DEAR DR. DONOHUE: I am a 64-year-old male and take no medicine. Is there such a thing as sleeping sickness? I get six to eight hours of sleep each night. By noon I am sleepy, and again in the evening. What can I do? – C.D.

ANSWER:
There is such a thing as sleeping sickness. Its official name is narcolepsy. In a crowd of 100,000 there will be up to 25 who suffer from narcolepsy. It most commonly occurs between the ages of 15 and 25, and it frequently is a family affair.

Narcolepsy has four prominent features, but not all of them need to be present in order to make the diagnosis.

Sleep attacks are its most prominent feature. These attacks are irresistible urges to nod off regardless of where people find themselves or what they are doing. They can nod off while the boss is talking to them, while playing tennis, while laying bricks or while driving a car. An attack lasts from a few seconds to 30 minutes.

Cataplexy is the second sign. It’s a loss of muscle control during highly emotional situations, such as anger or laughter. Cataplexy makes the narcoleptic crumble to the floor.

A third sign is sleep paralysis, which is a little like cataplexy, but here the muscle weakness occurs when falling asleep or when wakening from sleep.

The fourth sign is hypnagogic hallucinations – seeing things not present or hearing sounds not heard by others. This too happens in the span between wakefulness and sleep.

Treatment for narcolepsy entails planned daytime naps and medicines such as Provigil, Ritalin or Cylert.

You are not describing true sleeping sickness. Your symptoms sound more like overwhelming fatigue, a symptom of many illnesses, such as anemia or a poorly functioning thyroid gland. Can I talk you into seeing your family doctor for investigation of the many conditions that bring on fatigue?

DEAR DR. DONOHUE: Why is there no drug for Alzheimer’s disease? It’s been around for a long time, and it has plenty of patients. What is taking so long? – B.K.

ANSWER:
There are drugs for Alzheimer’s disease. Aricept, Exelon and Reminyl are three examples. They are not wonder drugs, and they do not bring a cure, but they can slow the progression of Alzheimer’s.

A new drug, used in Germany but not yet approved by the Food and Drug Administration, is memantine. It restores the supply of a particular brain chemical. Restoration of the chemical slows the loss of memory and the confusion that clouds the brains of those with this illness. It is not a miracle drug, either, but even a slight help from these drugs promises that more potent drugs are bound to come.

People wishing for a more detailed account of Alzheimer’s can order the Alzheimer’s pamphlet by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four to six weeks for delivery.

DEAR DR. DONOHUE: I request that you inform other readers and me about aspartame. Enclosed is an article I received from the Internet. I average two cans of diet pop a day. Is this dangerous? – D.D.

ANSWER:
I have seen the article many times. My position on aspartame stays the same.

Aspartame is an artificial sweetener. It has been subjected to a great deal of testing and scrutiny from the FDA, the American Medical Society, the World Health Organization and the Scientific Advisory Board to the European Union. All have declared it to be safe. You are not poisoning yourself with two cans of diet soda a day.

Many well-intentioned people hold a dissenting point of view. In their eyes, aspartame is linked to multiple sclerosis, epilepsy, brain tumors, Alzheimer’s disease, Parkinson’s disease, headaches and even blindness. I respect those people’s right to their opinion and hope they respect my right to mine.

People with a genetic illness called PKU should not use aspartame, since it contains the amino acid phenylalanine, a substance they cannot properly digest.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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