Director, I have narcolepsy, can you let me call in sick?

I believe that many people are sleepy, especially those of us who are doctors. After 24 hours of night shift or even an operation, when sleepiness billows, our eyelids basically give up fighting and our brains are free. No matter when we were doing what, we were in what’s posture at that time. As long as we closed our eyes, it would be dark…

I’m so sleepy!

On November 16, a news item was reported online.

Sichuan Senior Three student, one second he listened carefully and took notes in class, and the next second he may fall on the table and start to sleep. In this case, he does not know how many times to repeat it in a day, but he can’t control this drowsiness even if he tries his best.

In addition, even when he woke up, he felt weak all over. Whenever he was excited, his limbs would suddenly feel weak. Because it seriously affected his study, he finally had to give up the college entrance examination and seek medical treatment everywhere.

[Sleeper] Possession?

To say the cause of drowsiness, one must first consider whether one has enough sleep at night. If one suffers from repeated drowsiness caused by insufficient sleep, the drowsiness will disappear and one’s energy will be very abundant after adequate sleep. Obviously, he is not caused by short sleep time.

The second common cause may be sleep apnea hypopnea syndrome (OSAHS). Due to respiratory tract obstruction and body hypoxia, patients cannot sleep deeply and are easy to wake up, resulting in insufficient rest for the brain, which is easy to lead to daytime sleepiness, fatigue and headache. The most obvious characteristic of OSAHS is snoring.

There are also two diseases that easily lead to daytime drowsiness, namely restless leg syndrome and periodic limb movements during sleep, which will lead to frequent or short awakening of patients and make them prone to drowsiness during the day, but sleep monitoring can be ruled out.

It’s not really [sleeping ghost] possessed, is it?

This is a rare sleep disorder-narcolepsy.

When suffering from this disease, no matter when, where and where, as long as drowsiness strikes, the patient can fall asleep immediately, so it is easy to cause the patient to fall down, accompanied by hallucinations when falling asleep or awakening, and some people will also suffer from sleep paralysis, commonly known as “ghost pressing bed”.

Editor of Clove Garden, who has insomnia at night and yawns during the day: This disease sounds good, how can I get it? It’s urgent to wait online.

Editor-in-chief of Clove Garden: There is no money for grinding coffee in the tea room. If one cup is not enough, then two cups. So the editor went to drink coffee.

Sleepy to death every day, is it narcolepsy?

For this question, there was a time when the author himself asked himself whether he had narcolepsy. Why do you yawn every day?

In fact, the clinical manifestations of narcolepsy are not only daytime lethargy, but also sudden attacks, especially when strong emotional stimulation (mostly positive emotions), when sudden attacks, consciousness will not be lost. In addition, there are sleep disorders at night, such as nightmares, sleep interruption at night, sleep paralysis, hallucinations before falling asleep, etc.

Narcolepsy is often accompanied by other diseases. For example, the more obese and sleepy patients are, the more significant the weight gain may be, which may be related to the low metabolic rate of narcolepsy patients. In addition, there are OSAHS, migraine and so on.

To be diagnosed as narcolepsy, the course standard must be met first: not less than 3 months; Secondly, laboratory tests should be carried out, such as Hcrt-1 content in cerebrospinal fluid, multiple nap latency test (MSLT), night polysomnography (NPSG), etc. Finally, it is necessary to identify and exclude lethargy and cataplexy caused by other diseases, such as epileptic absence seizure and transient ischemic attack.

-Director, I have narcolepsy, can you let me call in sick?

-Yawn and want to call in sick? Isn’t it just a night shift? Just sleep.

-However, only sick leave can I sleep. Today I am still on night shift…

Is this disease really hopeless?

In the news, the Senior Three boy who got narcolepsy gave up the college entrance examination because he could not get effective treatment.

It is generally believed that narcolepsy is a lifelong disease, but there are also some studies that suggest that the symptoms of some patients will be relieved after several years of onset. Reasonable treatment of narcolepsy can also relieve the symptoms of patients to a greater extent, mainly through behavioral intervention and drug therapy.

Patients with narcolepsy can take regular naps every day for 15-20 minutes. It is also necessary to maintain good sleep habits. In addition, it is equally important to change living habits and try to adapt to narcolepsy so as not to induce anxiety and depression.

Patients with narcolepsy had better not drive or work high above the ground. However, patients with narcolepsy can be competent for some inspiring jobs, such as teachers or trainers. If some work is monotonous or requires extremely high accuracy, it may be prone to errors.

Director, I have narcolepsy. Can I take a sick leave?

-You don’t have to come anymore.

However, psychological and behavioral intervention is effective based on clinical experience and is not supported by good evidence-based research evidence.

The main direction of drug therapy is to reduce daytime drowsiness, cataplexy and increase sleep quality at night, minimizing the impact on daytime study and work.


The preferred drugs have not been approved for listing in the past 20 years.

The reduction of daytime drowsiness is mainly achieved through the use of central stimulants. Antidepressants and sedative and hypnotic drugs can be selected to reduce cataplexy and improve sleep disorders.

At present, modafinil is the preferred drug in the guidelines of various countries (including China’s guidelines), but the drug has not yet been listed in China-the guidelines recommend a drug that cannot be bought.

Modafinil was first used to treat narcolepsy in 1980, It was approved by FDA in 1998. But in the past 20 years, Phase II clinical trials of modafinil generic drugs in China have been completed, and the fastest-growing enterprises have entered the listing application stage in 2012. However, due to the verification of CFDA’s clinical trial data last year, their tablets have withdrawn their applications and dispersible tablets have not been approved. Now only capsules may be approved through on-site verification.

In addition to modafinil, other drugs to choose from are mazindole and methylphenidate. These drugs are strictly controlled as central stimulants and require psychiatrists to prescribe them. # Imagine staying up late with stimulants like American college students? You must have been dreaming

There is no conclusion used by what.

In our view, narcolepsy may be just a rare talk. However, for patients, this [seemingly harmless, controllable but unable to cure] disease may become a turning point in their lives.

We hope that the life trajectory of narcolepsy patients will never change again because they cannot buy drugs.

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