side effects includes: rash, hives, fever, joint pain, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, breathing or swallowing difficulty, fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness, hallucinating, seizures.

Hypnotic Compounds medication drugs for narcolepsy

Sodium Oxybate (Xyrem) - is useful to prevent attacks of cataplexy (episodes of muscle weakness that begin suddenly and last for a short time) in patients who have narcolepsy. It is a class of medications called central nervous system depressants.

Possible side effect include bedwetting, headache, dizziness, stomach upset, vomiting, diarrhea, heartburn, stomachache, back pain, weakness, and difficulty falling or staying in asleep, sweating, flu-like symptoms, ringing in the ears, vision problems, painful or irregular menstruation, and abnormal sensitivity to touch or sound.

Other serious side effects include sleepwalking, abnormal dreams, sore throat, fever, chills, and other signs of infection.

Hypnotic Benzodiazepines - are classifying in the CSA as depressants. Benzodiazepine family of depressants is useful therapeutically to produce sedation, induce sleep, relieve anxiety, and muscle spasms, and to prevent seizures. In general, it acts as hypnotics in high doses, anxiolytics in moderate doses, and sedatives in low doses.

Narcolepsy has no known cure. However, lifestyle changes, medications, and other therapies can help to relieve its symptoms. Treatment for narcolepsy based on the type of symptoms and its severity.

Not all medication and home remedies or lifestyle guidelines work for everyone. It may take several weeks to months to find the best treatment.

Lifestyle guidelines or home remedies narcolepsy

Lifestyle guidelines or home remedies can help to relieve some narcolepsy symptoms. Take necessary steps to make it easier to fall asleep at night and stay asleep.

• Keep a regular sleep schedule - go to bed and wake up at the same time every day.
• Be relaxed during bedtime - do some relaxing things at bedtime, such as a warm bath.
• Sleep-friendly bedroom - keep the bedroom at an optimal temperature, quiet, comfortable, dark, and free from distractions, such as a TV or computer.
• Take about 20 minutes to fall asleep or fall back asleep after waking up. If not, get up and do something relaxing, such as reading until get sleepy again.
• Certain foods, and drinks before bedtime can affect normal sleep. Try to avoid those things – avoid large heavy food or beverage, avoid tobacco, alcohol, and caffeine containing beverages.
• Physical activity – regular exercise helps to relieve symptoms, but should not practice within three hours of bedtime.

In addition, author suggested to go through sleep hygiene for effectively relieve narcolepsy symptoms.

Narcolepsy is mostly misdiagnosed or undiagnosed. The most common symptom is the excessive daytime sleepiness, this symptom that is general to many conditions – such as depression, epilepsy and other sleep disorders. Cataplexy – a sudden muscle weakness; is the only unique symptom of narcolepsy?

Diagnosis of Narcolepsy

Diagnosis of narcolepsy can take a very long time that may be more than one year, or even several decades. This is because narcolepsy is very rare condition.

Narcolepsy is sometimes also mistaken for learning problems, seizure disorders, or laziness, especially in school-aged children and teens.

Narcolepsy is diagnosed based on:

• Signs and symptoms,
• Medical and family history - infections, brain injuries, exposure to toxins such as pesticides, or autoimmune disorder,
• Physical exam - infections, thyroid diseases, drug and alcohol abuse, and other medical conditions or sleep disorders also has the same symptoms as narcolepsy,
• Certain diagnostic tests

Common narcolepsy diagnostic tests are

• Sleep study
  • Polysomnogram (PSG)
  • Multiple sleep latency test
• Hypocretin test

Sleep Studies for narcolepsy

Sleep studies are performing at a sleep center; it has two test’s polysomnogram (PSG), and a multiple sleep latency test (MSLT) used to diagnose narcolepsy.

Polysomnogram (PSG) – Need to stay overnight at a sleep center for a PSG. The test records brain activity, eye movements, breathing, heart rate, and blood pressure. This test can help find out:

• How quickly fall asleep
• Whether go into rapid eye movement (REM) sleep immediately after falling asleep.
• Whether wake up frequently during the night

Multiple sleep latency test (MSLT) - a daytime sleep study measures how sleepy during the daytime. It is mostly performing in the next day after a PSG test. During this test, patient should need to be relaxed in a quiet room for about 30 minutes. A technician will record brain activity during this time. The test is repeats three or four times throughout the day.

A MSLT helps to find how quickly one fall asleep during the day (after a full night sleep). It also finds whether one go into REM sleep immediately after falling asleep.

Other tests for narcolepsy

Hypocretin test - measures the levels of hypocretin in the fluid surrounding the spinal cord. Mostly, people with narcolepsy have low levels of hypocretin.

Sample of spinal cord fluid is getting by spinal tap, also called a lumbar puncture. It is performing by the doctor by inserting a needle in the lower back area and then sample of spinal fluid to draw.

Most common narcolepsy symptoms are excessive daytime sleepiness and abnormal REM sleep.

Symptoms of Narcolepsy

• Excessive daytime sleepiness - Strong emotions, such as laughter, anger, or fear can bring on sleepiness.
• Mental fog - Memory problems or problems concentrating, Lack of energy or excessive exhaustion and depression.
• Muscle weakness while awake (cataplexy) - It may make the head nod or make it hard to speak. Muscle weakness also may cause knee’s weakness or make to drop holding things.
• Hallucinations when sleeping - vivid dreams while falling asleep, wake up, or dozing. They feel their dreams as real with feeling of seeing, hearing, smelling, and tasting things.
•  - prevents moment or speech while falling asleep or wake up, which lasts just a fewSleep paralysis when sleeping seconds or minutes usually it is very scary. Full consciousness (aware) is absorbed during this time.
• Many with narcolepsy have sleep episodes in the daytime, in which they fall asleep suddenly while reading, talking, watching TV or sitting ideal (particularly when inactive).

Narcoleptics may have one or more of these symptoms. They can range from mild to severe. Rarely, people who fall asleep in the middle of an activity may continue that activity for a few seconds or minutes called automatic behavior (but do not perform them well).

Narcolepsies in children’s often have difficulties in study, concentration, and remember things. In addition, they may seem hyperactive that is they speed up their activities rather than slow them down.

Narcolepsy is a chronic neurological disorder, affecting the area of the brain that regulates the asleep and awake cycle. Narcoleptics can fall asleep while working, talking, or driving.

What causes Narcolepsy?

Most people with narcolepsy have low levels of hypocretin, a chemical in the brain that controls wakefulness. A cause of insufficient hypocretin level is still not clearly understandable.

Research suggests that certain factors may contribute to the cause of low level of hypocretin. These factors may include:

• Heredity (Genetics) - Up to 10 % of people with narcolepsy has a relative with this condition.
• Infections
• Brain’s injuries are due to certain conditions, such as brain tumors or strokes.
• Expose to toxins, such as pesticides.
• Autoimmune disorder is the body's immune system attacks the own healthy cells, such as rheumatoid arthritis.

Heredity alone does not cause narcolepsy, also must have at least one more triggering factor listed above, to develop narcolepsy.

Restless leg syndrome is treating with lifestyle guidelines or home remedies, if it does not produce expected result, your doctor might prescribe some medications.

Restless leg syndrome has no specific medications, but medications that depress central nervous system, Parkinson’s disease medications, medication that prevents or relieves convulsions and some pain relieving medication can provide relief for RLS.

Medications used for RLS treatment

• Central nervous system’s depressants: Benzodiazepines shows positive relief from the RLS symptoms.
• Partkinson’s medication - Dopaminergic agents & Dopamine agonists (such as pergolide mesylate, pramipexole, and ropinirole hydrochloride) which are effective in the treatment of Parkinson's disease can limit or relive RLS symptoms and are considering as the initial medication of choice. Fast heartbeat, headache, nausea, and vomiting are some possible side effects.
• Opioids - is pain-relieving medication beneficial in the treatment of RLS. Constipation, nausea, and vomiting are some possible side effects.
• Anticonvulsants - such as carbamazepine and gabapentin are medicines that prevent or relieve convulsions used in the treatment of epileptic seizures. It can also relieve RLS symptoms. Dizziness, fatigue, and sleepiness are some possible side effects.
• Ropinirole - is the only drug approved by the U.S. Food and Drug Administration, specifically for the treatment of moderate to severe RLS. This drug was first approving for Parkinson’s disease. Nausea, dizziness, drowsiness, trouble sleeping, constipation, unusual weakness, stomach upset, and pain, headache or dry mouth is some possible side effects.
• Benzodiazepines - such as clonazepam and diazepam is a sleep-inducing medication. It may prescribe for mild or intermittent symptoms. It helps to obtain restful sleep but does not provide complete relief from RLS symptoms and can cause daytime sleepiness. It aggravates sleep apnea so advisable to avoid it in case of sleep apnea. Drowsiness, dizziness, stomach upset, blurred vision, headache, confusion, depression, impaired coordination, change in heart rate, trembling, weakness, memory loss, hangover effect (grogginess), dreaming or nightmares are some possible side effects.

One medicine does not work for all in the case of RLS. What is effective to one may actually worsen symptoms for another? In addition, medications taken regularly may lose their effectiveness, thus needs to change medications periodically.