What is narcolepsy?

Narcolepsy is a sleep disorder. It is a lifelong disease of the central nervous system.

Narcolepsy causes excessive and overwhelming daytime sleepiness, even after getting plenty of nighttime sleep. If you have narcolepsy, you are likely to become drowsy or to fall asleep at inappropriate times and places. These sleep attacks may occur with or without warning.

You may have repeated attacks in a single day. The drowsiness may last a long time. Nighttime sleep may be split up, and you may wake up often.

What causes narcolepsy?

The cause of narcolepsy is not known. It involves the body's central nervous system, which includes the brain and spinal cord. Narcolepsy is a genetic disorder. It is caused by a deficiency in the production of a brain chemical that helps neurons talk to each other.

What are the symptoms of narcolepsy?

The following are the most common symptoms of narcolepsy. However, people may experience symptoms differently. Symptoms may include:

  • Excessive daytime sleepiness (EDS). An overwhelming desire to sleep at inappropriate times.
  • Cataplexy. A sudden loss of muscle control ranging from slight weakness to total collapse.
  • Sleep paralysis. Being unable to talk or move for about one minute when falling asleep or waking up.
  • Hypnagogic hallucinations. Vivid and often scary dreams and sounds reported when falling asleep.

Other symptoms include:

  • Automatic behavior. Performing routine tasks without conscious awareness of doing so, and often without memory of it.
  • Disrupted nighttime sleep and waking up often

You may have other difficulties as you cope with this condition including:

  • Feelings of intense fatigue and continual lack of energy
  • Depression
  • Difficulty in concentrating and memorizing
  • Vision (focusing) problems
  • Eating binges
  • Weak limbs
  • Difficulties in handling alcohol

How is narcolepsy diagnosed?

In addition to a complete medical history and physical exam, lab tests to confirm diagnosis and plan treatment may include:

  • Overnight polysomnogram (PSG). A sleep specialist will monitor you during an entire night of sleep. 
  • Multiple sleep latency test (MSLT). This test measures when you fall asleep and how quickly rapid eye movement (REM) sleep occurs.
  • Genetic blood test. To test for a genetic mutation often found in people who tend to have narcolepsy.

How is narcolepsy treated?

Specific treatment will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Severity of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

The goal of treatment of narcolepsy is to help you remain as alert as possible during the day. It’s also important to reduce times when you lose muscle control. Ideally, this can be done using a minimal amount of medication.

  • Medications. Central nervous system stimulants are usually prescribed for excessive sleepiness. Antidepressants may help with muscle control.
  • Nap therapy. Two or three short naps during the day may help control sleepiness and maintain alertness.
  • Proper diet
  • Regular exercise
  • Behavioral therapy

Key points about narcolepsy

Narcolepsy is a chronic, neurological sleep disorder with no known cause. The main characteristic of narcolepsy is excessive and overwhelming daytime sleepiness, even after adequate nighttime sleep.

  • In addition to a complete medical history and physical exam, there are several lab tests to confirm the diagnosis.
  • The goal of treatment of narcolepsy is to help you remain as alert as possible during the day.
  • Treatment of narcolepsy may include:
    • Medications
    • Nap therapy
    • Proper diet
    • Regular exercise
    • Behavioral therapy

Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.