Nursing prof gives hope to the perpetually sleepy

Imagine yourself driving a car, waiting for the streetlight to change and drifting spontaneously into a deep sleep. It may sound comical to some, but to those who suffer from narcolepsy, it's a nightmare waiting to happen. Enter Nursing Professor Ann Rogers, a newcomer to Penn who came here from the University of Michigan in January -- a board-certified expert in sleep disorders who is among about 20 other sleep researchers here at Penn. "[Narcolepsy] is a physical problem related to the neurotransmitters, which are chemical signals, in the brainstem," Rogers said. "Its onset is usually in the late teens and it's lifelong." Rogers emphasized that there is plenty of hope for those stricken with the disorder. According to Rogers, narcolepsy is "a treatable illness? treated with stimulants such as amphetamines and ritalin. [The patients] don't get high, they simply attain normal wakefulness." "My research is focused on treatment efficacy," says Rogers. "We don't know much about how to manage treatment." In her research, Rogers has used a device that is about the size of a Walkman, known as "ambulatory recording" equipment, that monitors the 24-hour sleep-wake pattern of a subject. Rogers maintains that while on stimulants 40 percent of her subjects were able to stay awake all day and attain normal sleep patterns. Rogers has also studied patient use of medication by using a special pill bottle that contains a computer chip. By detecting when the cap is removed, the chip records the frequency and interval between doses. Currently, she is involved in an examination of the difference between those who respond to stimulant medications and those who do not. For Rogers, the greatest obstacle to research that "it's not a real common disease.? [Only] about one out of every 100,000 people suffer from it." Another complication to narcolepsy research is its common confusion with another disorder called obstructive sleep apnea, which causes the patient to stop breathing during periods of deep sleep. Although it usually does not lead to suffocation, the patient often experiences several restless nights. The lack of sleep leads to excessive daytime sleepiness, the main symptom of narcolepsy. Still, Rogers is optimistic about the future of narcoleptic patients. She is especially excited about the release of a new drug, made by the pharmaceutical company Cephalon, based in West Chester, Pa., known as Provigil. Provigil, which often bears the name Monafinil, was first marketed in France over 10 years ago and is the first daytime sleepiness combatant to be approved by the Food and Drug Administration since the 1960s. The new drug will offer physicians another option for fighting daytime sleepiness. Since patients react differently to each treatment, it is possible that an increasing number of narcolepsy patients could lead normal, wakeful lives.