Falling to the floor when laughing

[Aneka]

There's a strange phenomena I've been dealing with since I've been a kid: When I laugh I completly lose control of my body movements and just slump down. I'm unable to control a muscle until my laughter dies down. Just today it happened again and I hit my head pretty hard. Anyone else who has experienced this? It's pretty annoying and a most effective way to incapicitate me. Just make laugh and you win

 

[Varzar]

So, when you ROFL, you literally ROFL...

 

[SDRSpark]

I can literally laugh myself into respiratory distress...I start wheezing and coughing.

Fortunately, it's short lived and has never been an actual problem requiring any sort of intervention.

 

[Pats]

That IS a strange phenomena. Is it when you're laughing hard, or just laughing at all?

 

[Aneka]

So, when you ROFL, you literally ROFL...

So, when you ROFL, you literally ROFL...

Quite literally

 

[Aneka]

That IS a strange phenomena. Is it when you're laughing hard, or just laughing at all?

When I'm laughing hard, like today, after bantering.

 

[Varzar]

Now I'm curious.. Are you safe if you're sitting? Or will you sort of slump down out of your chair?

 

[Aneka]

Now I'm curious.. Are you safe if you're sitting? Or will you sort of slump down out of your chair?

I tend to slouch over. Fortunately I haven't fallen out of a chair yet because of this. There are varying degrees: It often involves my neck or arms, sometimes also my legs or the whole body. When it's the whole body it fells like sleep paralysis (only that I'm fully conscious and don't have any hallucinations) I can't tell you how long it lasts, approximately several seconds to a minute. The more I move when it hits me, the worse the "paralysis" gets. So sitting down is pretty safe.

 

[Darwin]

Sounds like cataplexy to me. It is related to narcolepsy.
I think you should see a doctor. Head injuries are concerning. And there are medications and precautions that you should take for it.

 

[Aneka]

Sounds like cataplexy to me. It is related to narcolepsy.
I think you should see a doctor. Head injuries are concerning. And there are medications and precautions that you should take for it.

Is cataplexy always related to narcolepsy? Well it's only a small bump and I don't feel sick or dizzy. Seeing a doctor right now is impossible, you know, corona. I could only phone my doctor and it's not an emergency.

 

[Darwin]

Is cataplexy always related to narcolepsy? Well it's only a small bump and I don't feel sick or dizzy. Seeing a doctor right now is impossible, you know, corona. I could only phone my doctor and it's not an emergency.

It may be. I think mentioning that you hit your head alone would qualify it as cataplexy. You said something about sleep paralysis. I think that’s related, too.

It doesn’t matter if you have narcolepsy or not. The medications would be to help you not to fall and injure yourself. If you can control it without medications, that’s great.
But you really need to take it seriously. If a head trauma causes an internal bleeding, well, that can be ... very bad. I don’t want to freak you out, but that’s true.

 

[Varzar]

It may be. I think mentioning that you hit your head alone would qualify it as cataplexy. You said something about sleep paralysis. I think that’s related, too.

It doesn’t matter if you have narcolepsy or not. The medications would be to help you not to fall and injure yourself. If you can control it without medications, that’s great.
But you really need to take it seriously. If a head injury causes an internal bleeding, well, that can be ... very bad. I don’t want to freak you out, but that’s true.

I agree.. As much as I was making light of it/joking about it, Darwin's absolutely right. At some point you might laugh, and fall in a way where you just hit your head on the wrong thing in the wrong way, and that could end up being very bad.

Nobody wants to see you get hurt.
I'm glad Darwin knew something about what this might be!
I've never heard of such a thing before..

 

[Manidomakwakwe Ma'iingan]

Is cataplexy always related to narcolepsy? Well it's only a small bump and I don't feel sick or dizzy. Seeing a doctor right now is impossible, you know, corona. I could only phone my doctor and it's not an emergency.

What you are describing sounds like textbook catalepsy, which as far as I know is pretty strongly correlated with type one narcolepsy. Other symptoms of type 1 N would be feeling excessively tired, having episodes of autonomic behaviour (doing things on auto pilot) or micro sleeps (these look similar to absence seizures) in the day, and sleep paralysis, which could happen with or without hallucinations. You might also experience periods of insomnia or difficulty staying asleep, basically because your brain is having a harder time regulating your sleep cycle. Symptoms often develop over time, differently for different people, so if you aren't having all the symptoms now, that doesn't mean you won't develop them in the future.

It might be a good idea to call your doctor and let them know what is happening, just so that they can be informed. Narcolepsy is suspected to be an auto immune disorder, and for some people it can progress to be quite disabling. Getting an appointment for a sleep lab is clearly off the table for the time being, and it can take a long time to get properly diagnosed to begin with. So the sooner you can start the process the better, but it also isn't something you need immediate care for unless you are really worried about hitting your head. It's your call if this is something you want to pursue now, or wait until after the pandemic, but I would recommend looking into it when you can.

Things you can do to manage N in the meantime:
-keep a journal of when you have catalplexsy or sleep episodes, cataplexiy is often triggered by strong emotions, which is why many people experience it when laughing. Other emotions than laughter, or environmental stimulus, can also be triggers. Knowing your triggers can help you predict when an attack might happen and avoid injury.
-take afternoon naps. These are often refreshing for people with type 1 N and reduce symptoms for a short time after waking up. This is less helpful for type 2 N.
-avoid sugar and eat a high protein diet (the research on this is very preliminary, and more research with larger sample sizes are needed to verify, but there have been some small scale studies that suggest dietary changes might help with managing N)
-talk to the people around you, some symptoms can make it appear like you are drunk, or can look like seizure activity, and that can prompt people to react in unpredictable ways. It can be better if they know what's going on so that they are less likely to get mad at you for "being drunk", or panic. They might also be able to help you if you are concerned about the risk of injury or the risk of having episodes while driving.
-If you have sleep paralysis or false awakenings getting up and walking around the room before going back to sleep can help prevent you from going immediately back into the cycle.
-a low dose of an SSRI or St. John's wort can help reduce the REM sleep intrusions that cause cataplexy, but this is something you should definitely talk to your doctor about because of the potential for side effects and interactions. Also if you are on an SSRI or St. John's wort you will need to stop your medication for at least several weeks before going in for a sleep lab because it will interfere with lab results.

I hope some of this is helpful. Narcolepsy can be difficult to deal with when you don't quite know what's going on, and what to expect. I hope you are able to manage during this outbreak, and that this isn't causing too much additional stress, and that you get answers when you are able to go in to the doctor.

 

[Aneka]

What you are describing sounds like textbook catalepsy, which as far as I know is pretty strongly correlated with type one narcolepsy. Other symptoms of type 1 N would be feeling excessively tired, having episodes of autonomic behaviour (doing things on auto pilot) or micro sleeps (these look similar to absence seizures) in the day, and sleep paralysis, which could happen with or without hallucinations. You might also experience periods of insomnia or difficulty staying asleep, basically because your brain is having a harder time regulating your sleep cycle. Symptoms often develop over time, differently for different people, so if you aren't having all the symptoms now, that doesn't mean you won't develop them in the future.

It might be a good idea to call your doctor and let them know what is happening, just so that they can be informed. Narcolepsy is suspected to be an auto immune disorder, and for some people it can progress to be quite disabling. Getting an appointment for a sleep lab is clearly off the table for the time being, and it can take a long time to get properly diagnosed to begin with. So the sooner you can start the process the better, but it also isn't something you need immediate care for unless you are really worried about hitting your head. It's your call if this is something you want to pursue now, or wait until after the pandemic, but I would recommend looking into it when you can.

Things you can do to manage N in the meantime:
-keep a journal of when you have catalplexsy or sleep episodes, cataplexiy is often triggered by strong emotions, which is why many people experience it when laughing. Other emotions than laughter, or environmental stimulus, can also be triggers. Knowing your triggers can help you predict when an attack might happen and avoid injury.
-take afternoon naps. These are often refreshing for people with type 1 N and reduce symptoms for a short time after waking up. This is less helpful for type 2 N.
-avoid sugar and eat a high protein diet (the research on this is very preliminary, and more research with larger sample sizes are needed to verify, but there have been some small scale studies that suggest dietary changes might help with managing N)
-talk to the people around you, some symptoms can make it appear like you are drunk, or can look like seizure activity, and that can prompt people to react in unpredictable ways. It can be better if they know what's going on so that they are less likely to get mad at you for "being drunk", or panic. They might also be able to help you if you are concerned about the risk of injury or the risk of having episodes while driving.
-If you have sleep paralysis or false awakenings getting up and walking around the room before going back to sleep can help prevent you from going immediately back into the cycle.
-a low dose of an SSRI or St. John's wort can help reduce the REM sleep intrusions that cause cataplexy, but this is something you should definitely talk to your doctor about because of the potential for side effects and interactions. Also if you are on an SSRI or St. John's wort you will need to stop your medication for at least several weeks before going in for a sleep lab because it will interfere with lab results.

I hope some of this is helpful. Narcolepsy can be difficult to deal with when you don't quite know what's going on, and what to expect. I hope you are able to manage during this outbreak, and that this isn't causing too much additional stress, and that you get answers when you are able to go in to the doctor.

Thank you this is very informative and helpful Are you a professional or suffer from it yourself?

 

[Manidomakwakwe Ma'iingan]

Thank you this is very informative and helpful Are you a professional or suffer from it yourself?

I'm not a professional, I'm a medical anthropologist, so not a doctor. But I've done quite a bit of reading on narcolepsy in the process of trying to figure out my own sleep issues. My official dx is idiopathic hypersomnia, but that's basically a catch all label because my sleep labs came back inconclusive. I had sensory issues with all the wires and didn't sleep. I also don't think I was off of caffeine and my meds for long enough before hand. They recommended for me to be off of them for two weeks, but some of the sources I've read suggest going off meds even earlier before the lab. My symptoms are more consistent with type two narcolepsy. I don't have pronounced cataplexy, but I do have micro-sleeps, autonomic behaviour, and sleep paralysis. Being in diagnostic limbo led me to start researching, and my Autism did the rest.