Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.
Narcolepsy can cause serious disruptions in your daily routine.
Cataplexy is often triggered by a strong emotion, most commonly laughter.
Narcolepsy is a chronic condition for which there’s no cure.
However, medications and lifestyle changes can help you manage the symptoms.
Support from othersfamily, friends, employer, teacherscan help you cope with narcolepsy.
The symptoms of narcolepsy most commonly begin between the ages of 10 and 25.
They may worsen for the first few years, and then continue for life.
They include:
Excessive daytime sleepiness.People with narcolepsy fall asleep without warning, anywhere, anytime.
For example, you may suddenly nod off while working or talking with friends.
You also may experience decreased alertness throughout the day.
For example, your head may droop uncontrollably or your knees may suddenly buckle when you laugh.
Not everyone with narcolepsy experiences 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 brieflasting a few seconds or minutesbut can be frightening.
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 without narcolepsy experience some episodes of sleep paralysis, especially in young adulthood.
People with narcolepsy may also act out their dreams at night by flailing their arms or kicking and screaming.
Some episodes of sleep attacks are brief, lasting seconds.
Some people with narcolepsy experience automatic behavior during these brief episodes.
When you awaken, you might’t remember what you did, and you probably didn’t do it well.
See your doctor if you experience excessive daytime sleepiness that disrupts your personal or professional life.
The exact cause of narcolepsy is unknown.
There may be many causes.
Most people with narcolepsy have low levels of the chemical hypocretin (hi-poe-KREE-tin).
Hypocretin is an important neurochemical in your brain that helps regulate wakefulness and REM sleep.
Hypocretin levels are particularly low in those who experience cataplexy.
In some cases, genetics may play a role.
The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep.
During this phase, your brain waves slow considerably.
After an hour or so of NREM sleep, your brain activity changes, and REM sleep begins.
Most dreaming occurs during REM sleep.
Narcolepsy may cause serious problems for you professionally and personally.
Others might see you as lazy or lethargic.
Your performance may suffer at school or work.
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 greater if you fall asleep while preparing food.
People with narcolepsy are more likely to be overweight.
You’re likely to start by seeing your family doctor or a general practitioner.
Here’s some information to help you prepare for your appointment.
Preparing a list of questions for your doctor will help you make the most of your time together.
List your questions from most important to least important.
After an initial diagnosis, your doctor may refer you to a sleep specialist for further evaluation.
Often, in addition to this sleep log, the doctor will ask you to wear an actigraph.
This gear 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.
Polysomnography.This test measures a variety of signals during sleep using electrodes placed on your scalp.
For this test, you must spend a night at a medical facility.
It also monitors your breathing.
Multiple sleep latency test.This examination measures how long it takes you to fall asleep during the day.
You’ll be asked to take 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.
There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms.
Side effects of modafinil are uncommon, but they may include headache, nausea, or dry mouth.
Some people need treatment with methylphenidate (Aptensio XR, Concerta, Ritalin) or various amphetamines.
They include fluoxetine (Prozac, Sarafem, Selfemra) and venlafaxine (Effexor XR).
Side effects can include weight gain, sexual dysfunction, and digestive problems.
Sodium oxybate (Xyrem).This medication is highly effective for cataplexy.
Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy.
In high doses it may also help control daytime sleepiness.
It must be taken in two doses, one at bedtime and one up to four hours later.
Xyrem can have side effects, such as nausea, bed-wetting, and worsening of sleepwalking.
Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness.
If you have narcolepsy, your doctor will likely recommend that you avoid taking these medications.
Lifestyle modifications are important in managing the symptoms of narcolepsy.
You may benefit from these steps:
Dealing with narcolepsy can be challenging.
Making adjustments in your daily schedule may help.
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.
Updated: 2015-09-01
Publication Date: 1999-03-08
