Narcolepsy

Overview

Narcolepsy is a type of sleep disorder that causes you to feel exhausted during the day, sometimes to the point that you spontaneously fall asleep. People with this condition usually awake feeling rested but typically have felt tired throughout the day and have trouble staying awake.

Narcolepsy affects males and females equally. Symptoms of narcolepsy can start as early as childhood, adolescence, or young adulthood, but can occur at any time in life.
Almost all people with narcolepsy who have cataplexy (sudden muscle weakness while awake that makes a person go limp or unable to move) have extremely low levels of the naturally occurring chemical hypocretin. Hypocretin helps regulate wakefulness and rapid eye movement (REM) sleep.

There are two types of narcolepsy; Type 1 and Type 2:

Type 1: Also called narcolepsy with cataplexy, is diagnosed when the individual has either low levels of hypocretin or has cataplexy and has excessive daytime sleepiness. 

Type 2: Also called narcolepsy without cataplexy, is diagnosed when a person has excessive daytime sleepiness but does not have muscle weakness caused by emotions.

Narcolepsy causes 

The cause of narcolepsy is not completely understood. However, experts do know that people with this condition have low levels of hypocretin. Research suggests that narcolepsy may also be the result of a combination of factors including autoimmune disorders, family history (genetics) and rarely, traumatic brain injury to parts of the brain that regulate wakefulness and REM sleep.

Narcolepsy risk factors

Factors that increase the risk of developing narcolepsy include:

• Being between the ages of 10 and 30
• Having a family history of narcolepsy

Narcolepsy symptoms

Signs and symptoms of narcolepsy can include:

• Excessive daytime sleepiness, or EDS
• Cataplexy (sudden loss of muscle tone)
• Changes in rapid eye movement sleep, such as dreaming soon as falling asleep
• Hallucinations
• Sleep paralysis (feeling that you can’t move during or right after sleep)

Narcolepsy diagnosis

Your specialist will use one or more of the following diagnostic tools to diagnose narcolepsy:

• Physical exam. Your specialist will complete a physical exam and ask you about your symptoms related to narcolepsy, including excessive daytime sleepiness and cataplexy. You may also need to fill out a detailed sleep history.
• Sleep log. Your specialist may ask you to keep a detailed sleep log that includes information on when you go to bed and get up, how many times you wake up during the night and other information.
• Sleep study. You may need to undergo one or more types of sleep studies in a sleep lab so that your provider can closely analyze your sleep-wake patterns and brain activity. Some common types of sleep studies include polysomnography and multiple sleep latency test.

Narcolepsy treatment

Treatment for narcolepsy typically involves one or more medications. These medications include short-acting medications to help you sleep better, as well as medications that stimulate your brain during the day and help you stay more alert. Your specialist may prescribe medications – such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) – to help with symptoms related to narcolepsy.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a sleep medicine provider for more specialized treatment.