What Is Narcolepsy?
Narcolepsy is a chronic, neurological sleep disorder that involves the body's central nervous system. People with narcolepsy have extreme sleepiness and can fall asleep uncontrollably during the day. Because people with narcolepsy can't control when they fall asleep, having narcolepsy have interfere with driving, working, and other day-to-day activities.
Doctors don't know what causes narcolepsy. It's a genetic disorder where a part of the brain called the hypothalamus doesn't produce enough of the neuropeptide orexin.
Symptoms of Sleep Attacks
The main symptom of narcolepsy is overwhelming daytime sleepiness, even if you are getting enough sleep at night. A person with narcolepsy is likely to become drowsy or fall asleep at inappropriate times and places. These sleep attacks may occur with or without warning. Sleep attacks can also happen multiple times in a single day.
If you have narcolepsy, you may be drowsy for long periods of time and wake up frequently when you're sleeping at night.
Common Narcolepsy Symptoms
Each person may experience narcolepsy differently. But these are the most common symptoms:
- excessive daytime sleepiness (EDS) is when you have an overwhelming desire to sleep at inappropriate times;
- cataplexy is a sudden loss of muscle control ranging from slight weakness to total collapse;
- sleep paralysis is when you are unable to talk or move for about one minute when falling asleep or waking up;
- hypnagogic hallucinations are vivid and often scary dreams and sounds when you're falling asleep.
Secondary or other symptoms include the following:
- automatic behavior—this is when a person performs routine tasks without being aware that they are doing them. People also often won't remember that they did these tasks; and
- disrupted nighttime sleep, which can include multiple episodes of waking up.
Problems Caused by Narcolepsy
If you have narcolepsy, you may have difficulty coping with day-to-day activities and emotions. You may experience these symptoms:
- feelings of intense fatigue and continual lack of energy,
- difficulty concentrating and memorizing,
- vision problems (focusing),
- eating binges,
- weak limbs, or
- difficulties handling alcohol.
How is Narcolepsy Diagnosed?
Doctors usually diagnose narcolepsy after a patient shows symptoms of EDS or cataplexy. Cataplexy is when a person loses muscle strength after experiencing an intension emotion, like laughing or crying.
In addition to these symptoms, a doctor will ask for your complete medical history and will give you a physical examination and lab tests to confirm your diagnosis.
Your doctor or sleep specialist may use these tests to diagnose narcolepsy:
- overnight polysomnogram (PSG)—this is a sleep test that monitors how you sleep throughout a whole night;
- multiple sleep latency test (MSLT)—this test measures sleep onset and how quickly rapid eye movement (REM) during sleep occurs; or
- genetic blood test—doctors use these tests to test for a genetic mutation often found in people who have a predisposition to narcolepsy.
Treatments for narcolepsy can include the following methods:
- medications: excessive daytime sleepiness and cataplexy are treated separately. Doctors usually prescribe central nervous system stimulants for EDS and antidepressants for cataplexy;
- nap therapy: two or three short naps during the day may help control sleepiness and maintain alertness;
- healthy diet;
- regular exercise; and/or
- behavioral therapy to help you cope with stress or anxiety.
The goal of narcolepsy treatment is for the patient to remain as alert as possible during the day while taking the least amount of medication possible. Another goal of treatment is to prevent recurring episodes of cataplexy.
You and your specialist will determine the best possible method or combination of methods to treat your disorder.