Narcolepsy

Basic Facts

  • Narcolepsy is a chronic sleep disorder characterized by an excessive amount of fatigue during the daytime and, in severe cases, sudden attacks of sleep.
  • Patients can suffer for years before the correct diagnosis is made. 
  • There is no cure for narcolepsy, but medications and lifestyle changes can help manage symptoms.
  • Narcolepsy also is characterized by abnormal rapid eye movement (REM) sleep. The brain cycles through five phases during sleep. REM typically occurs about 90 minutes after sleep begins but, in patients with narcolepsy, REM sleep occurs almost immediately in the sleep cycle, and intermittently during the waking hours. REM sleep is associated with dreams.  

 

Narcolepsy symptoms usually start between adolescence and 25:

  • Difficulty staying awake for long periods of time
  • Falling asleep without warning
  • Sleeping for a short period of time, awakening refreshed, then falling asleep again.
  • Halluncinations – At the onset of sleep, some patients have vivid hallucinations. For example, they might have visions that someone or something is present in the bedroom.
  • Sleep paralysis – Patients may lose the ability to move and feel paralyzed for a short period of time (seconds or minutes) when falling asleep or waking up.
  • Disturbed nighttime sleep – Many patients have trouble sleeping through the night.

Narcolepsy can be mistaken for other sleep disorders that cause daytime sleepiness such as sleep apnea or restless leg syndrome.

 

 

 

 

 

The cause of narcolepsy, which affects approximately one in 2,000 people, is unknown. However, most people with narcolepsy have low levels of the chemical hypocretin, which is a neurochemical in the brain that controls wakefulness.

Researchers believe the loss of hypocretin-producing cells in the brain could be the result of an autoimmune disease, a disorder in which the body’s immune system mistakenly attacks healthy cells as if they were foreign invaders.

Researchers also have identified a gene that is linked to narcolepsy.

 

Formal diagnosis requires staying overnight at a sleep center for an in-depth sleep analysis by sleep specialists. Methods of diagnosing narcolepsy and determining its severity include:

  •  Sleep history. Your sleep specialist will ask you for a detailed sleep history.

  • Sleep records. You may be asked to keep a detailed diary of your sleep pattern for a week or two, so your doctor can compare how your sleep pattern and alertness are related.

  • Wear an actigraph. This device has the look and feel of a wristwatch. It measures periods of activity and rest and provides an indirect measure of how and when you sleep.

  • Polysomnogram (sleep study)- Stay in a sleep center overnight to monitor brain activity, eye movements, leg movements, heart rate, breathing functions, and oxygen levels during sleep. 
  • Multiple sleep latency test- A daytime study that measures your sleepiness and the types and stages of sleep you go through during daytime naps.  

A chronic condition, Narcolepsy is treatable but not curable. Lifestyle changes and medications can help manage symptoms.

  • Keeping a consistent sleep schedule,
  • Scheduling short naps throughout the day,
  • Exercising regularly,
  • Avoiding the use of tobacco or alcohol, 
  • Medications are typically stimulant agents,
  • Cataplexy can be lessened by antidepressant drugs, with work by suppressing REM sleep.