Narcolepsy
A chronic disorder affecting the part of the brain where regulation of sleep and wakefulness take place, narcolepsy can be viewed as an intrusion by dreaming sleep (REM, or rapid eye movement) into the waking state.
Should people with narcolepsy become certified for scuba diving? No scientific studies exist on the subject: all that is written is pure supposition, based on knowledge of the condition and knowledge of what can happen to the diver with decreased awareness or consciousness.
Some individuals, no matter how much they sleep, continue to experience an irresistible need to sleep -- these persons are narcoleptics. People with narcolepsy can fall asleep while working, talking or driving a car. These "sleep attacks" can last from 30 seconds to more than 30 minutes. They may also experience periods of cataplexy, or loss of muscle tone, which ranges from a slight buckling at the knees to a complete, "rag doll" limpness throughout the body.
In the general population, narcolepsy happens to one in every 2,000 people. It can occur at any time throughout life, but it will most likely begin during the teen years. Although narcolepsy has been found to be hereditary, some environmental factors contribute. Narcolepsy is a disabling and underdiagnosed illness: for sufferers, the effects can be devastating.
Studies have shown that even treated patients are often significantly psychosocially impaired in the areas of work, leisure and interpersonal relations, and they are more prone to accidents. These effects are even more severe than the well-documented deleterious effects of epilepsy when similar criteria are used for comparison.
Symptoms include excessive sleepiness, a temporary decrease or loss of muscle control (sometimes associated with getting excited), vivid dreamlike images when drifting off to sleep and waking up unable to move or talk for a period of time.
Narcolepsy and Driving
Several states have imposed driving restrictions on people with narcolepsy. These restrictions usually entail a narcolepsy-free period of one year after starting treatment and no drug-related symptoms. Although these restrictions do not extend to scuba diving, some dive physicians believe such guidelines may be advisable.
Side effects from the drugs used to combat the sleepiness of narcolepsy constitute another concern. Medications used to treat narcolepsy include stimulants, anticataleptic compounds and hypnotic compounds, some of which have definite effects and side effects that are definitely adverse for scuba divers. Stimulants that increase the metabolic rate, as some narcolepsy-fighting medications do, can cause an increased risk of oxygen toxicity in divers using enriched air (nitrox). Any drug that affects the sense organs can also alter the decision-making process or increase risk-taking, and they are definitely adverse to divers.
Advice About Diving
The merits of each case, the drugs required, the response to medication and the length of time free of narcolepsy should determine each diver's fitness. How each diver copes with excitement, emotions and stressful situations are key considerations.
Any prospective diver should fully disclose this condition and any medications to the dive instructor and certifying agency. In addition, any prospective diver with narcolepsy should be mindful of the safety of buddies, dive instructors, divemasters and other individuals who can be affected by diving incidents. Divers with this condition who choose to dive might consider using a full face mask to decrease the risk of drowning in case of unconsciousness during a dive.
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