Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Narcolepsy

Episode Date: June 24, 2016

You probably think you have narcolepsy all figured out, but did you know that it's also the most horrifying disease of all time? It's true! Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We pushed on through the broken glass and had ourselves a look around.

Some medicines, some medicines that escalate my cop for the mouth. Wow! Hello, everybody, and welcome to So bones and metal tour miss guy medicine. I'm your cohost Justin McElroy and I'm Sydney McElroy This is kind of late recording session for us normally we don't record this late Both in the week and the evening specifically. No, that is very true We you know, I used to be quite the night out in my younger days, and so this would be no big deal for me. But you know, I don't know if it was turning 30 or having a baby. Or a little bit of both. Or both.

But- It's about pretend that is not fake people. That's the real stuff. So now you know you're in for a really good show. No, that was the one I do, and now I'm drinking some diet coke. And spicy things up a bit. So our daughter's done sleeping. She's over that phase, the sleep phase. She actually, this is true.

I haven't told you this yet, Justin. And I, Justin and I take turns going in the room and trying to coax her into sleeping for as long as that takes. We just keep dragging off. We're not tagging in and out as we get exhausted. And at one point, I had her in her bed, curled up with her baby Margaret, her favorite stuffed animal, and her blankie.

And she was, I thought drifting, and she set up, pulled off her blanket and looked at me and said, I'm done. And I said, what? And she said, I'm finished. Great. With sleep. Yeah. With sleep forever. And it's so ironic because the thing about it is, it's like a, maybe this is what people knew when they talk about the generation gap. I would give anything for two giants to come put me in a bed and insist that I go to sleep. Her bed looks so inviting too. Her big girl bed, her toddler, I don't know why.

Maybe it's just because I miss sleep. I miss sleep and Sydney's grown. It's not gonna, bed looks comfy. Hospital service this week, so she's up at six. You know what, this, this, where does sleep be 6. Anyway, this order of sleepy is the point. And we're sleepy all the time. So that's my life. That's where we're at.

And this has been your update on how sleepy we are in 2016. But I thought in light of the fact that Justin and I are very sleepy, that we should do a sleep related topic. Oh, cool. I'm not sure we've done a lot of sleep related topics before. I think sleep is fascinating. I know you do. I know Justin tried for a while I think we may have even mentioned this on that. I think we talked about insomnia before and that you did that. What is that sleep schedule called that like Presidents? Oh polyphasic sleep. Yeah. Yeah. That did not go well. He thought that we would just insert into our co-life, our couple life, because it is a life conjoined.

A shared life, no. That we share, that he would just sleep every two hours or something? Yeah, it's a weird schedule. It's something like that. It's like every three hours you sleep for 90 minutes or something like that and just keep the train rolling. And that's just our life, is that he does that and I sleep like you know a regular person

and I mean like we just live like that. It's worth knowing like I did not do this for I made it like half a day basically I took a nap in the middle of the day and that was my attempt to polyphase and sleep so it was the same length of time that you managed to do the juice fast. Yeah that did the juice fast. That he started on trick or treat. Yeah, I made it. I basically just had some juice that day. And then the night trick or treat candy. And that was it.

That was it. Let's talk about narcolepsy. Okay, let's. Okay. I have a, do you have anything to add? You sounded like you were going to start us off. Well, let me kick it off. No, I have a, what I would describe is perhaps a layman's understanding of narcolepsy.

I don't know if there's more to it, but from my limited layman's understanding of it, it is people who fall asleep basically when they're not trying to and in opportunity times. I think most people kind of get that perception of narcolepsy and they, I think you see images of that. I feel like I've seen that kind of trope before, like used for comedic effect in movies or television shows where someone has narcolepsy. And so the joke is that periodically they're just asleep.

And so that's all that people know about it. It's actually a little more complicated than that. And there are a lot of people who wanted to talk about narcolepsy. So thank you to Ellie and Erica and Brett and Jesselyn and Sarah and Allison and Ali for recommending this topic. And I think there were probably many others on Twitter and Facebook, because it's not very common.

I think it's actually considered kind of a rare disorder. I don't. It's like one in 2000 people. I'm only ever known anybody. You were known anybody or treating me to that? I personally know two people that do. Really? Yeah. Wow. So there you go.

You're putting on a note? Well, I mean, no. You don't. No, okay. But yeah, no, but I do. And I have taken care of people with it. So I saw some numbers that were way more common than that. I don't know.

Maybe that is a point of dispute. It's still not completely understood. So you find that. I don't know, maybe that is a point of dispute. It's still not completely understood. So you find that, you know, like people don't really know they have it because there can be different flavors, different variations. So let's talk a little bit about what narcolepsy is before I kind of give you the history.

So first of all, the term narcolepsy comes from the Greek word narque or narque. narcolepsy comes from the Greek word, narque or narque, narque. Something like to sleep, sleepy some, close enough, stupor, numbness. I think of narcotic, which is where I'm going. Same root word, you know, narque and then lepsis, which means like attack or seize.

Okay, so an attack of numbness or... Super. Yeah, sleep attack is what it was called at times. Throughout the literature, you'll see reference that people had sleep attacks and they're talking about narcolepsy. Since the 1950s, we've really had a pretty good definition of what it is.

Now, we're still trying to understand what causes it to this day, but as far as like how do you diagnose somebody with it? Yossin daily at the Mayo Clinic, defined what we consider the classic tetrad, the classic symptoms. And those are excessive daytime sleepiness. So people with narcolepsy are gonna feel pretty tired most of the day. Okay. Untreated especially. A cataplexy.

What's that? Cataplexy and what people think of as like sleep attacks get confused a lot. So yes, people with narcolepsy are sleepy a lot and so they may take frequent naps. And they may fall asleep very easily or very quickly during those naps, which I think is kind of what you see depicted on television like the idea that some of you would just be sitting there and then have their head on their desk and pass out asleep. But I think it often gets confused with cataplexy, which is when you basically just lose all muscle tone and drop to the floor, and it's usually in response to some sort of extreme emotion.

It can be laughter, it could be stress, it could be excitement, it could be anything, and you just lose all muscle tone and hit the floor. Yikes. But you're not asleep, so that's actually separate from the- Oh, so the frequency. It's like worse.

Yes. And not everyone with narcolepsy has cataplexy. You don't have to have all of these things to have narcolepsy, but these are kind of the most common thing you'll see. And some people have all four. Sleek paralysis is another common symptom, which means you're awake, but you can't move.

Okay. And it's very scary. We'll talk a little bit more about that. Is that because of the cataplexi? Yes, because cataplexi is your awake during the day, you're walking around talking doing things, extreme emotion, bam, you're on the floor. Sleep paralysis is either while you're trying to fall asleep or while you're waking. Okay, got it.

And then there are also something that are very common. You can have these outside of narcolepsy, but with narcolepsy are hipnagogic hallucinations, which just means when you're falling asleep. They're hipnagogic and hipnopopic hallucinations, and the hipnagogic ones are the ones when you're starting to drift off to sleep and you can hear things or see things, they can be very upsetting and unsettling. Everybody can have those from time to time, but with narcolepsy, they're much more frequent. Many patients don't have all the symptoms. Only about a quarter,

a fifth to a quarter, have all of them. And then there's this proposed fifth symptom that you can see in a lot of patients with narcolepsy, which is basically their sleep at night is just disturbed. It's just they have very abnormal sleep patterns if we were to watch their brain waves. Oh, and it's like a causation of just getting like your circadian rhythms getting fair and off. Well, that's part of it. Like a side effect, I guess.

And it is. It's one of those vicious cycles because of the disorganized sleep patterns throughout the day and then at night. But you see a lot of people who, you know, if we look at what we consider their sleep architecture, which is when we map your brainwaves as you descend through the levels of sleep and then come back up to the more, you know, stages of wakefulness. A lot of people with narcolepsy, it does not go in an orderly fashion, which is probably part of why they feel so tired too, but it all feeds into each other. Now this may have been mentioned as far back as the early 1600s when Thomas Willis wrote

about certain patients that he saw as a physician and he saw patients who had a sleepy disposition who suddenly fall fast asleep. And that he was probably talking about, probably patients who had narcolepsy. Either that or Jughead was who I thought of. Maybe he was talking about Jughead from Archie College. Yeah, maybe this was the earliest mention, history's earliest mention of Jughead. That'll be a very,

very 1600s early, early, very early mention of Jughead. Jughead would need to be like a time lord or something, as to a, oh no. Jughead is a time lord. Why does Saul search? Ah, the next doctor. The next doctor is Jughead.

Oh, God, be Jughead. Oh, that is a crossover. My nerd brain just exploded. If I was the kind of person who had artistic talent or was apt to draw fan art. Yeah, please send this to your fan. Please send me a picture of Jaggedeha as the doctor. We got to Sydney, McAroy. Because I can't draw. Either way, Thomas Lewis, no, it wasn't. Either way, he suggested caffeine. Was that work? Is it help? I mean, you know, keep you awake better. Yeah, I guess that's true. I mean, when we didn't have anything better, it wasn't a terrible idea.

The first better descriptions of narcolepsy, we see in 1878 and 1888, my two German physicians, Westphal and Fisher, specifically Westphal, who wrote a lot about this. And he noted that there were these episodes of muscle weakness and that they could be triggered by strong emotions. This is where we get the cataplexy entering in. And he wrote a really thorough description of it, which was very helpful, you know, to try to understand what is this disorder. But at the same time,

he linked it to a lot of the emerging psychoanalytic theories of that time period. I thought it was more of something psychological, basically, that was happening with these people. And specifically, he had somebody out, like he mentions one patient who probably had narcolepsy, and then he talks about another patient who probably didn't, but he links them together

and then blames it on excessive masturbation causing sleepiness I Don't know I mean that is not a cause of okay. I got it narcolepsy I Have a theoretical question for you, and I don't want to derail you We're running behind but You talked about the first doctor, Thomas Willis, who described it as patients of the sleepy disposition who suddenly fell fast asleep.

I think there's a very human impulse, and we see it a lot in medicine to talk about things in terms of nature back then, and then as we learn more to try them in a diagnosis, do you, first off, is that right that we, that things tend to evolve from, oh, they have a nature towards something, towards, that turning into a diagnosis, and is that, do you think that's necessarily helpful for people to be able to,

quote unquote, diagnose themselves rather than thinking themselves as having a, a nature or one way or the other. I think it's a double-edged sword. I think that, I mean, when you're talking about historically, because that was, you're right, that there are a lot of diseases, disorders that we would just think, like, well, that's how people are.

That's just who they are. They're like that. And we blamed it on, they were too negative, or they were too anxious, or they worried too much, or whatever and That was because we didn't understand You know anything about what was happening inside the body certainly nothing on a molecular level on a DNA level biochemistry alluded us so

At that time, I think it you know it was not helpful at all because it just made you say, well, your problem is that you got to get your thinking straight or you've got to, you know, it led to things like you got to go to church more or something like that and that'll fix your medical condition. Yeah. I think it is important to remember now because I talked to people a lot about that. I would say a good example would be something like anxiety. There are people who have anxiety and then there are people who, you know, we might say things like they're just a bit of a warrior. And they do. And there might be more prone to having, you know, anxiety about isolated events than someone you know, it doesn't interfere with anything. Makes sense. And I think that that's a big difference

from someone who has anxiety and who needs treatment for that. So I talk to patients a lot about that the difference between this is who you are and then this is something that needs treated. Okay, I hate to derail you. You just finished talking about the guy who loves a master bail time.

Okay. So I want to stop talking about the guy who loves masterbae all the time So I want to stop talking about him great. Great. I mean, I'm sure he's a rich character with multiple layers But I want to talk about are really a lot of where the the interest in narcolepsy and the research started was from 1888 or 1880 Sorry by Jean Baptiste Edward from 1880, sorry, by Jean Baptiste Edward Gellano. Okay. Which is just a lovely name. Yeah, so... Trips off the tongue. He was a physician who studied a lot of different things,

but one thing that he wrote in the description of was narcolepsy. He observed this wine merchant that he was taking care of, who he wrote about how he was tired all day long, and he had up to 200 episodes a day of sleep attacks. Okay. Now, he was probably combining the sleeping and the cataplexy in this patient.

He probably wasn't distinguishing in this description. But one way or another, this guy, 200 times a day, was not being able to do his job. Hachi mochi. He had previously been diagnosed with, in the writing, he says, he, you know, that we thought he had morbis sacer, which is the sacred disease,

which was epilepsy. Oh, right. Because we've talked about before epilepsy with its, you know, kind of origins, and we talk about it biblically, and the idea that epilepsy comes from something divine or beyond us. It was affecting his life so much that he actually would keep his 13-year-old son with him at all times at work to wake him up. Oh wow, so it's take your son to work

day every single day. Every single day to keep that awake. To keep you awake, right? He did. It's interesting because when you read this description of narcolepsy, he writes that the man claims that his infant son was conceived. And the way they say it is that it was during a moment that he was overtaken with the disease. He was asleep. So he's asleep is what it was saying. He actually, his wife conceived a child while he was asleep. So he was asleep is what he was saying. But he actually, his wife conceived a child while he was asleep. I tried to follow him.

And that could have just been, it wouldn't be uncommon, especially with extreme emotions for him to have maybe post-coitily had catapultxied, that could have happened. Sure, yeah. Or just fell asleep really quickly. Or maybe you just fell asleep. You know, that happens to people sometimes. No comment. He had, he had many episodes of what was likely

cataplexian. Those were well described like he went through a lot of different situations that could do that. So playing cards and having a good hand specifically. The worst, the worst bluff possible, like the easiest tell you could possibly have. Like, I get a hint, they're like, are you in or are you gonna find me? Yeah, I'm in. You get it and he hits the floor and you're like,

well, I'm out. All right, yeah, yeah, he, uh, I'm betting a sec. Uh, smiling at someone poorly dressed in the street. I'm, we all been there, though, it's a nervous reaction. effect. Smiling at someone poorly dressed in the street. I'm all been there though. It's a nervous reaction. You don't want to know what you really think. I get it. I like that. That's a reaction formation and then cataplegsy. So being surprised by a sudden danger, that makes sense, anticipating the pleasure of a good play in the theater. Man, I know that that puts me to sleep plays a lot. And you imagine

if that if that if that is a trigger for cataplexie and narcolepsy is more common, there would just be like people laying on the sidewalk outside of Hamilton. Yeah. daily. Most notably, they describe in depth him looking at monkeys making faces in the zoo and having an event. That's enough to put it in his leg. No, one of these are the cataplexi, extreme motion and he hits the ground. He, all the monkeys, by the way, if monkeys see you do that, they'll tear you apart. They will take that sign of weakness and they'll jump out of the cage and tear your face around. So don't have cataplexi in front of them?

Don't fall asleep from a monkey. He thought it was a neurosis of some sort. That was his, so this again is kind of with, at this time period, like this whole concept of the subconsciousness and psychoanalysis comes soon after this. And so these things are being explored. He thought it was some sort of neuroses.

He also hypothesized in several other patients, not the wine merchant, that it could have been the result of maybe too much sex, using up all the oxygen that you need for certain parts of the brain that keep you awake. A lot of sex shaming here. Yeah, it's weird. The treatments he used, the treatments

that he would recommend for narcolepsy. He had already, by the way, made quite a name for himself, treating epilepsy, this particular doctor, Gellino, and he developed these Dr. Gellino's tablets, which were just a combination of bromide and arsenic. They were very popular for the treatment of epilepsy. So he kind of took off of that and arsenic was a treatment, strict nine bromides, curari. There are a bunch of different things that he

used. Amel nitrate, hydrotherapy, electricity. He would propose that you cauterize the nape of the neck. Any of those effective? None of them really worked. I'm not sure. He eventually just kind of abandoned the apple. Silly me. Silly me. He basically said like his last line on that was so pretty much after nothing worked, the patient and I both agreed that we would go our separate ways or something. Well, it was fun while it lasted, but nobody's getting anywhere. I wonder if he would really he fell asleep to sneak out.

It was really, it was really not until the early 1900s where we start seeing like caffeine is used still. We see a fedron like as a stimulant that's used and then finally in the 1950s where we see more stimulant medications like ridolin for instance, those kinds of medicines actually being used for narcolepsy. Are those effective? Stimulus can be. They're not, this would not be like our best bet there.

I'm going to tell you about there's some other options, but yeah, I mean, they will keep you awake. No, okay, great. I want to hear some of the others. What are we doing now? Well, I'm going to get to that Justin, but first, why don't you follow me to the billing department? Let's go. The medicines, the medicines that ask you let my God for the mouth.

Is there anything, you mentioned how I sort of had part of the picture of narcolepsy? Is there anything else that sort of factors into it? Well, one thing that I wanted to feature a little bit more because it has been historically one of the most misunderstood parts of narcolepsy. Because I mean the idea of people being sleepy or sleeping a lot, taking a lot of naps, even people passing out is probably what they would have thought cataplexy was, just somebody passing out, is not a strange thing. And there are lots

of different things that was confused with or you know the people didn't necessarily have a lot of weird theories about that. But the sleep paralysis, that feature of narcolepsy has been turned into I mean kind of a folklore all its own. So sleep paralysis can happen to people who don't have narcolepsy. You may have experienced it in your life. It is not, I don't want to say it's common, but an isolated event of this once in your life, you may have had one.

I don't think I have. Not to my knowledge. I'll probably remember that. I hope. Yeah, I know you would. Let me say, I have definitely not. You would remember it. At least I would assume from the descriptions I've read. But with narcolepsy you might have it more more often and then there are some people who don't

have narcolepsy who do have this commonly. So it's a parasomnia which just means a disorder that happens around the time of sleep parasomnia. Yeah, beside sleep. But again, it's associated with narcolepsy. It is usually when you're falling asleep with narcolepsy, although it can happen when you're waking up too. And if you don't have narcolepsy, it could be either way. And what is basically happening is the REM cycles of sleep, which is when you dream, the rapid eye movement part of sleep, that's the part of sleep where you dream, that overlaps with waking. They're not supposed, those are distinct times in sleep, right? One's not sleep. REMs like right at the bottom of your sort of sleep.

Yeah, that's a very deep sleep. REM sleep, during that sleep, your body is actually intentionally paralyzed. It turns off your motor centers, so to speak. Reason being, this is a good thing. This is an important function. If it didn't, you may act out all your dreams. That I never really thought about that, but that makes perfect sense. That's why if you ever get that feeling like you can't move or talk or whatever with a dream That's intentional your body's doing that so that you're not wandering all over the place hurting yourself Why you're right? Okay, that's a whole other problem if you don't have that you might wander around and act out your dreams

That's that's a problem too, but a different disorder exactly so the problem with sleep paralysis comes when you are trying to fall asleep and the REM starts before you are actually asleep. And this is a common thing with narcolepsy. Actually, one of the ways, and I'll get into that that we diagnose it, is to see how long it takes

from the moment you fall asleep to when you hit REM. It's supposed to take a while. People with narcolepsy, they are almost instantly in REM sleep. Does that work out sometimes? Like, sometimes I think that would be kind of nice. Have a hard time falling asleep. No, overall, it doesn't. I mean, because they have all the symptoms. So overall, I mean, it sounds like a good thing, but overall, it is it, it's leading to more disorganized sleep. It makes sense. So either you enter REM before you're actually asleep or you wake up and you're still in REM

at the end of sleep. So these are the two times it can happen. Basically, you are awake, but you can't move. Now, you can imagine this is accompanied by fairly significant distress. Sure. I can't imagine. That's not surprising.

A lot of people with this will report a feeling that someone is in the room with them when it's happening. That there's an intruder there, and they can't do anything about it. Some sort of alien presence, something scary, some non-specific threat. You know, we give... A lot of times in this show, we give old-timey people a lot of flack for like, what, why did you just assume that it was angels or whatever? But like, on this one, I sort of want to cut them some slack.

That would probably be like pretty much the weirdest thing that had ever happened to you, if you're in like, and in the list of things that you could mistake for something otherworldly, I got paralyzed, and then there was a demon in the room, would be like pretty high on the list of things that you could mistake for something otherworldly, I got paralyzed and then there was a demon in the room would be like pretty high on the list, I think. Well, and that's exactly what people thought that there was a demon in the room. That is a very common perception and throughout history and folklore and legend and kind of our common mythology, you see this across cultures.

Now, one thing that I think is interesting to know, why do people have this sensation that somebody is in the room? This is probably related to kind of their survival mechanism. So in response to a threat, we have the fight or flight reaction. We know that if something threatens our safety or security, have the fight or flight reaction. We know that if something threatens our safety or security, we get scared, we are heart rate goes up, we get sweaty, we get ready to run or fight or jump or get out of there.

We know that response. If you get some stimulus that your body can't understand, awake but can't move. Usually I can't move, but at this moment understand, awake, but can't move. Usually I can move, but at this moment, I'm awake and I can't move. Basically our body airs on the side of caution. We interpret that as a threat. We assume a threat. And so then we begin the feeling

that there is a threat nearby. And then however you personify that, it's probably more related to your culture and your, what your personal beliefs are, what you have watched on TV the night before. So this was designed. This was the good wife because then you'll imagine that the good wife is in the room with you and she's trying to kill you. Is the good wife a scary move or show?

No, well, no, but when you're paralyzed and the good wife is lurking in the corner, like the girl from the ring, then good wife gets scary real fast. But she's a good wife. Right. Yeah. When the lights are on to me, when lights are off and you can't move, then you do not want the good wife in the room with you. Never watch the good wife. If you think you might have sleep paralysis, the next night, I didn't have the good wife was a horror program. It is when you can't move, Sydney.

So things are like today's special What if you what if imagine Jeff that mannequin with the magic hat wasn't around you? Let's not get into that. Okay. Now we're scared now. You're scared now. It's here. No, I got in your head It was defined all the way back in 1755 by Samuel Johnson actually an addiction area of English language Where he groups in a description of sleep paralysis with nightmare. And you'll see that the word nightmare used, like historically, used to describe sleep paralysis, not just a bad dream, but used to describe sleep paralysis. It was long blamed on demonic possession.

So either the reason this happened to you is because there was a demon inside you or a very common myth is that there was a demon sitting on top of you. Excellent. Great. So you see that there are a lot, if you, if you Google the sleep process, or if you look for incubus or succubus, you'll find lots of imagery of a person asleep with a demon sitting on their chest. And it is because you get that feeling like I can't breathe.

I can't move. I'm, you know, you begin to feel like you're suffocating and there's a scary thing in the room. There's something sitting on top of you. And of course, when we talk about incubus and succubus, we're also adding to that like a possible sexual component. Because that's what, you know, what an incubus is and a succubus. There are incubus's male, succubus's female, they're demons who supposedly come and can

take advantage of you at night. Oh, got it. Okay. In Europe, in the 1800s, it was very fashionable to blame food for this. That is where I've always wondered about this. You know, in Dickens, in a Christmas Carol, when Scrooge says, yes, that Marley the ghost he has seen is a bit of beef or a spot of gravy or whatever he says he is That is what he's referencing That you might see ghosts or see scary things or demons or whatever if you ate the wrong thing

That makes a lot more sense. Yes. I'd never understood that but now I do it You were advised to avoid bad wine fatty greasy foods get plenty of exercise From this throughout most cultures you get the concept of advise to avoid bad wine, fatty greasy foods, get plenty of exercise. From this, throughout most cultures, you get the concept of the night hag. And the night hag is just the idea that there is this creature that might come and sit on you and suffocate you and prevent you from moving in the middle of the night. And I won't get into it. I mean, literally you can look there, there's one in, in every country and every history

and every different culture throughout Earth. They go by different names, but it's the same idea every time. And some of them are quite horrific. People still recount people who have this will still kind of talk about like the feeling maybe they were abducted or maybe they were aliens. maybe some of those stories maybe they're related to this. You can't move and all of a sudden if you're afraid of aliens already. Exactly. Or out of body experience or near death experience, so there's some theory like, well maybe this was actually sleep paralysis. There's a documentary about it called The Nightmare

that came out last year that's all about this. It looks too spooky. We have worked up the nerve to watch it. That's exactly right because it looks very scary. Now, just to get back to narcolepsy in general, so that you know kind of where we are. A lot of what we understand now about narcolepsy really comes from the discovery that this happens in dogs. So in the 1970s, we did a lot of studies understanding narcolepsy in Labrador's Beagles and Dobramans. And that helped us a lot to understand human narcolepsy. There's some thoughts that maybe there's an autoimmune role in some of it, that maybe

it's an autoimmune disease, especially people with cataplexia, but we're not completely certain. And a lot of it has to stem from that you don't have enough of something called hypocretins or ereccens, which are just these things that are released in the brain from a certain part of the brain and their job is to keep you awake. And if you don't have enough of those, you're not awake enough. So that's probably where it's coming from, we're beginning to understand that. And maybe someday we can come up with a really great drug that'll target exactly that. Yeah. To keep people awake and to help treat narcolepsy.

It's not a huge market to get that drugnaval, though. Well, it's hard when they're rare diseases. They're always harder to get enough research funding for that. If you think you have it, they do a sleep study, and then they do a test like I talked about to see how fast it's a sleep latency test, to see how fast you get into that REM sleep, and that can diagnose it. It's usually treated with things that will stimulate your cerebrum. So stimulants that we talked about, there are things like provigial, not crank.

Nope, not crank. And then actually GHB, but unfortunately, we probably know as the date rape drug. Yeah. GHB is actually does have a medical use for cataplexia. That's wild. It's a lot deeper than amrenies, isn't it? Yeah, there's a lot more than narcolepsy. It's very poorly understood. We still need, I mean, even on the medical end, we still need to do a lot of research to

treat this better and to diagnose people better. Because there are probably people who have narcolepsy Who have not been the there's a huge delay in diagnosis a lot of people wait many years just thinking I don't know what's wrong with me, but I'm tired all the time before they finally get diagnosed So if you're having sleep problems It may not be your baby. It's worth checking out. Okay. Going and seeing your doctor and see is is there something else going on? You never know. Thanks the maximum fund.org network for making us a part of their extended podcast family. And thank you to you for listening. We really appreciate you so much. I don't think we recorded

since we released this episode. So thanks to DC and New York for being so cool to us. We had a lot of fun. Yeah, the whole cities. We're thinking of the whole cities there. They were lined up around several blocks to get into the shows. Thank you all. That was a wonderful, wonderful experience. Thanks to TaxPair for this user's song, Medicines is the International of Our Program. That is going to do it for us for this week, until next week,

my name is Justin McAroy. I'm Sydney McAroy. And as always, don't drill a hole in your head Maximumfund.org Comedy and culture, artist owned Listener supported.