Secondary Service Connection For Narcolepsy
Narcolepsy may be brought on by both physical or emotional stress. If you had an injury or psychiatric disorder during your time in the service, then you can file for more than one condition. A secondary service connection is essentially a disorder that was directly caused by a primary condition that VA recognizes as service-connected.
So lets say that you broke your leg after slipping and falling during a routine transit stop. The leg heals, but you still suffer from inflammation long after the cast comes off. Over time, chronic pain begins to build and interfere with the quality of the sleep and your levels of hypocretin. While the primary service connection would be the chronic pain from the injury, the secondary condition could be narcolepsy.
The disability rating system from the VA allows you to file for more than one condition, so long as the point of connection is clear. If you choose to file as a secondary condition, youll need to submit a diagnosis from your doctor, as well as an official medical explanation about how your narcolepsy is related to the primary event. You can obtain this explanation by talking to your doctor and thoroughly explaining the events.
Is Sleep Apnea Considered A Disability By The Ada
sleep apneaADA’sdisabilitysleep apneaADA
. Also to know is, is sleep apnea a disability under the ADA?
The Mayo Clinic’s website defines sleep apnea as a potentially serious sleep disorder in which breathing repeatedly stops and starts. If a disabilityunder the ADA is a physical or mental impairment that substantially limits one or more major life activities, what major life activity does sleep apnea impair?
Also Know, can you be fired for sleep apnea? An employer may be justified in dismissing an employee where the nature of the illness, such as OSA, means that the continued employment of the employee could pose a risk to themselves, their colleagues or, where appropriate, the employer’s customers or clients.
Consequently, is Narcolepsy considered a disability under ADA?
Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. Therefore, the court said, the narcolepsy substantially limited a major life activity this qualified the condition as a disability under the ADA.
Can you be signed off work with sleep apnea?
Borge Sivertsen of the University of Bergen, found that workers with OSA symptoms were more likely to need long-term sick leave or go on work disability, even with other factors – such as lifestyle habits and other medical conditions taken into account.
Why An Accurate Narcolepsy Diagnosis Is So Important
Kids with narcolepsy can go to school just like their peers, according to sleep-medicine specialist Richard Castriotta, MD, a professor of clinical medicine at the University of Southern California Keck School of Medicine in Los Angeles. The biggest hurdle is making sure students are diagnosed properly, he says, and many physicians are not trained to pick up on the sleep disorder.
Sometimes are diagnosed as having ADD or ADHD , or are not diagnosed with anything at all, or people think they are lazy because they are always sleepy, Dr. Castriotta says.
Getting an accurate narcolepsy diagnosis requires going to a sleep lab and undergoing a round of tests, according to Castriotta. But there are a few warning signs to look for in your student.
Watch out for sleep attacks, which is a sudden bout of overwhelming sleepiness that comes on quickly, regardless of how much the child has slept.
Having hallucinations right as they fall asleep or wake up is another symptom of narcolepsy, as is cataplexy, says Sudha Tallavajhula, MD, an associate professor of neurology at McGovern Medical School at The University of Texas Health Science Center and the medical director of the Neurological Sleep Medicine Center at TIRR Memorial Hermann in Houston.
If you see these symptoms in your child, you should have them evaluated by a sleep medicine specialist.
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Counseling And Support Groups
Its very common for those with narcolepsy to suffer from depression. Many symptoms of narcolepsyparticularly sleep attacks and cataplexycan cause great embarrassment and wreak havoc on your ability to live a normal life. These episodes can be frightening, and you may become depressed because of the sudden lack of control.
Fear of falling asleep or collapsing suddenly can also lead some people to become reclusive and withdrawn. Reaching out to a psychologist, counselor, or support group can help you cope with the effects of the disorder.
Reaching out may seem overwhelming at first, but being with others who face the same problems can help reduce your sense of isolation and remove any stigma you may feel. It can also be inspiring to share experiences and learn how others have coped with their symptoms. For help finding a therapist or support group, see below.
Affordable Online Therapy for Sleep Problems
Get professional help from BetterHelps network of licensed therapists.
Excessive Daytime Sleepiness And Related Phenomena
EDS is a core symptom of narcolepsy. In essence, it refers to the inability to stay awake and alert during the major waking episodes of the day, resulting in periods of irrepressible need for sleep or unintended lapses into sleep. In ICSD-3, the term hypersomnolence is used.18 Although this can sometimes be surprisingly difficult, EDS should be distinguished from fatigue, which in fact can be regarded as a separate symptom often occurring in narcolepsy .
EDS is usually the presenting symptom of narcolepsy both in children and adults, although this may often only be recognized later, when other symptoms prompted a formal diagnosis. When sleepiness is experienced in active conditions , its pathological nature is more easily identified. However, patients experience drowsiness predominantly during passive conditions, such as sitting in a classroom or being a passenger in a vehicle, and this may sometimes be regarded as a bothersome, but normal phenomenon by bystanders, attributing it to sleep deprivation or laziness. Daytime sleep episodes in narcolepsy are characteristically but not invariably relatively short and are typically perceived as temporarily refreshing. These may all be clinical leads to distinguish narcolepsy from other disorders of hypersomnolence such as idiopathic hypersomnia.25
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What Treatments Are Available
Although there is no cure for narcolepsy, some of the symptoms can be treated with medicines and lifestyle changes. When cataplexy is present, the loss of hypocretin is believed to be irreversible and lifelong. Excessive daytime sleepiness and cataplexy can be controlled in most individuals with medications.
Medications
Tips On Applying For Disability Benefits With Narcolepsy
Narcolepsy is a sleep disorder that results in severe drowsiness and fatigue during the day and being prone to fall asleep at any time. This disorder is extremely unpredictable and can be dangerous. There is no cure, but treatments such as medication and scheduled naps can reduce some of its effects.
Medical Evidence
The Social Security Administration does not recognize narcolepsy as a medical condition that automatically qualifies you for disability benefits. Therefore, you must provide a Residual Functional Capacity assessment that provides evidence of your disorder and how it affects your ability to work.
Including certain medical evidence on your RFC may be helpful in proving that you qualify as disabled due to your narcolepsy. This evidence should include results from any sleep studies or tests on your brain, as well as tests based on your familys medical history of sleep disorders. It is also helpful to keep a sleep journal that details your sleep pattern due to narcolepsy. Providing the SSA with medical evidence of any doctors appointments, treatments, and diagnosis of your narcolepsy will also be helpful in proving your case for disability benefits.
Non-Medical Evidence
A complete and thorough RFC will help in proving to the SSA that your narcolepsy makes it unable for you to work.
Also, narcolepsy usually causes extreme drowsiness, which could make jobs that involve the use of heavy machinery or any safety equipment extremely dangerous for a narcoleptic person.
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Types Of Sleep Disorders
Insomnia
Insomnia is the most common sleep disorder. Insomnia affects nearly 60 percent of adults at least one night each week. Common symptoms of insomnia include trouble going to sleep and waking before it is time to wake up. Many factors contribute to insomnia, which includes stress and other underlying medical conditions. Typical medical treatment of insomnia includes sleeping pills and behavior therapy. Practicing good sleep habits, such as going to bed at the same time each night, can often be effective for treating mild cases of insomnia.
Sleep Apnea
Sleep apnea is the second most common sleep disorder. Sleep apnea affects approximately 20 million Americans each year. As stated above, this disorder causes people to stop breathing suddenly while they are asleep. During this brief period where the individual is not breathing, carbon dioxide builds up in the blood and the sleeper wakes up suddenly to gasp for breath. The length of time that the individual stops breathing may vary from a few seconds to so long that the individuals skin actually turns blue from the lack of oxygen.
Narcolepsy
In addition to sleepiness, narcolepsy may be accompanied by cataplexy, which involves the sudden loss of muscle tone and control. Cataplexy events can last from several seconds to several minutes. Other symptoms include hallucinations and paralysis during ones sleep.
Sleepwalking and Night Terrors
Chronic Cor Pulmonate
Organic Mental Disorders
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder is characterized by symptoms of inattention, impulsivity and hyperactivity . Many clinicians perceive ADHD to be the antithesis of narcolepsy however, there is a significant clinical similarity. Historically, there has even been the suggestion for various overlap syndromes, such as Syndrome Z and Primary Disorder of Vigilance, which were defined by a combination of narcolepsy and ADHD symptoms .
Recently, there is increasing evidence that sleep dysfunction is intimately related to the development of attention deficit hyperactivity disorder . Restricted, dysfunctional, or fragmented sleep may precipitate ADHD features . On the other hand, problems with sleep may represent an intrinsic component of ADHD . Individuals with ADHD have an increased association with restless legs syndrome/periodic limb movements in sleep , obstructive sleep apnea/snoring, rhythmic movement disorder , and parasomnias . The presence of ADHD symptoms in children and adolescents with narcolepsy were found to be about two-fold higher than in controls . Retrospectively, adults with narcolepsy had been found to have a much greater likelihood of having a diagnosis of ADHD in childhood compared to controls .
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Sleep Paralysis In Children
Sleep paralysis seems to be less frequently reported by children compared to adults. Its occurrence gradually increases with age.72,73 Similar to hallucinations, verbalizing the inability to move and distinguish the transitional conditions between REM sleep and wakefulness can be quite difficult and stressful for young narcolepsy patients and might lead to underestimation. Anxiety when going to bed could be a potential signal for the presence of sleep paralysis and warrants further exploration.
Behavioral Approaches To Treatment
Behavioral approaches are non-medical forms of therapy, and there are multiple ways that they can be incorporated into the daily habits of people with narcolepsy.
- Planning short naps: Because brief naps are refreshing for people with narcolepsy, budgeting time for naps during the day can reduce EDS. Accommodations at school or work may be necessary to make time for naps.
- Having healthy sleep hygiene: To combat poor sleep at night, people with narcolepsy can benefit from good sleep habits. Good sleep hygiene includes a consistent sleep schedule , a sleep environment with minimal distractions and disruptions, and limited use of electronic devices before bed.
- Avoiding alcohol and other sedatives: Any substance that contributes to sleepiness may worsen daytime narcolepsy symptoms.
- Driving with caution: People with narcolepsy should talk with the doctor about safe driving. Napping before driving and avoiding long or monotonous drives are examples of measures to improve safety.
- Eating a balanced diet: People with narcolepsy have a higher risk of obesity, which makes eating well an important part of their overall health.
- Exercising: Being active can help prevent obesity and may contribute to improved sleep at night.
- Seeking support: Support groups and mental health professionals can promote emotional health and counteract the risks of social withdrawal, depression, and anxiety in people with narcolepsy.
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Is Hypersomnia The Same As Narcolepsy
Both conditions involve excessive daytime sleepiness, but narcolepsy takes sleepiness to a new level. It causes sudden and uncontrollable episodes of sleep, often at inconvenient times. People with narcolepsy also have greater nighttime sleep disturbance than those with hypersomnia, resulting in reduced sleep quality.
Drug Treatments For Sleepiness
Modafinil
Modafinil is a drug used to treat the excessive sleepiness associated with narcolepsy and other sleep disorders. It has largely replaced methylphenidate and other stimulants for treatment of narcolepsy sleepiness. People who switch to modafinil from stimulants such as methylphenidate have few problems if they gradually taper off the stimulant dose.
Dosage for adults ranges from 100 to 200 mg/day, usually taken once in the morning. Doses up to 400 mg/day may be used in some situations.
Modafinil helps people with narcolepsy stay awake during the day. While only some experience normal wake times, patients taking modafinil often have up to a 50% improvement in the ability to stay awake, as well as a 25% reduction in the number of involuntary sleep episodes. Modafinil is not recommended in pregnant women. Pregnant women or those wishing to get pregnant should discuss the risks and benefits of this medication with their doctors.
Some of modafinil’s additional benefits include what it does not do:
Side effects of modafinil may include:
- Headache .
- Nausea.
- Back pain
- Difficulty sleeping.
- Modafinil is approved only for adults and should not be given to children.
Armodafinil is a newer drug, which is nearly identical to modafinil. In clinical trials comparing it with placebo, armodafinil improved wakefulness, memory, attention, and fatigue in people with narcolepsy.
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How Can I Help Research
The NINDS supports the NIH NeuroBioBank, a national resource for investigators using human post-mortem brain tissue and related biospecimens for their research to understand conditions of the nervous system. The NeuroBioBank serves as a central point of access to collections that span neurological, neuropsychiatric, and neurodevelopmental diseases and disorders. Tissue from individuals with narcolepsy is needed to enable scientists to study this disorder more intensely. Participating groups include brain and tissue repositories, researchers, NIH program staff, information technology experts, disease advocacy groups, and, most importantly, individuals seeking information about opportunities to donate. More information about NeuroBioBank and opportunities to donate tissue is available at .
Additionally, the NINDS supports genetic and immunological research in narcolepsy at Stanford University. Blood samples from individuals with narcolepsy can be sent by mail and are needed to enable scientists to study this disorder more intensely. Prospective donors may contact:
Stanford University Center for Narcolepsy450 Broadway Street
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
Qualifying Under A Medical
If the SSA determines that your narcolepsy is not equal to the epilepsy listing, or another listed impairment, it doesn’t necessarily mean your claim will be denied. The SSA has one more step it will go through to determine whether or not you are disabled for purposes of SSI or SSDI.
The SSA will look at all of the evidence in your file, which includes medical evidence and non-medical evidence, such as statements from you, your family and friends, therapists, and so on, to assess your residual functional capacity, or “RFC.” Your RFC dictates what type of work you can do and what your limitations are.
If you have narcolepsy, your RFC assessment will almost certainly be limited at the very least to: no work where you need to drive no work involving heavy or dangerous machinery and no work in high, unstable, or otherwise unsafe places.
If the SSA decides that, based on the severity of your narcoleptic symptoms and the work restrictions you need to keep yourself and others safe, there is no job you can perform, you will be eligible for disability under a “medical-vocational allowance.”
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Fragmented Nighttime Sleep In Children
Although studies in pediatric populations are limited, fragmented nighttime sleep is also a distinct sleep pathology found in young narcolepsy patients.52 A recent survey study by Ingram, showed fragmented nighttime sleep in fact to be the second most common and problematic complaint in narcolepsy as rated by young patients and their parents.56 In children, fragmented nighttime sleep may even be more underestimated given the tendency to contribute an unstable nighttime sleep to common behavioral sleep problems of childhood.
How Can I Better Live My Day
Here are some tips:
Driving: Driving can be dangerous if you have narcolepsy. People with narcolepsy have a greater risk for motor vehicle accidents. Ask your doctor if it safe for you to drive.
Some safety tips if you drive include:
- Take a short nap before you drive.
- Drive for only short stretches of time. Stop, get out of your vehicle, walk around and/or stretch and consider taking a short nap before continuing to drive.
- Keep yourself engaged while driving. Sing to the music, talk with others in the car or better yet, let them drive if possible.
- Find out about car pool options or consider Uber or Lyft or other driver services.
Work: If you are working, you may want to look into the American with Disabilities Act. This law requires employers to provide reasonable work provisions for employees with disabilities. Your employer may allow you to adjust your work schedule or take brief rest breaks during the work day.
Support: Ask your doctor about local support groups . Support group allow you to meet and share experiences and solutions to common issues and concerns all group members have about narcolepsy. Share your thoughts and feelings with family and friends too. Tell them how they might be able to help you .
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