Miss World 2008

• ksenya sukhinova from russia on december 13th, 2008 after being a crowned miss world.
• she beaten other 108 international beauties in the glittering african vaganza.

First Pilot With No Arms

• Jessica cox thoughts was "Nothing is possible".
  
• This confidence is makes her great achiever.
• Now she has a no-restrictions drive license.
• she is great psychology achiever,because she can write, type,drive a car & etc in individually.
• So dont depress yourself. Be 'confident & achieve more'

Loving couple

10 habits of loving couple

1. Say "I Love You" at least once a day. Your partner does need to hear the words.

2. Kiss good-bye & hello. Throw in a hug while you're at it.

3. "Date" your partner for the rest of your lives. Treat your partner even better than when you were dating... Remember that you are sweethearts:
open her door

straighten his tie

hold out her chair

hold hands when you're walking together

4. Don't sweat the small stuff. You can let his/her bad habits bother you to distraction. .. or you can accept them, and work around them. Does she leave the cap off the toothpaste? Buy separate tubes... Does he leave clothes laying around? Ignore them, or pick them up, remembering just how much he does for you in other ways. Or, make it easier

for your partner to satisfy you... buy several clothes hampers and keep them handy.

5. Concentrate on the positive. Instead of thinking about the ways that s/he lets you down, think of all the positive things about your partner that drew you to them in the first place.

6. Take a breather when you're mad. Don't try to talk when either of you are angry. Take a few minutes to walk around the block, lay down, just get away from each other so you can regroup. A short break will allow you both to stay on track and discuss what's bothering you instead of accidentally making personal insults that you will regret later.

7. Don't use your partner's secrets or weaknesses against them... ever! What may seem insignificant, trivial, or cute to you may be serious to your partner. Recognize what is important to your partner, and don't discuss it with your friends, mother, his family, anyone! And certainly don't throw the words back at them in an argument. A loving relationship is one of the most intimate and trusting that anyone can have.

8. Think about your partner first. If both of you do this, then you can't help but win! Say "yes" to your partner as often as possible... go to that sports event with him, get him out on that golf course because he loves golf, make life easier for your partner, and hopefully they will do the same for you!

9. R-E-S-P-E-C- T your partner. Don't badmouth your partner to anyone! When you talk about your partner, let your respect and love shine through.

10. Find a way to regroup together every day. Discover what works well for you both... eat a

meal together, meet for happy hour drinks, skip Leno at night and just lay in bed in the dark, take a walk around the block, etc. You can even mix things up and vary your routine. If one of you is traveling, call home at night just to hear their voice. The point is to spend time together daily, just talking or breathing the same air, feeling connected.

Instant colour foil - German product

• German foil wrapping technology introducing a newly foil coating gives your car as new look while keeping the old one.
• The German high- end product ensure the same optical appearance and surface structure like a regular paint finish.
• care and cleaning also identical one.
• The foils density grantees 100% opacity and actually shields the paints against the chips,abrasions and weathering to preserve your car's sale value.
  

2009 prototype car of Lamborghini

1. This one is the 2009 plan to release of Lamborghini, named as Lamborghini Gallardo LP560-4.
2. Lamborghini Gallardo LP560-4 ($TBA) crams in a 5.2 lit V-10 Engine delivers 560 horsepower.
3. Newly installed front and rear fascias.
4. They also do some improvement in suspension, fuel consumption and CO2 emissions.
5. some outer goodies are Bi-Xenon headlights for night driving and LED day time running lights.
   

BMW M1 - Rarest Models

1. This Car is produced by German Automaker BMW from 1978 to 1981.
2. In 1970's Lamborghini agreement with BMW to built a racing car,from this result 1978 to 1981, as BMW M1.
3. This is one of highest mass production car in 1970's.
4. Employed a twin cam M88/1 3.5 L 6-cylinder gasoline engine with kugelfischer Injection.
5. The body was Designed by Giugiaro,taking inspiration from the 1972 BMW Turbo show car.
6. BMW commissioned Lamborghini to work out the details of the car's chassis , assemble prototype and manufacturing the vehicle,but Lamborghini's financial position meant that BMW reassumed control over the project in April 1978.
   
7. Then only 456 car produced,making it one of the BMW rarest models.
8. From this spirit M1 lived in first generation M5 ,as both models shared the same engine till now.
9. Then M1 is the most successful in the motor sports in 1970's of magazine.

Dreams come true - M Riderknecht (SQuba)

SQuba is the world's first real submersible car(move like a fish underwater).
Frank M Rinderknecht, 52 yrs old Auto visionary and Boss of the swiss automaker Rinspeed, has turned a dream into reality with his "SQuba"
Drive upto 32.8feet below the surface of the water, and its move 1.8miles per hour.
Its is electric car with lithium-ion batteries and three electric motor for propulsion
Especilay its a ZERO EMISSION CAR documented by rotating license plate in the rear. So NO EXHAUST EMISSION produce.

The first car that could drive in underwater was Quandt's Amphibicar, built in 1968.
Then Gibbs technology came up with Gibbs Aquada in 2004 which Virgin boss Richard Branson used to break the speed record for crossing the English channel.
SQuba "relies on the stainless steel -cover suspension from KW automotive and large pirelli tires mounted on the custom-made forged light weight wheel from AEZ with 17- and 18-inch diameter".

Performance
Top speed --120 km/h
Acceleration-- 0-80 km/h in 7.1 sec
Water speed --6 km/h
Under water --speed 3 km/h
Drive Depth --10m

Engine
In Street --Electric
Power Output -- max 54kW at 4'500 /min
Torque --160 NM at 1'500 / min
In Water --Stem Propellers Electric
Power Output --2*800 W
Driving -- bow jet Drives Electric
Power Output --2*3.6 kW Rotinor
Batteries --Lithium-Ionen
Voltage --6*48 Volt

Measurements
Length --3'785mm
Width --11"940mm
Height --1'117mm
Empty --Weight approx 920kg
Ground clearance --130mm

Propulsion
Power train --Rear wheel drive
Gear Box --R-N-F
Chassis --Steel
Body Panels --Carbon Nano Tubes
Seating Capacity --2nos
Front & Rear suspension --Double wishbones
Damper /spring ---KW automotive
Steering --Rack and pinion
Lubricant --Motorex
Laser Scanner --lbeo
Tyres --Pirelli P zero (Front - 205/40 R17)(Rear - 225/40 R18)
Front Wheel --AEZ 7.5*17'
Rear Wheel --AEZ 8*18'
Air supply --1*15lit + 1*18lit SQuba pro

MIVEC Engine

MIVEC - Mitsubishi Innovative Valve timing Electronic Control system

Installed in
Mitsubishi OUTLANDER Sports Utility Vehicle (SUV),
US Lancer RalliArt,
TOYATO Innova,
Repowered with 1400 cc 100 hp 4cyl Suzuki Swift engine.

The new engine is one of the results of the World Engine project conducted by Mitsubishi
Motors Corporation (MMC), DaimlerChrysler Corporation, and Hyundai Motor Company.

For high quality and reliability
MMC adopted rigorous development process by Mitsubishi MotorsDevelopment System (MMDS)

Its indicate

High output and low fuel consumption
Lightness and compactness
Low exhaust emissions
Low vibration and noise

How INTER-PERSONAL COMMUNICATION SKILLS to Improve??

INTER-PERSONAL COMMUNICATION SKILLS consists of a set of skills, knowledge about communication, and self-evaluation. This skills include self-disclosure, owned feelings and thoughts, and descriptiveness and support.


Whenever we communicate we always do the following two things simultaneously:

1.Representation - We represent some information. We make some statement about the world around us.

2.Presentation - We present the information in a particular way, which will then define our relationship with the other person in a particular way.

Several skills are required to communicate effective.

Refer to the person you are talking to by name. People are complimented when they know that you are making the conversation personal. Making it personal also means making your message appropriate to the receiver's frame of reference. For example, the same message may be explained differently to your friend than to a boss or coworker.

Make your messages specific and complete. When speaking, include all of the necessary information the receiver needs to comprehend your message. You need to communicate the frame of reference you are using, the assumptions you are making, the intentions you have, and the leaps in thinking you are making. Repeating your message more than once and using more than one means of interpersonal communication, such as pictures and nonverbal cues, will help the receiver understand you.

HoW to PrEfeR yoUr jObs bAseD onYouR Degree ??

What jobs suit me?
Ask yourself what is really important to you and what you are willing to do. Everyone has unique motivations and ambitions. Yours may be different from people you know. Writing your ideas down or having conversations may help you capture your thoughts.

Help making decisions
Try what jobs would suit me?, a tool designed to assist you with the decision-making process. After answering a series of questions, see, which jobs might best, match your preferences. Compare two jobs side-by-side or start by considering an employment sector. Your friends and family may help you identify the key deciding factors for your career planning and may point out strengths that you take for granted. Your university careers service has a wealth of resources to support career research and planning. As well as talking to a careers adviser, you may gain insights from psychometric tests, which focus on aptitude, ability, or personality. Ask which psychometric tests are available or have a look at psychometric tests.

What do different jobs entail?
Learning what people actually do on a day-to-day basis is a crucial step in your job search. Understanding jobs is the best way to ensure you make the right decision for you. It is also essential for writing strong applications, which persuade a company or organization that you are a good fit for the job. Get more details about jobs you are considering at explore types of jobs. Be sure to read the case studies. Alternatively, you may start your job search by looking at all the related jobs in a sector at explore job sectors.

How do I use my degree?
You may want to directly apply your subject-related knowledge and skills to the world of work. Ask your university careers service for the results of previous surveys, which may provide some insight into what people with your degree have gone on to do. Visit what do graduates do? to view national survey results of what students on your course have pursued. Also, find out about options with your degree by looking at options with your subject.

Small tips - APPEARANCE & APPROCH in the interview

1.Strengthen Your Voice

2. Speak Slower

3. Enunciate and Use Volume

4. Good Eye Contact

Nail Biting

Ta-dum. Yes, it often begins with boredom. Or impatience. Or fidgeting. Then a nibble. And the next thing you know, your fingernails look like the Mad Nail Nibbler went on a binge.

If you are among the millions who regularly bite their nails, you know the Mad Nail Nibbler all too well. And you've probably said to yourself (how many times?) "I wish I'd stop biting my nails!"

Anyone can be a nail biter--and it often begins in childhood. Forty to 50 percent of all children regularly pick and chew their nails and cuticles, though many of them manage to kick the habit by the time they get to be adults. But nail biting can also get started in adulthood--sometime s out of the blue.

"While nail biting in some people may be a nervous reaction to stress, those who engage in it generally are not nervous individuals, " according to R. Gregory Nunn, Ph.D., a clinical psychologist and president of R. G. Nunn and Associates, a private clinic in San Diego. "Nail biting is a learned behavior that usually results from factors that have nothing to do with stress. Ironically, one of the most common causes is the physical condition of the nails."

"If the nails become irregular or damaged, it promotes attempts to try to smooth them, and biting is one such means," says Nathan H. Azrin, Ph.D., professor in the Department of Psychology at Nova University in Fort Lauderdale, Florida. "But biting just worsens the condition of the nails and encourages further biting."

How, then, do you resist this urge to indulge in a five-finger feeding frenzy? Just sink your teeth into these proven tips.

First, pretend to bite your nails. That's right. And do it in slow motion in front of a mirror, so you can actually see all the movements that are involved.

"Most nail biters begin by running their thumb along the nails' edges, feeling for irregularities, before bringing the hand to the mouth," explains Dr. Azrin. "We want them to identify the initial parts of the movement. It's much easier to interrupt it at the initial stage than to wait until the finger is nearly in the mouth." Other signals: rubbing your face or cupping your hands just before you bite.

Keep a daily record. Build up your awareness by noting when nail biting occurs--that is, how often, when, where and with whom. Your goal is to identify all the situations in which you are more likely to engage in the habit, then consciously remind yourself not to bite your nails in those situations as you enter them.

Grip, grab and clench. You can't bite your nails if your hands are involved in other activities. So if you realize you're getting the urge to bite, immediately do something else with your hands. If you're sitting on a sofa, for instance, grab the armrest. If you're reading, hold the book firmly. And if you're in a meeting, gently grab your knee. Just hold on for a couple of minutes and the urge will pass.

File your nails daily. "Keep your nails well trimmed and short, especially for the first few weeks," says Trisha Webster, a hand model with the Wilhelmina Modeling Agency in New York City. "Use an emery board instead of a metal file or scissors--it is gentler and won't weaken your nails."

She recommends filing your nails into a rounded or oval shape. "If you file your nails straight across," she warns, "they will have two sharp points that are tempting to bite."

Baby them. "Soak or massage your nails with baby oil, olive oil, vitamin E oil or a gentle dish detergent at least twice a day to replenish lost moisture, stimulate growth and prevent cracking and chipping," says New York City skin care specialist Lia Schorr, author of Lia Schorr's Seasonal Skin Care. "Also, use a moisturizing hand lotion several times a day to keep the skin around the nails healthy and attractive."

Make your nails less tasty. Schorr and Webster both suggest coating your fingers with hot pepper or lemon juice: Any nontoxic, bitter substance will make you think twice about putting your fingers near your mouth. But make sure you also keep your hands away from your eyes.

Go undercover. When you're at home, suggests Schorr, try wearing some light cotton gloves. They're surefire protection against nail biting.

Dress up your digits. Once the appearance of your nails has improved, don't hide them--show them off! Dr. Azrin and Dr. Nunn both suggest wearing rings and jewelry and putting your hands on top of a desk or table rather than hiding them underneath. After you've given up nail biting, you should begin to feel comfortable extending the fingers rather than cupping them. If you draw attention to your fingers and receive compliments, that's a wonderful incentive to keep up the good work.

DRY SKIN & WINTER ITCH

As winter approaches, our bodies turn toward flannel, our attention turns toward cheap Florida airfares, and our skin takes a turn toward something resembling Melba toast.

You can blame that toasted skin on the warm, toasty air that heats our homes, schools and offices. When it gets cold, we naturally warm up the house. The problem is, unless you add humidity to your surroundings with a humidifier or pans of water near radiators, a heated room has only about 15 percent relative humidity-as dry as Death Valley. And that turns our skin dry, flaky, scaly and usually itchy (and always bothersome).

Plus, there are other irritants to make matters worse--wind, cold, soaps, water (which dries skin when it evaporates), even added stress. Put it all together and your epidermis can dry out quicker than Aunt Gizelda's holiday fruitcake.

Dry skin and winter itch share a lot of symptoms with eczema and dermatitis, and some of the remedies for those problems can bring relief. But the key to making the winter season a merry one, itch-wise, is keeping your birthday suit well protected.

Here's how.

Keep skin moisturized. Probably the most important thing you can do to prevent and treat dry skin is to moisturize daily with a cream-based moisturizer, advises Sheryl Clark, M.D., a dermatologist at The New York Hospital-Cornell Medical Center in New York City. "An oil-free moisturizer is recommended for those who tend to break out. Also, those with sensitive skin should choose a moisturizer without perfumes or lanolin." The brands most highly recommended by experts include Eucerin, Complex 15, Moisturel, Aquaphor and Aquaderm-all available over the counter.

But don't get soaked. You don't need expensive skin creams to keep skin moisturized. "Nothing beats plain petroleum jelly or mineral oil as a moisturizer, " says Howard Donsky, M.D., associate professor of medicine at the University of Toronto and author of Beauty Is Skin Deep. In fact, he acids that virtually any vegetable oil or hydrogenated cooking oil--from Crisco oil to sunflower or peanut oil--can be used to relieve dry skin. But note: They do feet greasier than commercial moisturizers.

Don't be too hyper about your hygiene. "Bathe in cool to tepid water as briefly as possible and no more than once a day," according to Michael Ramsey, M.D., clinical instructor of dermatology at Baylor College of Medicine in Houston. "Cleansing lotions are more gentle than soaps, and they're just as effective at removing dirt," adds Leonard Swinyer, M.D., clinical professor of medicine at the University of Utah in Salt Lake City. And don't use a washcloth--just your fingertips. If you must use soaps, stick with mild brands such as Dove, Aveeno or Basis.

Add some oil to your bath. Make the most of your tub time by adding a bath oil rich in moisturizers- -even when you apply creams after bathing.

Again, there's no need for the fancy stuff: Plain ol' castor oil is an excellent, low-cost choice. "It's one of the few oils that will disperse in water, and it won't leave a ring around the tub," says Varro E. Tyler, Ph.D., professor of pharmacognosy at Purdue University in West Lafayette, Indiana, and author of The Honest Herbal.

Make your own bath oil by mixing 1/2 cup of castor oil with ten drops of sandlewood-, pine-, rosemary- or mint-scented oil and storing it in a closed jar. Add one teaspoon of the mixture each time you bathe. For those who prefer store-bought brands, Alpha Keri body oil, Geri-Bath and Nutraderm bath oil are highly recommended.

Caution: Be careful in the bathroom, because these oils can make tubs and floors extremely slippery.

Dry yourself damp. After bathing, pat your skin almost dry-never totally dry with a towel. While the skin is still damp, apply your moisturizing lotion. "It's more effective to apply moisturizer to damp skin immediately after bathing than to put it on totally dry skin, because the moisturizer is what holds the water in," says Kenneth H. Neldner, M.D., professor and chairman of the Department of Dermatology at Texas Tech University Health Sciences Center in Lubbock. "A couple of pats with a towel will make you as dry as you want to be before you apply the lotion. You're trying to trap a little water in the skin, and that's the fundamental rule in fighting off dryness." If you have dry hands, he advises keeping some moisturizer near each sink in the house and using it as needed.

Be wary of wool. Clothing made of wool--or any other fuzzy or heavy material--can be particularly irritating to excessively dry skin, says Stephen M. Purcell, D.O., chairman of the Department of Dermatology at Philadelphia College of Osteopathic Medicine and assistant clinical professor at Hahnemann University School of Medicine in Philadelphia. "The last thing itchy skin needs is to have something scratchy over it. Cotton is probably the best material to wear, since polyester blends can also be irritating to some people."

Shave before bedtime. Shaving is tough enough on your tender skin, but meeting the cold reality of Old Man Winter right afterward makes your dry skin even worse, adds Dr. Swinyer. Unless you're hampered by severe five o'clock shadow, shave before bedtime, when your puss won't be subjected to such a drastic change in temperature.

And avoid eye-opening after-shaves. Their high alcohol content is too drying and zaps remaining moisture during this mean season, adds Dr. Swinyer.

Wear baggy, loose-fitting clothing. In addition to being more abrasive, tighter clothing traps perspiration, which softens the outer layer of skin, breaks down its protective barrier and worsens dry skin, says dermatologist Rodney Basler, M.D., assistant professor of internal medicine at the University of Nebraska Medical Center in Omaha. But looser-fitting clothes, particularly in "breathable" fabrics like cotton, allow perspiration to be absorbed naturally.

Sorry still "Iam in love"

I'm sorry That I'm writing you but I just can't forget.
All the memories of me with you,
Are running through my head
I'm sorry that I cried today
Though you didn't see my tears,
I just can't forget the fact
That today would be one year.

You said you didn't love me
But I know its not the truth
So here it is,
I'm saying it,
I still love you too.

I can hear it when you talk to me
When you say my name.
How the words almost slip out,
But you hold them back in shame

All day I've been thinking of you,
And what we could have been
Happily ever after,
Is what we both said.

I sit here,
And concentrate
On leaving you behind
But I know that no matter what happens
No words could make you mine

Dear Valentine,
I'm sorry that I told the truth,
Sorry you're the one,
Sorry that it hurts so much,
Sorry I'm still in love.

NARCOLEPSY ::: Daytime Sleeping

Definition

Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.

People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine.

Some people mistakenly attribute symptoms of narcolepsy to depression, seizure disorders, fainting, simple lack of sleep, or other conditions that may cause abnormal sleep patterns.

Narcolepsy is a chronic condition that doesn't go away completely. Although there's no cure for narcolepsy, medications and lifestyle changes can help you manage the symptoms. And talking to others — family, friends, employer, teachers — can help you cope better with narcolepsy.

Symptoms

The signs and symptoms of narcolepsy include:

• Excessive daytime sleepiness. The primary characteristic of narcolepsy is overwhelming drowsiness and an uncontrollable need to sleep during the day. People with narcolepsy fall asleep without warning, anywhere and at any time. For example, you may suddenly nod off while at work or talking with friends. You may sleep for just a few minutes or up to a half-hour before awakening and feeling refreshed, but then you fall asleep again.
  In addition to sleeping at inappropriate times and places, you may also experience decreased alertness throughout the day. Excessive daytime sleepiness usually is the first symptom to appear and is often the most troublesome, making it difficult for you to concentrate and function fully.
• Sudden loss of muscle tone. This condition, called cataplexy, can cause a range of physical changes, from slurred speech to complete weakness of most muscles, and may last for a few seconds to a few minutes. Cataplexy is uncontrollable and is often triggered by intense emotions, usually positive ones such as laughter or excitement, but sometimes fear, surprise or anger. For example, your head may droop uncontrollably or your knees may suddenly buckle when you laugh.
  Some people with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes each day. About 70 percent of people with narcolepsy experience cataplexy.
• Sleep paralysis. People with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief — lasting one or two minutes — but they can be frightening. You may be aware of the condition and have no difficulty recalling it afterward, even if you had no control over what was happening to you.
  This sleep paralysis mimics the type of temporary paralysis that normally occurs during rapid eye movement (REM) sleep, the period of sleep during which most dreaming occurs. This temporary immobility during REM sleep may prevent your body from acting out dream activity. Not everyone with sleep paralysis has narcolepsy, however. Many people experience a few attacks of sleep paralysis, especially in young adulthood.
• Hallucinations. These hallucinations, called hypnagogic hallucinations, may take place when a person with narcolepsy falls quickly into REM sleep, as he or she does at sleep onset at night and periodically during the day, or upon waking. Because you may be semiawake when you begin dreaming, you experience your dreams as reality, and they may be particularly vivid and frightening.

Other characteristics
Other signs and symptoms of narcolepsy include restless nighttime sleep and occasional automatic behavior. During episodes of automatic behavior, you continue to function during sleep episodes — even talking and putting things away, for example — but you awaken with no memory of performing such activities, and you generally don't perform these tasks well. As many as 40 percent of people with narcolepsy experience automatic behavior. People with narcolepsy may also act out their dreams at night by flailing their arms or kicking and screaming.

The signs and symptoms of narcolepsy can begin anytime up to your 50s, but they most commonly begin between the ages of 10 and 25. Narcolepsy is chronic, which means signs and symptoms may vary in severity, but they never go away entirely.

Causes

The exact cause of narcolepsy isn't known. It's believed that genetics may play a role. But the larger influence may be a trigger, such as an infection, that leads to damage to certain brain cells important to sleep.

Normal sleep pattern vs. narcolepsy
The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep. During this phase, your brain waves slow down considerably. After an hour or two of NREM sleep, your brain activity picks up again, and REM sleep begins. Most dreaming occurs during REM sleep.

In narcolepsy, however, you suddenly fall into REM sleep without first experiencing NREM sleep and at abnormal times, such as during the day. Also, some of the aspects of sleep that normally occur only during REM sleep, such as sudden lack of muscle tone, sleep paralysis and vivid dreams, occur at other times during sleep in people with narcolepsy.

The role of brain chemicals
Hypocretin is an important chemical in your brain that helps regulate staying awake and keeps REM sleep stable and occurring at the appropriate time during sleep. The cells that make hypocretin are severely damaged in narcolepsy. Because the cells are damaged, hypocretin is found in low levels in people with narcolepsy — lowest of all in those who experience cataplexy.

Exactly what causes the damage to hypocretin cells is not known. But it's thought that there's probably some factor such as an infection and an abnormal immune response that leads to the damage. Certain genetic markers are also more common in people who develop narcolepsy. If another family member has narcolepsy, it is slightly more likely you could develop it.

Research continues to focus on whether an abnormal gene may be responsible for narcolepsy or if the body's immune system may be involved in mistakenly attacking hypocretin-producin g cells in the brain.

The low levels of hypocretin may even lead to the development of a diagnostic test for narcolepsy. Hypocretin is normally present in spinal fluid of people without the disorder, but is present in only very low levels in the spinal fluid of people with narcolepsy.

Risk factors

Narcolepsy may be more common in men than women and occurs in all racial and ethnic groups. However, rates do seem to vary by country.

In the United States, about one in 2,000 people is affected by narcolepsy, while in Israel only one in 500,000 people has the disorder. Japan has the highest rate, affecting about one in 600 people.

The condition may run in families. A small percentage of people with narcolepsy have a close relative with the disease.

When to seek medical advice

See your doctor if you experience excessive daytime sleepiness that seriously disrupts your personal or professional life.

Tests and diagnosis

Your doctor may make a preliminary diagnosis of narcolepsy based on your experience of both excessive daytime sleepiness and sudden loss of muscle tone (cataplexy). After an initial diagnosis, your doctor may refer you to a sleep specialist for more evaluation.

Formal diagnosis may require staying overnight at a sleep center where you undergo an in-depth analysis of your sleep by a team of specialists. Methods of diagnosing narcolepsy and determining its severity include:

• Sleep history. Your doctor will want to obtain from you a detailed history so that the onset of your illness, and any other factors that could help explain your symptoms, are fully considered. A part of the history involves filling out the Epworth Sleepiness Scale, which uses a series of short questions to gauge your degree of sleepiness. You'll rank on a numbered scale how likely it is that you would doze off in certain situations, such as sitting down after lunch.
• Actigraphy. You may be asked to keep a detailed diary of your sleep pattern for a week or two, so that your doctor can compare how your sleep pattern and alertness are related. Often, in addition to this "sleep log," the doctor will ask you to wear an actigraph. This device has the look and feel of a wrist watch and measures how and when you sleep.
• Polysomnogram. This test measures a variety of signals during sleep using electrodes placed on your scalp before you fall asleep. For this test, you must stay overnight for observation at a medical facility. The test measures the electrical activity of your brain (electroencephalogr am) and heart (electrocardiogram) , the movement of your muscles (electromyogram) and eyes (electro-oculogram) , and monitors your breathing.
• Multiple sleep latency test. This examination measures how long it takes for you to fall asleep during the day. You'll be asked to fall asleep for a series of four or five naps, each nap two hours apart. Specialists will observe your sleep patterns. People who have narcolepsy fall asleep easily and enter into rapid eye movement (REM) sleep quickly.

These tests can also help doctors rule out other possible causes of your signs and symptoms. Other sleep disorders, such as sleep apnea, can cause excessive daytime sleepiness.

Complications

Public misunderstanding of the condition
Narcolepsy may cause you to experience serious problems in both your professional and personal life. Others may perceive your condition as lazy, lethargic or rude. Your performance may suffer at school or work.

Interference with intimate relationships
Narcolepsy can affect intimate relationships. Extreme sleepiness may cause low sex drive or impotence, and people with narcolepsy may even fall asleep while making love. The problems caused by sexual dysfunction may be further complicated by emotional difficulties. Intense feelings, such as anger or joy, can trigger some signs of narcolepsy, causing affected people to withdraw from emotional interactions.

Physical harm
Sleep attacks may result in physical harm to people with narcolepsy. You're at increased risk of a car accident if you have an attack while driving. Your risk of cuts and burns is higher if you fall asleep while preparing food.

Treatments and drugs

There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms. Medications include:

• Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Modafinil (Provigil), a newer stimulant, isn't as addictive and doesn't produce the highs and lows often associated with older stimulants. Some people need treatment with methylphenidate (Ritalin) or various amphetamines. Although these medications are effective, they may cause side effects, such as nervousness and heart palpitations, and can be addictive.
• Antidepressants. Doctors often prescribe antidepressant medications, which suppress REM sleep, to help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis. These medications include tricyclic antidepressants such as protriptyline (Vivactil) and imipramine (Tofranil) and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem) and sertraline (Zoloft).
• Sodium oxybate (Xyrem). This medication controls cataplexy in people with narcolepsy. Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy. In high doses it may also help control daytime sleepiness, even though you take it only at night. However, because the use of this drug has been associated with serious side effects, such as trouble breathing during sleep, sleepwalking and bed-wetting, it's strictly regulated by the Food and Drug Administration.

If you have other health problems, such as high blood pressure or diabetes, ask your doctor how medications for existing conditions may interact with those taken for narcolepsy.

Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness as a side effect. If you have narcolepsy, your doctor will likely recommend that you avoid taking these medications.

Medications to treat narcolepsy can help reduce your signs and symptoms, but they can't alleviate them entirely. Lifestyle changes also are an integral part of treating narcolepsy.

Lifestyle and home remedies

Lifestyle modifications are important in managing the symptoms of narcolepsy. You may benefit from these steps:

• Stick to a schedule. Go to sleep and wake up at the same time every day, including weekends.
• Take naps. Schedule short naps at regular intervals during the day. Short naps of 20 minutes at strategic times during the day may be refreshing and reduce sleepiness for one to three hours.
• Avoid nicotine and alcohol. Using these substances, especially at night, can worsen your signs and symptoms.
• Get regular exercise. Moderate, regular exercise at least four to five hours before bedtime may help you feel more awake during the day and sleep better at night.

Coping and support

Dealing with narcolepsy can be challenging. Making adjustments in your daily schedule may help. Consider these tips:

• Talk about it. Tell your employer or teachers about your condition and work together to find ways to accommodate your needs. This may include taking naps during the day, breaking up monotonous tasks, recording meetings or classes, standing during meetings or lectures, and taking brisk walks at various times throughout the day. The Americans With Disabilities Act prohibits discrimination against workers with narcolepsy and requires employers to provide reasonable accommodation to qualified employees.
• Be safe. If you must drive a long distance, work with your doctor to establish a medication schedule that ensures the greatest likelihood of wakefulness during your drive. Stop for naps and exercise breaks whenever you feel drowsy. Don't drive if you feel your sleepiness is not well controlled.

Support groups and counseling can help you and your loved ones cope with narcolepsy. Ask your doctor to help you locate a group or qualified counselor in your area.